好消息!大病保險報銷比例提高至60%
丨來自:地區醫保卡局微(wei)信營銷
一是繼續提高城鄉居民醫保和大病保險籌資標準。《通知》明確2019年居民醫保人均財政補助標準新增30元,達到每人每年不低于520元,新增財政補助一半用于提高大病保險保障能力,即大病保險在2018年人均籌資標準上增加15元。同(tong)(tong)時(shi),要(yao)求個人(ren)繳(jiao)費同(tong)(tong)步相應提(ti)高(gao)。
二是穩步提升待遇保障水平。《通知》要求新增籌資主要用于兩方面:一方面,要確保基本醫保待遇保障到位。鞏固提高政策范圍內住院費用報銷比例,建立健全居民醫保門診費用統籌及支付機制,把高血壓、糖尿病等門診用藥納入醫保報銷。另一方面,要提高大病保險保障功能。降低并統一起付線,原則上按上一年度居民人均可支配收入的50%確定;政策范圍內報銷比例由50%提高至60%;對貧困人口加大支付傾斜力度,在起付線降低50%、支付比例提高5個百分點的基礎上全面取消封頂線。
三是全面(mian)建立(li)統一(yi)的城(cheng)鄉居民(min)(min)醫(yi)(yi)保(bao)制(zhi)度(du)(du)。《通知(zhi)》主要是針(zhen)對城(cheng)鎮居民(min)(min)醫(yi)(yi)保(bao)和(he)新農合(he)(he)尚未整(zheng)合(he)(he)統一(yi)的地區,要求加快兩項制(zhi)度(du)(du)整(zheng)合(he)(he),于2019年底前實現兩項制(zhi)度(du)(du)并軌運行向統一(yi)的居民(min)(min)醫(yi)(yi)保(bao)制(zhi)度(du)(du)過渡,在制(zhi)度(du)(du)政(zheng)策(ce)“六(liu)統一(yi)”基礎上,進一(yi)步統一(yi)經辦服務(wu)和(he)信息系統,提高運行質量和(he)效率。
四是完善規(gui)范大(da)(da)病(bing)保(bao)(bao)(bao)險(xian)政(zheng)策(ce)和管理。《通知(zhi)》重點要(yao)求:各地同步(bu)建(jian)立統(tong)一的(de)城鄉居民(min)大(da)(da)病(bing)保(bao)(bao)(bao)險(xian)制度,統(tong)一規(gui)范大(da)(da)病(bing)保(bao)(bao)(bao)險(xian)籌(chou)資(zi)及待(dai)遇(yu)保(bao)(bao)(bao)障政(zheng)策(ce);并按(an)照(zhao)《政(zheng)府工(gong)作報告》要(yao)求,落實籌(chou)資(zi)待(dai)遇(yu)調(diao)整政(zheng)策(ce),于2019年底前按(an)最新(xin)籌(chou)資(zi)標準完成撥(bo)付,確(que)保(bao)(bao)(bao)政(zheng)策(ce)、資(zi)金、服務(wu)落實到位;優化大(da)(da)病(bing)保(bao)(bao)(bao)險(xian)經(jing)辦管理服務(wu)。
五是切(qie)實(shi)(shi)落(luo)實(shi)(shi)醫(yi)療(liao)保(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)(zhang)精(jing)準(zhun)扶(fu)貧(pin)(pin)硬(ying)任務。2019年(nian)是打贏脫貧(pin)(pin)攻(gong)堅戰的關鍵之年(nian)。《通知(zhi)》要求各地(di)切(qie)實(shi)(shi)負起政(zheng)治擔當,聚焦深度(du)貧(pin)(pin)困(kun)地(di)區(qu)因(yin)病(bing)致(zhi)(zhi)貧(pin)(pin)返貧(pin)(pin)特殊貧(pin)(pin)困(kun)群眾,全(quan)面(mian)落(luo)實(shi)(shi)《醫(yi)療(liao)保(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)(zhang)扶(fu)貧(pin)(pin)三(san)年(nian)行動實(shi)(shi)施方案(2018-2020年(nian))》,著力解決“兩不愁、三(san)保(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)(zhang)”中醫(yi)療(liao)保(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)(zhang)薄弱(ruo)環節,確保(bao)(bao)(bao)(bao)貧(pin)(pin)困(kun)群眾應(ying)保(bao)(bao)(bao)(bao)盡保(bao)(bao)(bao)(bao),加強三(san)重制(zhi)度(du)綜合(he)保(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)(zhang),按(an)照現(xian)有支付范(fan)圍和既定標準(zhun)保(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)(zhang)到位,建立防范(fan)和化解因(yin)病(bing)致(zhi)(zhi)貧(pin)(pin)、因(yin)病(bing)返貧(pin)(pin)的長效機(ji)制(zhi)。
六是全面做(zuo)實地市(shi)級(ji)統(tong)(tong)(tong)(tong)籌。《通知》以(yi)實現基(ji)金統(tong)(tong)(tong)(tong)收(shou)統(tong)(tong)(tong)(tong)支為(wei)重(zhong)點,提(ti)出做(zuo)實城鄉居民醫(yi)保(bao)地市(shi)級(ji)統(tong)(tong)(tong)(tong)籌標準(zhun),即基(ji)金統(tong)(tong)(tong)(tong)收(shou)統(tong)(tong)(tong)(tong)支、政策制度統(tong)(tong)(tong)(tong)一(yi)、醫(yi)療服務(wu)協議管理統(tong)(tong)(tong)(tong)一(yi)、經(jing)辦服務(wu)統(tong)(tong)(tong)(tong)一(yi)、信息系統(tong)(tong)(tong)(tong)統(tong)(tong)(tong)(tong)一(yi),并鼓勵有條(tiao)件地區探(tan)索(suo)省級(ji)統(tong)(tong)(tong)(tong)籌。