Huanggang's Notice on Adjusting Some Policies of Medical Insurance for Urban Workers Directly under the Municipal Government requires:
1. First of all, you have to go to the medical insurance bureau for referral approval;
2. Those who are referred to other hospitals are only allowed to go to specialized hospitals in Wuhan in principle. So you have to find out whether Wuhan Minsheng Otolaryngology Hospital is a specialized hospital of Huanggang Medical Insurance.
Details consultation: Huanggang Medical Insurance Bureau, tel: 07 13-8366397.
Luotian County Medical Insurance Bureau, Tel: 07 13-5065995 Address: Duanjiaqiao, Fengshan Town.
Reference:
Notice on adjusting some policies of medical insurance for urban workers directly under the municipal government
Huanglaoshe [2009] No.7
Relevant units directly under the municipal government and designated medical institutions directly under the municipal government:
In order to further improve the basic medical insurance system for urban workers and improve the medical insurance benefits for insured workers, the relevant policies are now adjusted as follows:
First, reduce the threshold of hospitalization pooling fund in first-and second-class hospitals. The first-class and below hospitals were adjusted from the original 300 yuan to 100 yuan; The secondary hospital was changed from 400 yuan to 300 yuan; The tertiary hospitals remain unchanged, with the first hospitalization in 500 yuan, the second hospitalization in 400 yuan and the third hospitalization in 300 yuan.
Second, reduce the proportion of drugs and medical expenses. For the part above Qifubiaozhun and below the maximum payment limit of local hospitalization medical expenses, the self-payment ratio of Class A drugs and general diagnosis and treatment items in the first-class and below hospitals was adjusted from 8% to 4%; The secondary hospital was adjusted from 10% to 7%; The tertiary hospital was adjusted from 12% to 10%. The self-payment ratio of retirees is 2 percentage points lower than that of other on-the-job personnel. The out-of-pocket proportion of Class B drugs and special diagnosis and treatment items (partial payment for diagnosis and treatment items) was originally stipulated to be higher than that of Class A drugs and general diagnosis and treatment items 10%, and now it is adjusted to be higher than 5%. Referral and transfer should be made to 10% first and then implemented according to local hospitalization regulations.
Three, improve the maximum payment limit of medical insurance for serious illness. The scope and proportion of hospitalization reimbursement for serious illness medical insurance remain unchanged, and the maximum payment limit is raised from 6,543.8+0.5 million yuan to 6,543.8+0.7 million yuan. The annual maximum payment limit of the basic medical insurance pooling fund remains unchanged at 30,000 yuan, and the sum of the annual maximum payment limits of basic medical insurance and serious illness medical insurance is 200,000 yuan.
Four, retirees living in different places enjoy referral and referral reimbursement treatment, no longer implement the medical expenses contract. Before returning to China or taking refuge with their children in different places, they should go through the formalities of signing and filing in the medical insurance bureau. Hospitalization in different places must be in a medical institution at or above the township level run by the local government. Medical expenses are reimbursed according to the referral standard in different places. The diagnosis, treatment and drug purchase of special chronic diseases should still be carried out in the local designated hospitals and pharmacies in Huanggang, and the one-time drug purchase can be appropriately relaxed.
V. Continuous hospitalization care for special diseases. Chemotherapy, radiotherapy and advanced treatment of malignant tumor, dialysis of renal failure, and anti-rejection treatment of renal transplantation, if you are hospitalized many times in a natural year, you will only pay the Qifubiaozhun for the first hospitalization in that year, and the Qifubiaozhun for the second and above hospitalization will be exempted.
Six, strengthen the referral management of non-specialist hospitals. In principle, referral can only be transferred to specialized hospitals in Wuhan. Under special circumstances, if it needs to be transferred to a non-specialist hospital for diagnosis and treatment, it will be reimbursed within the limit of medical expenses for diseases after being approved by the Medical Insurance Bureau and signing an agreement with it. There is no single disease medical expenses limit standard of the disease, the first referral pays the proportion of 20%, and then according to the local hospitalization pays the provisions.
The above provisions shall be implemented from February 1 day, 2009 (subject to the date of admission).
February fifth, February ninth.