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(1) Children are raised according to the standard of 1 yuan per person per year. Individuals pay 3 yuan and give financial assistance to 7 yuan.

Among them, for children who enjoy the minimum living allowance for urban residents (hereinafter referred to as the minimum living allowance), individuals will pay 1 yuan and give financial assistance to 9 yuan; Children with severe disabilities (holding the Certificate of Disabled Persons of the People's Republic of China * * * and above) will pay 1 yuan for themselves and give financial assistance to 9 yuan (including the employment security fund for the disabled to 5 yuan).

(2) Non-employed urban residents are raised according to the standard of 25 yuan per person per year. Individuals pay 18 yuan and give financial assistance to 7 yuan.

Among them, for the urban non-employed residents with minimum living allowance and the elderly over 6 years old from low-income families, individuals pay 2 yuan and give financial assistance to 23 yuan; Non-employed urban residents with severe disabilities, individuals pay 2 yuan, and financial subsidies are given to 23 yuan (including employment security fund for the disabled subsidizes 15 yuan).

treatment of basic medical insurance

article 15 the basic medical insurance for urban residents mainly guarantees hospitalization and outpatient medical treatment for serious diseases.

article 16 the scope of medication, items of diagnosis and treatment, scope of service facilities and catalogue of diseases in hospital of the basic medical insurance for urban residents shall be temporarily implemented according to the relevant provisions of the basic medical insurance for urban employees, and may be revised in a timely manner according to the actual situation. Appropriately increase the proportion of payment from the overall fund for the treatment of insured residents with traditional Chinese medicine, and appropriately increase the drugs, diagnosis and treatment projects and service facilities suitable for children and adolescents. The specific measures shall be formulated separately by the municipal labor and social security administrative department in accordance with the relevant provisions of the state and province.

Article 17 The basic medical insurance for urban residents shall be managed by designated medical institutions (including designated community health service institutions). If the insured urban residents meet the requirements and need hospitalization, they can choose the designated medical institutions for urban workers' basic medical insurance in Xi 'an for medical treatment. Emergency and rescue patients are not subject to this restriction, but they should go through the examination and approval procedures at the district medical insurance agency within 3 working days.

article 18 the medical expenses incurred by insured urban residents in designated medical institutions for hospitalization (including family beds) that meet the requirements of medical insurance settlement and payment shall be paid according to the hospital level and the maximum payment limit.

(1) Qifubiaozhun is divided into 25 yuan, a community health service institution, according to different types of designated medical institutions; 35 yuan, a first-class hospital; 5 yuan, a secondary hospital; 7 yuan, a tertiary hospital.

(2) Annual cumulative maximum payment limit (total expenses of hospitalization and outpatient serious illness): 35, yuan for urban non-employed residents and 4, yuan for children (if the insured urban residents have paid for 1 years continuously, the maximum payment limit can be appropriately increased from next year).

(3) The hospitalization medical expenses that meet the requirements from Qifubiaozhun above to below the maximum payment limit shall be paid in the following proportions in designated medical institutions at different levels:

1. Community health service institutions for urban non-employed residents

7% shall be paid by the overall fund and 3% shall be borne by individuals;

in a first-class hospital, 6% is paid by the overall fund and 4% is borne by the individual;

for secondary hospitals, 5% is paid by the overall fund and 5% is borne by individuals;

for tertiary hospitals, 4% is paid by the overall fund and 6% is borne by individuals.

2. The proportion of children's fund payment shall be increased by 5% according to the corresponding standard of urban non-employed residents.

(4) Serious outpatient diseases include: special outpatient diseases (outpatient radiotherapy and chemotherapy for malignant tumors, outpatient renal dialysis, taking anti-rejection drugs after organ transplantation) and chronic diseases (hypertension, coronary heart disease and diabetes).

the management measures for outpatient treatment of special diseases and chronic diseases shall be implemented with reference to the relevant provisions of the basic medical insurance for urban workers. Outpatient treatment of special diseases: 5% from the overall fund and 5% from the individual; Outpatient treatment of chronic diseases: In one year, if the medical expenses for outpatient treatment of chronic diseases in designated medical institutions exceed 35 yuan, the excess will be paid by the overall fund according to the standard of 5%, and the maximum payment limit of the overall fund is 2, yuan.

(5) The medical expenses above the maximum payment limit and beyond the payment scope of the basic medical insurance for urban residents are no longer borne by the overall fund, and can be solved by establishing large medical subsidies, commercial health insurance or medical assistance.

(6) The balance rate of the basic medical insurance fund for urban residents shall not exceed 15%, and the risk reserve shall not be less than 15%.

Article 19 The basic medical insurance fund for urban residents shall not pay the following expenses:

(1) Medical expenses incurred in non-designated medical institutions without approval;

(2) committing suicide or self-mutilation (except mental illness);

(3) Fighting, fighting, drinking, taking drugs and other injuries caused by crimes or violation of the Law on Public Security Administration Punishment;

(4) traffic accidents, accidental injuries and medical accidents;

(5) being treated for cosmetic, orthopedic or physiological defects;

(6) it is covered by work-related injury insurance (including occupational diseases) or maternity insurance;

(7) Other cases of non-payment stipulated by the national and provincial medical insurance policies.