In China, serious illness fund payment refers to a special fund set up by governments at all levels and social insurance funds to pay the high medical expenses incurred by eligible patients due to serious illness.
The object of serious illness fund payment is usually patients who meet the following conditions:
1. Suffering from serious diseases stipulated by the government or social insurance funds, such as malignant tumor, organ transplantation, major cardiovascular diseases, etc.;
2. Patients with poor family economic conditions, such as low-income households, five-guarantee households, and poor households with established files;
3, other patients who meet the policy requirements.
To sum up, the funds paid by the serious illness fund usually come from government financial subsidies, social insurance funds and individual contributions. The use and management of funds paid by the serious illness fund should follow the relevant policies and regulations, ensure the rationality, standardization and impartiality of the use of funds, and strengthen the supervision and audit of the use of funds. Serious illness fund payment is a medical assistance measure provided by the government or social insurance fund to meet the requirements of patients in order to solve the high medical expenses caused by the treatment of major diseases.
Legal basis:
Article 23 of the Regulations of People's Republic of China (PRC) Municipality on the Basic Medical Insurance for Urban Employees.
Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.
Article 24
The state establishes and improves the new rural cooperative medical system. Measures for the administration of the new rural cooperative medical system shall be formulated by the State Council.
Article 25
The state establishes and improves the basic medical insurance system for urban residents. The basic medical insurance for urban residents combines individual contributions with government subsidies. People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.
Article 26
The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Article 27
Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.