The concept of serious illness assistance: it is a new medical assistance system based on the basic medical insurance for urban residents (employees) and the settlement platform of the new rural cooperative medical system. The system has the advantages of stable capital investment, * * using service platform, * * enjoying information resources, synchronous settlement and payment, standardized management and operation, and obvious rescue effect, and can provide fast service for people in need, covering urban and rural areas.

Reimbursement ratio The specific reimbursement ratio for serious illness assistance is as follows.

1, the proportion of overall subsidies for township and village clinics increased to 65% and 75% respectively.

2, a medical institution hospitalization expenses below 400 yuan, no deductible.

3, the proportion of secondary medical institutions subsidies, increased to 75%~80%.

4, the proportion of tertiary medical institutions subsidies, increased to 55%~60%.

5, the proportion of provincial tertiary medical institutions subsidies, increased to 55%.

6. Eight kinds of serious diseases such as congenital heart disease in children, 70% of the new rural cooperative medical subsidy diseases, and 12 kinds of serious diseases such as lung cancer, and strive to reach 70% of the new rural cooperative medical subsidy diseases.

Extended data

First, the target of assistance

1, rural five guarantees;

2. People in cities and towns who have no ability to work, no source of economic income and no dependents (hereinafter referred to as "three noes" in cities and towns);

3. Minimum living guarantee for urban and rural residents;

4, enjoy the civil affairs department regular quantitative living allowance in the sixties to streamline retired workers;

5, enjoy the key entitled groups of the civil affairs department regular pension subsidies;

6. Poor workers approved by the Federation of Trade Unions;

7. Urban and rural low income family members.

Second, the qualification for serious illness relief.

1, individual application materials:

(1) medical assistance application;

(2) the household registration book and identity card of the rescued person;

(3) rural (urban) low guarantee copy;

(4) The applicant's discharge certificate and transfer certificate;

(5) Original invoice of hospitalization medical expenses;

(6) Copies of medical diagnosis and medical records. ?

2, the village (neighborhood) committee to verify the materials:

(1) investigation and verification;

(two) the organization of the village (neighborhood) people's representatives;

(3) publicity of eligible villages (residences);

(4) To return the applicant who does not meet the requirements.

3, the town social assistance office work:

(1) investigation and verification;

(2) eligible to return to the countryside (residence);

(3) do not meet the conditions of the return of the village (neighborhood), and inform the reasons for not meeting the conditions in writing.

4. Work of District Civil Affairs Bureau:

(1) passed the examination;

(2) Publicize eligible villages (residences);

(3) Step-by-step return that does not meet the requirements.

5. After the above verification and review, eligible recipients can get relief funds.

Third, the standard of serious illness relief

1, urban and rural subsistence allowances, courageous wounded people hospitalized due to illness (injury), after being reimbursed by the new rural cooperative medical insurance, residents' medical insurance and serious illness insurance, they will be given assistance according to the proportion of 60%, and the maximum amount of one assistance is 20,000 yuan.

2, key entitled groups (excluding 1~6 disabled soldiers, 7~ 10 disabled soldiers) were hospitalized due to illness, and after being reimbursed by the new rural cooperative medical system, residents' medical insurance, serious illness insurance and special relief departments, each person was given a maximum of 20,000 yuan per year.

3. Low-income families with difficulties and families with major diseases who cannot afford them are hospitalized due to illness. After being reimbursed by the new rural cooperative medical system, residents' medical insurance and serious illness insurance, assistance will be given according to the proportion of 20%, and the maximum ceiling line for one assistance is 1 10,000 yuan.

4. After the amount of hospitalization assistance for urban and rural subsistence allowances reaches the ceiling line, the out-of-pocket expenses will start from 1 10,000 yuan, and the part exceeding 1 10,000 yuan will be given a second assistance at a rate of 30%, with no more than 40,000 yuan per person per year; After the amount of hospitalization assistance for other recipients reaches the top line, the out-of-pocket expenses will start from 1 10,000 yuan, and the part that exceeds 1 10,000 yuan will be given a second assistance at a rate of 20%, and each person will not exceed 20,000 yuan per year.

References:

Baidu encyclopedia-medical assistance for serious illness