The deductible line of Chinese medicine (integrated traditional Chinese and western medicine) hospital and the local comprehensive medical treatment at the same level are subject to downward floating standards, and the payment ratio of Chinese medicine (decoction and Chinese herbal pieces in the catalogue) is 100%. Insured residents are hospitalized for the first time in the year, and the deductible standard for second and later hospitalization is reduced by 50%. If you are hospitalized many times during the year, the cumulative deductible shall not exceed the transfer standard.
The payment standard of hospitalization bed fee for insured residents is based on the first-class (including the following) hospitalization bed fee of 20 yuan/day, the second-class hospitalization bed fee of 30 yuan/day and the third-class hospitalization bed fee of 40 yuan/day. Those below the prescribed standards shall be settled according to the facts, and those above the prescribed standards shall be paid by individuals at their own expense.
Hubei will merge the unified reimbursement ratio of urban residents' medical insurance and the new rural cooperative medical system next year.
The general office of the provincial government recently issued the "Work Plan for Integrating the Basic Medical Insurance System for Urban and Rural Residents in Hubei Province" (hereinafter referred to as the plan), which requires that the medical insurance for urban residents and the new rural cooperative medical system be merged in 20 17, and a unified medical insurance system for urban and rural residents should be implemented, and the proportion of hospitalization reimbursement should be unified at around 75%.
According to the plan, the organization, functions, personnel integration and asset transfer will be completed before the end of August this year; Before the end of September, study and formulate policies related to medical insurance for urban and rural residents; Before the end of the year, the audit of urban residents' medical insurance fund and new rural cooperative medical care fund, the development of urban and rural residents' medical insurance information system and the docking with medical institutions will be completed; In 20 17, the province implemented a unified medical insurance system for urban and rural residents.
In the management system, the management functions of the new rural cooperative medical system undertaken by the health and family planning department and the medical insurance management functions of urban residents undertaken by the human resources and social security department are merged and unified into the human resources and social security department. The organization, establishment, personnel and funds of the health and family planning departments related to the new rural cooperative medical system shall be integrated into the Ministry of Human Resources and Social Security. From institutional integration to the operation of the new system, urban residents' medical insurance and the new rural cooperative medical system are managed in a unified way, operating separately and accounting independently. During the period of system integration, the medical insurance for urban residents and the new rural cooperative medical policy will not be adjusted.
The integrated medical insurance system covers the existing urban residents' medical insurance and all the insured persons of the new rural cooperative medical system, and continues to implement the financing method combining individual contributions and government subsidies, and encourages collectives, units or other social and economic organizations to give support or funding. In addition, it is necessary to unify the protection treatment, including the minimum compensation standard, reimbursement ratio and maximum compensation limit. And the proportion of hospitalization expenses within the policy scope will remain at around 75%.