What is the basic medical insurance for urban and rural residents is closely related to our daily work or life. So, you can't just hear about it, but you don't know how. The following small series has compiled some related contents to share with you. Welcome to read, I hope it will help you. First, the concept of basic medical insurance for urban and rural residents is to integrate the basic medical insurance for urban residents (referred to as urban residents' medical insurance) and the new rural cooperative medical system (referred to as the new rural cooperative medical system) and establish a unified basic medical insurance system for urban and rural residents (referred to as urban and rural residents' medical insurance). Second, the basic medical insurance for urban residents. The basic medical insurance for urban residents is an integral part of social medical insurance. We will adopt a medical insurance system dominated by the government, with individual (family) contributions as the mainstay and moderate government subsidies as the supplement, and provide medical needs for urban residents in accordance with the principle of consistent payment standards and treatment levels. 1, the urban residents' basic medical insurance fund is mainly used to pay the medical expenses of insured residents for hospitalization and outpatient serious illness and outpatient rescue, and the scope and standard of payment are implemented according to the list of drugs, diagnosis and treatment items and medical service facilities of urban residents' basic medical insurance. 2, Qifubiaozhun (also known as the threshold fee) is the same as the basic medical insurance for urban workers, that is, three-level 980 yuan, two-level 720 yuan and one-level 540 yuan. 3. Medical treatment management: the system of fixed-point first consultation and two-way referral shall be implemented for the residents insured by the basic medical insurance for urban residents. The first-visit medical institutions are designated as community health service centers, specialized hospitals, hospital-store cooperation, secondary and below medical institutions, and some tertiary comprehensive and specialized medical institutions are designated as fixed points. When insured residents seek medical treatment, they should first seek medical treatment in the first-visit medical institution. If it is really necessary to be referred for treatment due to illness, the first-time medical institution shall issue a referral certificate before being transferred to the designated referral hospital for hospitalization. (That is to say, once you get sick, you must go to the designated community service center hospital or the designated small hospital to see a doctor. If these small hospitals don't look good, you can transfer to a big hospital with the certificate of the small hospital. When you get better, you should turn back to live immediately. 4. Payment proportion: The proportion of fund payment is determined according to different levels of medical institutions, and the proportion of fund payment of first-class (including community health service centers), second-class and third-class medical institutions is 75%, 60% and 50% respectively. After two years of continuous insurance payment for urban residents, it can be increased to 80%, 65% and 55% respectively. (In other words, the smaller the hospital, the more reports. 5. Basic insurance coverage: In a natural year, the maximum payment limit of the basic medical insurance pooling fund is 6.5438+0.6 million yuan per person per year. For patients with chronic renal failure (outpatient dialysis treatment), malignant tumor (outpatient radiotherapy and chemotherapy), organ transplantation and anti-rejection treatment, systemic lupus erythematosus, aplastic anemia (referred to as "outpatient serious illness"), the maximum payment limit of the annual pooling fund can be increased to 20,000 yuan per person. Third, the new rural cooperative medical system The new rural cooperative medical system (hereinafter referred to as the "new rural cooperative medical system") refers to the farmers' medical mutual aid system organized, guided and supported by the government, in which farmers voluntarily participate and individuals, collectives and the government jointly raise funds. It takes the form of individual donations, collective support and government funding to raise funds. Security object. The object of serious illness insurance is urban residents' medical insurance and the insured of the new rural cooperative medical system. Coverage. The coverage of serious illness insurance should be connected with urban residents' medical insurance and the new rural cooperative medical system. The medical insurance for urban residents and the new rural cooperative medical system should provide basic medical security according to the policy. On this basis, the major illness insurance mainly guarantees the eligible medical expenses of urban residents compensated by medical insurance and the new rural cooperative medical system when the insured (co-insured) is seriously ill and the medical expenses are high. High medical expenses can be judged by the fact that the accumulated annual compliance medical expenses of individuals exceed the annual per capita disposable income of urban residents and the annual per capita net income of rural residents announced by local statistical departments, and the specific amount is determined by local governments. Compliance medical expenses refer to the actual and reasonable medical expenses (which can be stipulated not to be paid), which are determined by the local government. All localities can also start to carry out serious illness insurance from diseases with heavy personal burden. Protection level. In order to avoid catastrophic family medical expenses for urban and rural residents and reasonably determine the compensation policy for serious illness insurance, the actual payment ratio is not less than 50%; The proportion of payment is determined according to the level of medical expenses. In principle, the higher the medical expenses, the higher the payment ratio. With the continuous improvement of financing, management and security, the proportion of reimbursement for serious illness will be gradually increased, and the burden of personal medical expenses will be reduced to the greatest extent. Do a good job in connecting basic medical insurance, serious illness insurance and medical assistance for serious and serious diseases, establish a serious illness information notification system, timely grasp the medical insurance payment of seriously ill patients, strengthen policy convergence, and effectively avoid the problems of poverty caused by illness and returning to poverty due to illness. The designated medical institutions, medication and diagnosis and treatment scope of urban and rural medical assistance shall be implemented with reference to the relevant policies and regulations of basic medical insurance and serious illness insurance respectively. The above is the relevant knowledge compiled by Bian Xiao for everyone. I believe everyone should know something about it. If you don't know anything about the basic medical insurance for urban and rural residents, you can read other articles about life cats, hoping to help you. I hope my answer is helpful to you! In case of doubt, legal advice is welcome. Wish you a happy life!

Legal objectivity:

"Regulations on Handling Medical Accidents" Article 23 Employees shall participate in basic medical insurance for employees, and employers and employees shall pay 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. Regulations on Handling Medical Accidents 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.