How much can serious illness assistance generally make up? In fact, faced with the sudden serious illness in many people's lives, most ordinary families still can't afford the medical expenses for serious illness. Let's talk about how much serious illness assistance can generally make up.
How much can serious illness assistance generally make up? 1 1. Urban and rural subsistence allowances and courageous wounded people who are hospitalized due to illness (injury) will be given assistance according to the proportion of 60%. The maximum amount of assistance is 20000 yuan.
2, key entitled groups (excluding 1~6 disabled soldiers, 7~ 10 disabled soldiers) who are hospitalized due to illness, each person is given a maximum subsidy of 20000 yuan per year.
3, low-income families with difficulties and families suffering from major diseases who can't afford to be hospitalized due to illness, according to the proportion of 20% to give assistance, the maximum limit of a rescue line is 1 ten thousand yuan.
4. After the amount of hospitalization assistance for urban and rural residents reaches the top 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%, and each person will not exceed 40,000 yuan 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.
What diseases are included in today's serious illness relief?
1, chronic severe hepatitis, liver cirrhosis; Tuberculosis, psychosis, cardiovascular and cerebrovascular stent implantation, myasthenia gravis, motor neuron disease, gangrene of limbs; Avascular necrosis of femoral head, idiopathic dermatomyositis, panniculitis, epilepsy, Parkinson's disease, multiple sclerosis, systemic lupus erythematosus, nodular polyarteritis.
2. Behcet's disease, systemic sclerosis, hypercortisolism, primary aldosteronism, rheumatoid arthritis (active stage), allergic purpura complicated with nephropathy, thrombocytopenic purpura; Pituitary tumor, diabetes insipidus, polycythemia vera, primary thrombocytosis, chronic renal insufficiency, chronic aplastic anemia, hemolytic anemia and dysplasia syndrome.
3. Idiopathic pulmonary fibrosis, bronchial asthma, bronchiectasis, nephrotic syndrome, chronic cardiac insufficiency, anticoagulation therapy with valve replacement, diabetes complicated with heart, kidney, eyes and neuropathy;
Hypertension with heart, brain, kidney and vascular complications; Stroke sequelae, uremia dialysis treatment, malignant tumor, organ transplantation, leukemia.
Time limit for applying for serious illness relief
There is indeed a time limit for applying for serious illness assistance. Only 1 and July can apply every year, and other times are not allowed. Moreover, there are still more than 20 days of review after the application is initiated. We must seize the opportunity and never wait until the time is up.
How to handle medical assistance for serious illness?
(1) Applicant
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 regular quantitative living allowance of civil affairs departments 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.
(2) required information
1. Fill in the Application Form for Charity Relief for Seriously Ill Patients;
2, the basic medical insurance designated medical institutions issued by the official medical bills and the basic medical insurance management department issued the original and photocopy of the reimbursement statement;
3. A copy of my ID card and household registration book;
4, urban and rural subsistence allowances, rural five guarantees, urban three noes, orphans, etc. Need to provide the "minimum living guarantee certificate", "rural five guarantees certificate" and other valid documents or certificates;
5 families with social difficulties need proof of income issued by the unit or neighborhood Committee;
6. Other application materials.
(3) Handling procedures
1, application. Poor residents suffering from the specified serious diseases shall submit a written application to the community where their household registration is located, fill in the "Approval Form for Medical Assistance Application", and provide relevant supporting materials.
2. register. The community guides the applicant to fill in the relevant forms, accepts the certification materials and documents that need to be submitted by the applicant, and registers the basic situation of the applicant. The applicant holds a letter of introduction issued by the community and relevant certification materials, and goes to the District Health Bureau for centralized appraisal.
3. investigation. Community by more than three people (including three people) staff to investigate and verify the situation of relief objects.
4. review. The community held a review meeting to review the relief objects.
5. First instance. After collective discussion and research, those who meet the conditions for enjoying assistance shall sign their opinions on the applicant's application form (specific examination and approval opinions are required). Explain the reasons for not meeting the requirements and publicize the situation.
6. review. After receiving the materials, the sub-district office shall verify the applicant's medical expenses and the degree of illness according to the regulations, and report to the District Civil Affairs Bureau for approval after publicity without objection.
7. recognition. The district civil affairs department shall, jointly with the district labor department, review and publicize the signature materials and medical bills reported by the sub-district office.
8. Distribution. The payment of medical assistance for serious illness in cities and towns is paid by banking institutions.
(4) address processing
Local civil affairs bureau.
(5) Time limit for handling
There is no time limit for applying for serious illness relief. As long as you reimburse according to the procedures, you will get feedback in about a month.
Content expansion
1. Can the new rural cooperative medical system apply for serious illness relief after reimbursement?
Yes, patients can still apply for serious illness relief on the basis of enjoying basic medical insurance reimbursement.
Medicaid for serious illness, full name of Medicaid for major illness. It refers to a medical subsidy system established by the insured on the basis of enjoying the basic medical insurance benefits to resolve the huge economic risks brought by serious illness treatment.
There is no need to apply for Medicaid for major diseases; In each social security year, the insured person's hospitalization and outpatient treatment of specific projects exceed the basic medical expenses corresponding to the maximum payment limit of the overall fund, which is paid by the serious illness subsidy. The maximum payment limit of the serious illness subsidy in each social security year is 6.5438+0.5 million yuan.
Second, what documents and procedures are needed for serious illness relief?
Serious illness relief needs to bring urban medical insurance, poverty certificate, patient ID card, household registration book, serious illness relief approval form, hospitalization invoice, discharge summary and other materials to the civil affairs department for application.
Eligible insured to the village (community) to apply for the "serious illness relief approval form"; The insured person shall fill in the Examination and Approval Form for Serious Illness Relief, and attach the original materials such as hospitalization invoice and discharge summary. Each hospitalization expense can only be used for one rescue application; The insured will "serious illness relief approval form", hospitalization invoices, discharge summary and other materials sent to the village (community) for review and signing opinions; The village (community) reported to the town (street) to verify and sign opinions.
Town (street) to send the new rural cooperative medical system office, after investigation, review and collective discussion, initially determine the list of relief objects; To the village (community) where the relevant information to be rescued is publicized, and the publicity time is 7 days; According to the results of publicity, the office of the new rural cooperative medical system in the district decides the list of relief objects and distributes relief funds through the town (street). The examination and approval time for serious illness assistance is generally 1 and July, twice a year.
Three, how to apply for the Red Cross serious illness relief fund?
The applicant for assistance should submit the poverty certificate (stamped and approved by the local government), the original case, the hospitalization certificate and the ID card to the local Red Cross for application.
Application conditions for serious illness relief: the applicant must be a local permanent residence; Or migrant workers who can be employed by organs, enterprises and institutions that have lived for more than 3 years, or rural household registration who participate in hospitalization insurance for rural cooperative medical care.
How much can serious illness assistance generally make up? 2 cities have different standards for serious illness relief, such as Shantou City's serious illness relief for disabled people with difficulties:
1, urban and rural residents, poor employees of enterprises, personal burden is insufficient 1 10,000 yuan, according to the actual amount of assistance; If the personal burden exceeds 6,543.8+0,000 yuan, it will be rescued at 6,543.8+0,000 yuan. Patients with special difficulties and dying patients whose illness seriously affects the basic life of their families shall be implemented with reference to the minimum living security assistance standard.
2. In case of financial difficulties, the personal burden: 50,000 yuan or more, 9,000 yuan for assistance; 20 thousand yuan more than 50 thousand yuan, give 7000 yuan to help; 1 10,000 yuan but less than 20,000 yuan, give 5,000 yuan to help; If the amount is less than 1 000 yuan, 50% of the actual amount of assistance will be provided.
Legal basis:
"Implementation Opinions on Serious Illness Relief for Difficult Disabled Persons in Shantou"
Second, the rescue standard.
In order to let the limited funds benefit more disabled people with difficulties, this assistance is an annual one-time assistance, as a supplement to the basic medical insurance and the medical insurance department's serious illness assistance policy. After deducting hospitalization fee waiver and medical insurance reimbursement:
1, urban and rural residents, poor employees of enterprises, personal burden is insufficient 1 10,000 yuan, according to the actual amount of assistance; If the personal burden exceeds 6,543.8+0,000 yuan, it will be rescued at 6,543.8+0,000 yuan.
Patients with special difficulties and dying patients whose illness seriously affects the basic life of their families shall be implemented with reference to the minimum living security assistance standard.
2. In case of financial difficulties, the personal burden: 50,000 yuan or more, 9,000 yuan for assistance; 20 thousand yuan more than 50 thousand yuan, give 7000 yuan to help; 1 10,000 yuan but less than 20,000 yuan, give 5,000 yuan to help; If the amount is less than 1 000 yuan, 50% of the actual amount of assistance will be provided.
Expenses incurred in non-designated medical institutions are not included in the accounting scope.
How much can serious illness assistance generally make up? What are the criteria for applying for serious illness relief?
Before talking about serious illness relief, what is a serious illness?
Everyone must be clear that the so-called serious illness rescue and serious illness in the serious illness insurance have nothing to do with what illness they have, but only with the "combined fees" of hospitalization expenses. Moreover, this fee is also included in the scope of reimbursement for combined treatment.
The criteria for applying for serious illness relief are: after economic cooperative treatment and reimbursement of serious illness insurance, the remaining compliance expenses exceed 1 10,000 yuan.
Serious illness relief is a kind of medical security for families in need by civil affairs departments.
Residents who participate in medical insurance for urban and rural residents will be reimbursed for joint treatment first, then for serious illness insurance, and finally for serious illness relief.
The conditions of critical illness insurance and critical illness assistance are that the remaining compliance expenses after reimbursement of economic cooperation treatment exceed 1 10,000 yuan, critical illness insurance accounts for 60% of the part that exceeds 1 10,000 yuan, and critical illness assistance accounts for 30% of the part that exceeds 1 10,000 yuan after reimbursement of combined treatment and critical illness insurance.
From a purely numerical point of view, as long as it is enough for serious illness insurance, it is also enough for serious illness relief.
Take the above figure as an example: the total hospitalization expenses are 40838, the compliance expenses are 35877, the total reimbursement amount is 35877×60%=2 1526 yuan, the remaining compliance expenses are 14350 yuan, and the insurance reimbursement amount is 4350×60%=26 10 yuan. Serious illness relief is (4350-26 10) × 30% = 522 yuan.
The above policies are aimed at ordinary people. If it is a low-income household, a poor household or a poor household, the policy will be much looser. Among them, all the destitute dependents are reimbursed, and after the low-income households and poor households are reimbursed for joint treatment, regardless of whether they have sufficient serious illness insurance conditions, the final proportion of serious illness assistance is 70%. In other words, for low-income households and poor households, 70% of the remaining compliance fees after reimbursement of combined treatment (including serious illness insurance) are used for serious illness relief. Note: The remaining compliance expenses exceeding 1 10,000 shall be borne by ordinary people, while the low-income households and poor households shall be responsible for the remaining compliance expenses.
Of course, don't envy low-income households and poor households. After all, each of us doesn't want to be such a difficult family.
How to apply for serious illness relief?
For low-income households, poor households, and destitute dependents, hospitals now have a "civil assistance" window, and they can handle joint treatment, serious illness insurance, and serious illness assistance at one time when they leave the hospital.
For ordinary people who are not civil objects, they need to apply for serious illness relief in local towns and villages. The required materials include:
1, ID card, household registration book, Zhenhui card.
2, diagnosis certificate, discharge certificate, hospitalization medical record home page, serious illness insurance reimbursement bills.
Fill in the application form for serious illness relief, which will be reviewed by the villagers' representatives and reported by the township government.