The reporter was informed yesterday that after the first batch of seven kinds of chronic diseases outpatient (referred to as outpatient chronic diseases) specialized drug expenses were included in the scope of medical insurance reimbursement, it is estimated that the basic medical insurance pooling fund will pay 4-5 million yuan each year, benefiting about 3, people. Through the calculation of chronic diseases, about 7% patients with chronic diseases will not have to worry about expensive medical expenses in the future. From now on, eight hospitals, including the First Affiliated Hospital of Guangzhou Medical College, have begun to accept the diagnosis service for patients with chronic diseases. Patients do not need to apply at the municipal medical insurance center, but only need to apply at designated medical institutions with diagnostic qualifications.

Monthly reimbursement for diabetes mellitus

Zhang Xuewen, director of the Medical Insurance Department of Guangzhou Labor and Social Security Bureau, said that according to their calculations, among the seven chronic diseases clinics (referred to as "chronic diseases" for short), the highest monthly drug cost is diabetes mellitus, which exceeds 15 yuan in terms of medium and high-grade drug cost every month. According to the new reimbursement scheme, if you go to a first-class community health service institution in this city for medical treatment, you can reimburse 1 yuan by 8%, and if you go to a second-or third-class hospital, you can reimburse 9 yuan, and the remaining 5-6 yuan can be paid out in your personal medical insurance account. According to the statistics of the medical insurance department, at present, there are about 1 yuan for employees and 15 yuan for retirees in the personal accounts of the participants of basic medical insurance in Guangzhou. In other words, if the personal account and the overall fund are added up, the insured person of basic medical insurance will see these seven kinds of chronic disease clinics in the future, and individuals will basically not have to pay for it. "This is better than the treatment of public medical care. In any case, public medical care must pay 2% at its own expense every time you see a doctor."

Two conditions must be met to enjoy the outpatient treatment

Zhang Qiuhong, director of Guangzhou Medical Insurance Center, said that they are stepping up the training of new policies to hospitals. After July 1st, every hospital qualified for outpatient diagnosis and treatment of chronic diseases will hang a big sign of "social security medical insurance outpatient service" in a conspicuous place in the hospital, and the hospital will provide one-stop outpatient service. In addition, a unified medical record of chronic diseases has also been worked out, and all chronic patients will use this unified medical record for treatment when they see the designated chronic diseases in the future. According to the regulations of the Price Bureau, the large medical record is 1 yuan/copy, and the small medical record is .5 yuan/copy.

Zhang Qiuhong said that the insured person must meet two conditions when he enjoys the door-to-door treatment. First, he has been insured (including basic medical insurance and hospitalization insurance) and paid the insurance fee in the current month. The insured person who participated in the hospitalization insurance is not allowed to enjoy the door-to-door treatment during the waiting period. Second, it must be diagnosed for the first time.

It should be noted that citizens must first go to a hospital with diagnostic qualifications for the diagnosis of chronic diseases, and do not need to go to Guangzhou Medical Insurance Center to apply. After the diagnosis, you can go to the medical insurance center of the hospital to complete the application procedure on the same day. After the medical insurance information system is confirmed, patients can prescribe drugs and keep accounts, and then they can go to any designated medical institution in the city to get drugs. Hospitals without diagnostic qualifications cannot handle diagnosis and application procedures for the insured.

Seven chronic diseases are:

diabetes, hypertension, coronary heart disease, Parkinson's disease,

rheumatoid arthritis, systemic lupus erythematosus and schizophrenia

Further reading: How to buy insurance, which is better, and teach you to avoid these "pits" of insurance.