Bureau of finance

Ren Xuan secret [20 1 1] No.219

Notice on Adjusting Relevant Policies of Basic Medical Insurance for Urban Residents

County Human Resources and Social Security Bureau and Finance Bureau:

In order to implement the spirit of the Notice of the People's Government of Anhui Province on the Implementation of 33 People's Livelihood Projects in 201/KLOC-0 (Wan Fu [20165438]1No.) and further improve the basic medical insurance benefits for urban residents in our city, with the consent of the municipal government, the relevant policies on the basic medical insurance for urban residents in our city are adjusted as follows:

1.20 1 1 year, governments at all levels have raised the medical insurance subsidy standard for urban residents from 120 yuan/year to 200 yuan/year. When the 80 yuan/year is increased, the central finance will bear 60% (i.e. the annual per capita 48 yuan), and the provincial and below finance will bear 40% (i.e. the annual per capita 32 yuan). Among them, the provincial finance bears 24 yuan, and the county finance bears 8 yuan.

Second, the insured hospitalization beyond Qifubiaozhun above in line with the provisions of the medical expenses, calculated according to the third, second and first-class hospitals, the fund respectively according to the proportion of 55%, 65% and 75%. The proportion of hospitalization reimbursement for two years or more of continuous insurance increased by 5% on the original basis.

Three, the basic medical insurance for urban residents prescribed diseases (refers to the provisions of chronic diseases that do not require hospitalization), from the original 23 to 27. (1) Hypertension above stage Ⅱ (including stage Ⅱ); (2) heart disease and cardiac insufficiency; (3) Diabetes with ineffective diet control; (4) decompensated cirrhosis; (5) Recovery period of cerebral hemorrhage and cerebral infarction; (6) Chronic renal failure needs dialysis treatment; (7) Radiotherapy and chemotherapy for malignant tumors; (8) Chronic hepatitis (B, C and D); (9) Chronic bronchitis, emphysema and bronchial asthma; (10) active pulmonary tuberculosis; (1 1) rheumatoid arthritis; (12) Systemic lupus erythematosus; (13) Chronic aplastic anemia; (14) hyperthyroidism (hypothyroidism); (15) After human organ transplantation (maintenance treatment); (16) mental illness; (17) Parkinson's syndrome; (18) epilepsy; (19) cerebral palsy; (20) Ankylosing spondylitis; (2 1) macular degeneration; (22) Renal insufficiency; (23) Crohn's disease; (24) hemophilia; (25) Polycystic ovary syndrome; (26) myasthenia gravis; (27) Prostate hyperplasia.

Within a settlement year, the outpatient expenses that meet the requirements will be paid by the fund at the rate of 65% after the individual pays 1000 yuan.

The reimbursement rate for outpatient radiotherapy and chemotherapy for malignant tumors, maintenance treatment after human organ transplantation and dialysis treatment for chronic renal failure increased to 75%.

Four, general diseases in accordance with the provisions of the total medical expenses reimbursement ratio adjusted to 45%, malignant tumors, organ transplantation in accordance with the provisions of the total medical expenses reimbursement ratio adjusted to 65%.

Five, the insured residents in the designated medical institutions outpatient expenses fund reimbursement ratio of 40%; The amount of reimbursement for an outpatient service in a first-class hospital is 30 yuan, and that in a second-class and above hospital is 40 yuan; The number of outpatient co-ordination reimbursement shall not exceed two times in a settlement year.

VI. The Notice shall be implemented as of September 20 1 1 year. If the original policy is inconsistent with this notice, this notice shall prevail.

20 1 1 July13rd.