At present, my country has not yet clearly and uniformly defined the scope of "critical illness" in "critical illness medical insurance".

According to the previous disease definitions for critical illness insurance jointly formulated by the Insurance Association of China and the Chinese Medical Doctor Association, 25 major diseases have been clarified, including: 1. Malignant tumors - excluding some early malignant tumors.

2. Acute myocardial infarction.

3. Sequelae of stroke—permanent functional impairment.

4. Major organ transplantation or hematopoietic stem cell transplantation—allogeneic transplantation is required.

5. Coronary artery bypass grafting (or coronary artery bypass grafting)—requires thoracotomy.

6. End-stage renal disease (or uremic stage of chronic renal failure)—requires dialysis treatment or kidney transplant surgery.

7. Loss of multiple limbs - complete disconnection.

8. Acute or subacute severe hepatitis.

9. Benign brain tumors—need craniotomy or radiotherapy.

10. Decompensated stage of chronic liver failure - does not include alcoholism or drug abuse.

11. Sequelae of encephalitis or meningitis—permanent functional impairment.

12. Deep coma - does not include alcohol or drug abuse.

13. Deafness in both ears - permanent and irreversible.

14. Blindness - permanent and irreversible.

15. Paralysis - permanent and complete.

16. Heart valve surgery—thoracotomy is required.

17. Severe Alzheimer's disease - complete loss of ability to live independently.

18. Severe brain injury—permanent functional impairment.

19. Severe Parkinson's disease - complete loss of ability to live independently.

20. Severe burns - at least 20% of body surface area.

21. Severe primary pulmonary hypertension—with symptoms of heart failure.

22. Severe motor neurone disease - complete loss of ability to live independently.

23. Loss of language ability—complete loss and active treatment for at least 12 months.

24. Severe aplastic anemia.

25. Aortic surgery - requires thoracotomy or laparotomy.

Legal basis: Article 26 of the "Measures for Basic Medical Insurance for Urban Employees" If an insured person is hospitalized due to illness, the expenses above the deductible shall be paid by the overall fund in accordance with regulations.

The minimum payment standard is determined according to the hospital level, 500 yuan for first-level hospitals, 600 yuan for second-level hospitals, 700 yuan for third-level hospitals, 200 yuan for community health service centers and township health centers that have signed inpatient medical service agreements with medical insurance agencies, and none.

Level 1 hospitals shall refer to level 2 hospitals.

The minimum payment standard for out-of-city referral is 1,000 yuan.

The minimum payment standard will be reduced or reduced in the following situations: (1) The insured person is hospitalized in a designated medical institution in this city due to AIDS, and the minimum payment standard will not be counted.

(2) For insured persons over 100 years old who are hospitalized in designated institutions in this city, the deductible will not be counted.

(3) For persons who have gone through the medical insurance retirement procedures and are hospitalized in the city's first-, second-, and third-level designated hospitals, the minimum payment standards will be reduced by 100 yuan each.

(4) The insured person suffers from mental illness, malignant tumor surgery and radiotherapy and chemotherapy, renal failure dialysis treatment and transplant surgery, anti-rejection treatment after liver, kidney, and bone marrow transplantation, severe aplastic anemia, myelodysplastic syndrome and

For myeloproliferative diseases and systemic lupus erythematosus who are hospitalized multiple times in designated medical institutions, the minimum payment standard will be calculated once a year after approval, and will be determined based on the highest level of the designated medical institution where the patient lives in the year.

(5) Insured persons can be referred in both directions due to illness needs during a treatment process.

When a person transfers from a low-level designated medical institution to a high-level designated medical institution in this city, only the difference in the minimum payment standard will be made up; when a person transfers from a high-level designated medical institution to a designated medical institution of the same level or a lower level, no additional minimum payment standard will be calculated.

Warm reminder: The above answers are only based on the current information and my understanding of the law. Please refer to it with caution!

If you still have questions about this issue, it is recommended that you sort out the relevant information and communicate with professionals in detail.