1. Employees participating in medical insurance: The minimum payment ratio of medical insurance fund will be increased from 75% to 80% for the expenses incurred by using special drugs due to serious diseases.
2. Medical insurance for urban and rural residents: The minimum payment ratio of medical insurance fund will be increased from 60% to 65% for the expenses incurred by using special drugs due to serious diseases.
First, medical insurance refers to social medical insurance.
1 is a social insurance system that meets the basic medical needs of workers when they are sick according to laws and regulations. 201610/2 the State Council issued the "Opinions on Integrating the Basic Medical Insurance System for Urban and Rural Residents", demanding the integration of the medical insurance for urban residents and the new rural cooperative medical system, and gradually establishing a unified medical insurance system for urban and rural residents throughout the country. On February 20th, 2065438+0616, Ministry of Human Resources and Social Security held a video conference on the nationwide networking of basic medical insurance and direct settlement of medical treatment in different places, and signed letters of responsibility with the first batch of 22 provinces including Beijing, which applied for nationwide networking of basic medical insurance and direct settlement of medical treatment in different places, marking the formal implementation stage of direct settlement of medical treatment in different places.
2. Social medical insurance is a social insurance system established by the state and society according to certain laws and regulations to provide basic medical needs for workers within the scope of protection. The composition of social overall medical insurance: the base of payment is m: wage income of employees+allowance. The unit pays 8% m every year; Individual employees pay 2% m every year; The unit pays 8% m: 6.6% m to 7%M into the overall account (1%M to 1.4%M into the personal account)-hospitalization expenses; 2%M: 2%M of the salary paid by the individual goes into the personal account (plus the unit payment 1%M to 1.4% M)- outpatient expenses.
Second, the Medical Insurance Management Service Bureau is responsible for the daily affairs such as the medical insurance bureau accepting the approval, payment and management of the basic medical insurance, industrial injury insurance, maternity insurance and retired cadres' medical expenses pooling fund, signing medical insurance service contracts with the designated medical institutions and pharmacies of Lanzhou Medical Insurance Bureau, and supervising, inspecting and assessing the implementation, and punishing the illegal medical behaviors of the designated medical institutions and pharmacies; Responsible for guiding the basic medical insurance business of the medical insurance bureau. The Medical Insurance Administration is a fully funded institution at the sub-county level under the leadership of the Municipal Human Resources and Social Security Bureau.