The serious illness subsidy in Linfen City, Shanxi Province

The medical subsidy for serious illness received by the Social Security Bureau refers to a medical subsidy system established by the insured in order to resolve the huge economic risks caused by serious illness treatment on the basis of enjoying the basic medical insurance benefits.

There is no need to apply for Medicaid for major diseases; The basic medical expenses corresponding to the insured's hospitalization and outpatient treatment for specific items accumulated over the maximum payment limit of the overall fund in each social security year are paid by the major illness subsidy, and the maximum payment limit of the major illness subsidy in each social security year is 15, yuan.

when the basic medical expenses incurred by the participants in Medicaid for major diseases exceed the maximum payment limit of the basic medical insurance pooling fund, the Medicaid for major diseases shall be paid according to the following standards:

(1) The basic medical expenses for specific items of hospitalization and outpatient service shall be paid by Medicaid for major diseases according to the standard of 95%.

(2) Designate the basic medical expenses for chronic disease outpatients, which shall be paid by Medicaid for major diseases according to the corresponding standards.

in a social insurance year, the maximum amount of medical subsidy for major diseases to pay the insured person's basic medical expenses for specific items of hospitalization and outpatient service and the basic medical expenses for designated chronic disease outpatient service is 15, yuan.

the supplementary medical insurance premium payable by retirees participating in the basic medical insurance shall be paid from the Medicaid for major diseases.

the adjustment of the payment rate, treatment standard and payment scope of Medicaid for major diseases shall be put forward by the municipal labor and social security administrative department in conjunction with the financial department according to the balance of medical insurance payments, and shall be implemented after being reported to the Municipal People's Government for approval.

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