To adjust and improve relevant policies, Suzhou City’s 2007 Medical Municipalities, District People’s Government, Suzhou Industrial Park, Suzhou High-tech Zone, Taicang Port Management Committee, units directly under the municipal committees and offices: In order to improve the overall health care and health of the insured

, to promote the construction of a harmonious socialist society, the 66th executive meeting of the municipal government, in 2007, the following opinions were put forward on the adjustment of the medical insurance policy for urban employees in Suzhou: First, increase the amount of outpatient personal accounts for retirees under the age of 70.

80 yuan to 660 yuan, 740 yuan per person per year, 70 years and above (including 70 years old), a year-on-year increase of 100 yuan, 730 yuan per person per year, 830 yuan, a part of older workers who worked before the revolution and the founding of the People's Republic of China, an increase of 1080 yuan

to 1,180 yuan.

Second, improve the level of protection of family hospital beds. The minimum payment standard for family hospital beds per time (180 days) is increased from the original 500 yuan to 400 yuan, and the medical insurance minimum payment standard is above the standard but below 3,000 yuan. This solves a series of expenses and coordinates the fund.

The proportion of payment increases to 80% to 85%; the sub-reimbursement of insured home hospital beds divided by 180 days is handled in accordance with the above regulations.

3. Influenza vaccine is included in the scope of medical insurance fund settlement. In order to strengthen the awareness of preventive health care among the insured, safely and effectively prevent and reduce the incidence of influenza, and improve the immunity of susceptible groups, influenza vaccination is included in the medical insurance fund.

Settlement coverage to improve the overall health of the insured through proactive disease prevention and control of influenza epidemics.

4. Medical insurance benefits for urban residents (A) Reduce the hospitalization minimum payment standard for urban residents. Adjust the hospitalization minimum payment standard for urban residents: the three-level hospital is reduced from 1,000 yuan to 800 yuan, the two hospitals are reduced from 800 yuan to 600 yuan, and the hospital is reduced from 600 yuan.

Yuan dropped to 400 Yuan.

(B) Adjust the financing standards of urban residents’ medical insurance. The financing standards of urban residents’ medical insurance are adjusted. The individual payment standard for urban residents is increased from 100 yuan to 200 yuan, and the financial subsidy is increased by 350 yuan from 250 yuan per person; from the 1960s

Streamline the standard unit of 1,500 yuan per person for retirees. The social security institution will not pay the outpatient medical expenses of the original unit. The original social security institution will pay the standard fee of 20 yuan a month. The land purchase and maintenance personnel will directly

The medical insurance fund transferred to residents stops being distributed by the social security agency; the subsistence allowance, poor workers from marginal subsistence families, who have completely lost, or lost most of their ability to work, the medical insurance premiums of severely disabled residents are borne by the finance

.

On January 1, 2007, 2007 households moved to Suzhou City less than 10 years ago. There is no medical insurance. Elderly urban residents can participate in urban residents medical insurance. The medical insurance premiums are paid in full by individuals. (C) Increase the outpatient medical subsidies for urban residents by insurance.

Urban residents can enjoy 50% subsidy for outpatient medical expenses less than 600 yuan at their selected community health service institutions that meet the scope of medical insurance settlement.

(D) Outpatient treatment methods for urban residents. Outpatient medical treatment for urban residents is a two-way choice.

The application designated by the municipal labor and social security administrative department, the service commitment of the labor and social security administrative department, is willing to undertake resident outpatient medical services to designated community health service institutions, including community health service centers (stations), outpatient departments, clinics, in cooperation with the health administration

The department selects the regional distribution of designated community health service institutions for urban resident medical clinics based on the insured's residents.

Its main service commitments are announced to the public.

Insured residents can independently choose designated medical institutions as community health service institutions near their own clinics (without annual adjustment in medical insurance).

Community doctors and family doctors who sign medical service agreements with residents at designated community health service institutions provide residents with basic outpatient medical services and health guidance.

Residents holding medical insurance medical records, doctor visits, and social security cards at selected community health service institutions, in accordance with regulations, enjoy subsidies, and go to designated hospitals and outpatient clinics for examination due to the patient's condition, and are checked by the selected community health service agency.

Service agencies handle referral procedures in the order they are referred.

Residents' follow-up visits to designated hospitals are within the scope of reimbursement by community health service agencies, which are settled in personal cash.

(E) Outpatient medical expense settlement The social security institution's quota assessment assesses the outpatient expenses of settled residents and the assessment of designated community health service agencies, based on the principle of revenue-determined expenditure, total volume control, savings incentives, over-expenditure sharing, and the actual monthly settlement

, quarterly assessment, annual liquidation at the end of the year. The settlement control indicator is 45 yuan per person per month. For the savings part that has not reached the total liquidation control indicator at the end of the year, 50% of the actual interest rate is settled by the designated community health service agency issued by the resident medical insurance fund.

The resident medical insurance fund has paid 50% of the portion exceeding 10% of the control indicator, and the resident medical insurance fund has not yet resolved.