National chronic disease subsidies 3 1 case. They are hypertension, diabetes, cirrhosis, rheumatic diseases, cor pulmonale, chronic viral hepatitis, tuberculosis, lymphadenopathy, hyperthyroidism, hypothyroidism, rheumatoid arthritis, hemolytic anemia, leukemia, recurrent aphthous oral ulcer, coronary heart disease (including myocardial infarction and angina pectoris only), chronic obstructive pulmonary disease (COPD), aplastic anemia and primary fibrosis. Stage III and above, myasthenia gravis, systemic lupus erythematosus, severe osteoporosis with multiple fractures, Behcet's disease, aggressive periodontitis, oral lichen planus, psoriasis, varicose veins of lower limbs, femoral head necrosis, Parkinson's disease, malignant tumor and schizophrenia.
Subsidy policy for chronic diseases
I. Qifubiaozhun
1. The payment standard for chronic diseases in designated community health service institutions is 200 yuan. In designated specialized hospitals, the deductible standard for chronic diseases in the first-level hospitals is 200 yuan, and the deductible standard for chronic diseases in the second-level hospitals is 400 yuan. Outpatient chronic disease Qifubiaozhun above, below the annual maximum payment limit of medical expenses, according to the proportion of reimbursement, outpatient co-ordination fund to pay 50%.
2, suffering from more than two kinds of chronic outpatient diseases, in accordance with the principle of "high is not low", to determine the annual payment limit, on this basis, the annual payment limit per person increased by 200 yuan.
3, outpatient chronic disease patients can not enjoy outpatient medical treatment at the same time during hospitalization, accounting for the highest payment limit of basic medical insurance, outpatient medical expenses and hospitalization medical expenses combined calculation.
4, outpatient special disease medical treatment according to the hospitalization standard, an insured year only calculate deductible, Qifubiaozhun according to the hospitalization level standard.
Second, the chronic disease subsidy object
Including the insured, including enterprises, institutions and institutions; Individual insured persons with flexible employment can enjoy subsidies for chronic diseases.
Third, the subsidy standard for chronic diseases
Chronic disease subsidy standard
Disease subsidy standard
On-the-job retired workers and retirees over 70 who participated in revolutionary work before the founding of People's Republic of China (PRC).
Class I, 1, hypertension stage II, hypertension stage III, minimum threshold 1200 yuan, minimum threshold 1000 yuan, minimum threshold 800 yuan.
2, coronary heart disease (angina pectoris, myocardial infarction) subsidy ratio: community health service institutions: 70%.
Non-community health service institutions: 60%
Maximum subsidy limit: 2000 yuan, subsidy ratio: community health service institutions: 85%.
Non-community health service institutions: 75%
Maximum subsidy limit: 3,000 yuan; Proportion of subsidy: community health service institutions: 95%.
Non-community health service institutions: 85%
Maximum subsidy limit: 3,500 yuan
3. Type 1 diabetes and type 2 diabetes
4. Chronic hepatitis B and chronic hepatitis D..
5. Chronic hepatitis C.
6. Decompensation of cirrhosis
7. Recovery and sequelae of cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage.
8. Parkinson's disease and Parkinson's syndrome
9. Chronic bronchitis with obstructive emphysema and pulmonary heart disease
10, bronchial asthma
1 1, active pulmonary tuberculosis
12, chronic nephritis, chronic renal insufficiency (non-dialysis treatment)
13, rheumatoid arthritis
14, ankylosing spondylitis
15, scleroderma/systemic sclerosis
16, Behcet's disease
17, hemophilia
18, myasthenia gravis
19, multiple sclerosis
20, autoimmune hepatitis
2 1, polycythemia vera
22. Polymyositis/Dermatomyositis
23. Primary thrombocytosis
Type ⅱ: 24 cases. The qifubiaozhun and subsidy ratio of systemic lupus erythematosus are the same as above, but the maximum subsidy limit is 1 10,000 yuan, but the maximum subsidy limit is 1 10,000 yuan.
25, chronic aplastic anemia
26, intracranial benign tumor
27 years old, * * fibrosis.
Suffering from two or more chronic diseases at the same time (subject to the disease serial number), the minimum threshold and subsidy ratio are the same as above, and the original maximum subsidy limit is increased by 1000 yuan.
Four, chronic disease subsidy reimbursement process
Consumers can go to local institutions to handle copies of hospitalization medical records (hospitalization home page, etc.). ), outpatient medical records, rescue medical records, diagnosis certificate. When handling, you need to provide the following materials:
1. Fill in the evaluation form of outpatient chronic disease subsidy application (in duplicate) and affix the official seal of the social security department of the company;
2. The above data are all medical data of hospitals above Grade II in recent two years;
3. Receive the application materials for outpatient chronic disease subsidies on June 1, April 7 and June 1-5 every year, and do not accept the application business at other times;
4. The first diagnosis certificate of hospitalization must be the chronic disease that I applied for.