In Mancheng District, urban and rural residents’ medical insurance payments have begun in 2023. In order to facilitate insured residents to grasp the new changes in medical insurance policies, the interpretation is as follows: 1. Continue to implement the continuous payment preferential policy.

The number of years urban and rural residents have paid for basic medical insurance is linked to the overall fund payment ratio. For every three consecutive years of continuous payment, the overall fund payment ratio can be increased by 1%, up to a maximum of 3%.

2. The three catalogs of medical insurance are expanding year by year.

The drug reimbursement catalog implements the national unified catalog, with more than 2,860 reimbursement categories, and the catalog of diagnosis and treatment items and service items have been expanded.

Over the past three years, imported drugs and “extremely expensive drugs” (such as raltitrexed, olaparib, pertuzumab, ruxolitinib, trastuzumab) used by patients with dozens of cancers, rare serious diseases, etc. have been gradually

(antibiotics, etc.) and medical consumables were included in the medical insurance reimbursement catalog, and through the national centralized procurement of drugs and medical consumables, the prices of more than 300 kinds of drugs and consumables (including imported drugs and "sky-high-priced drugs") were reduced by more than 65% on average, with some "sky-high-priced drugs"

"drugs", imported drugs and medical consumables have dropped by more than 90%. For example, the average price of coronary stents has dropped from 13,000 yuan to 700 yuan, and Plavix has dropped from 135 yuan to 27 yuan. Imported cancer drugs have generally dropped from tens of thousands per month.

Yuan has been reduced to the current 1,000-5,000 Yuan/month.

3. The benefits of hospitalization in other places are further improved.

First, the minimum payment line is lowered. There is no distinction between inside and outside the province. A unified minimum payment line is implemented according to the hospital level. The first level is 300 yuan, the second level is 600 yuan, and the third level is 2,000 yuan. Originally, the minimum payment line outside Baoding City was 2,500 regardless of level.

Yuan.

Second, the reimbursement ratio has been increased. The policy of no relocation for medical treatment within the province is implemented according to Baoding City standards, which is 90% for the first level, 75% for the second level, and 55% for the third level.

The first-level and second-level designated hospitals outside the province are 10% lower than those in the province, at 80% and 65% respectively. The third-level hospitals are the same as those in Hebei Province, with 55% reimbursement.

The third is to implement the Beijing-Tianjin-Hebei regional integration policy. The hospitalization deductibles and reimbursement ratios of designated hospitals at level 2 and above in Beijing and Tianjin follow provincial standards. The reimbursement catalog follows the Beijing and Tianjin catalogs. The actual reimbursement ratio for direct settlement of medical treatment in other places in Beijing is average.

10% higher than manual reimbursement in the province.

Fourth, continue to implement the policy of increasing the hospitalization reimbursement ratio of students and children by 10%.

4. Optimize overall outpatient reimbursement.

The first is to increase the annual cap limit from 100 yuan to 200 yuan/person.

The second is to expand the scope of application, from the past two-level designated rural areas in the district to all designated pharmacies in the district and outpatient coordination designated pharmacies, and provincial second-level and above hospitals.

The third is to lower the minimum payment threshold for college students from 100 yuan to 50 yuan.

5. Improve outpatient treatment for chronic and special diseases.

The first is to lower the deductible for outpatient chronic diseases from 800 yuan to 500 yuan.

The second is to increase the reimbursement ratio from 60% to 70%.

The third is to expand the scope of application, from being limited to designated hospitals in the past to extending to designated outpatient chronic disease pharmacies in the region.

The fourth is to optimize the declaration process, from the previous monthly declaration to online declaration and review and appraisal at any time.

Fifth, special outpatient diseases will continue to be reimbursed according to the hospitalization policy.

6. It is more convenient to register for medical treatment in other places.

There is no need to go to other places for medical treatment within the province, and no registration is required. Online self-service registration is required for medical treatment outside the province (both Hebei Smart Medical Insurance and the National Medical Insurance Platform can realize online self-service registration).

7. The one-card application of electronic medical insurance vouchers is fully promoted.

Through Hebei Smart Medical Insurance, WeChat City Services, online banking and other channels, after completing the activation of the electronic medical insurance voucher, you can realize the entire domestic medical settlement process without carrying a physical social security card.

The elderly and children who do not have smartphones can use the national medical insurance platform APP to bind their families.

8. Huimin physical examination is more considerate.

In order to encourage residents to actively participate in insurance, we have jointly implemented medical examinations to benefit the people in secondary designated hospitals in the district.

The preferential physical examination is only available to those who have completed the 2023 urban and rural residents’ medical insurance payment in Mancheng District before December 10, 2022, and each person can only use it once a year.

Personnel information and payment dates shall be subject to the tax system declaration records.

First, the price is favorable. After careful selection, the market price of 15 preferential physical examination items is 1,043 yuan, and the executive price is 180 yuan (13% off, only the cost of reagents and equipment consumption).

Second, the project is highly practical. The 15 physical examination items are all required routine examinations for outpatient medical examinations and pre-admission examinations, and the examination results of second-level and above medical institutions are mutually recognized.

Third, it is highly selective. The 15 physical examination items are divided into 4 packages according to their applicable scope. Insured residents can combine them in any package according to actual needs.