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According to a press conference held by the Information Office of Shenyang Municipal Government on December 13, the Implementation Measures for Shenyang's Improvement of Medical Insurance and Assistance System for Serious and Extraordinarily Serious Illnesses (hereinafter referred to as the Implementation Measures) will be fully implemented
in the administrative area of Shenyang from January 1, 2023 。
The Implementation Measures fairly cover employees in difficulty and urban and rural residents with a heavy burden of medical expenses, strengthen the comprehensive protection of supplementary medical insurance and medical assistance such as basic medical insurance and serious illness insurance in accordance with the principle of "insurance before assistance", focus on reducing the burden of medical expenses for serious and extraordinarily serious diseases of people in difficulty, establish and improve long-term mechanisms for preventing and resolving poverty and returning to poverty due to illness, and ensure that the basic medical care of people in difficulty is guaranteed and that their basic lives
are not affected by serious and extraordinarily serious diseases 。
The "Implementation Measures" mainly includes general provisions, medical assistance for people in difficulty, medical assistance for patients with serious illnesses caused by illness, monitoring mechanisms for poverty and poverty return due to illness, participation of social forces in aid guarantees, medical aid handling services, medical aid fund management, departmental responsibilities and supplementary provisions
.
In terms of expanding the scope of medical assistance recipients, the Implementation Measures establish a more comprehensive, long-term and systematic assistance mechanism based on the new development stage after comprehensive poverty alleviation, expand the scope of medical assistance targets to employees in difficulty and urban and rural residents, and uniformly standardize the recipients of assistance as people in extreme poverty, orphans (including de facto unsupported children), subsistence allowance recipients, marginalized family members of subsistence allowances, people who have been lifted out of poverty, and people in difficulty who do not meet the conditions of extremely poor persons, subsistence allowances or marginal families with dibao.
However, due to high medical expenses, serious difficulties in the basic life of the family are caused by illness
.
The Implementation Measures regulate the policy standards
for medical assistance.
The first is the subsidized insurance policy
.
Special hardship persons, orphans, subsistence allowance recipients, and people who have been lifted out of poverty will be fully subsidized for the part of the individual contribution to participate in the resident medical insurance, and 60% of the portion of the individual contribution of marginalized family members participating in the domestic medical insurance will be subsidized
.
The second is the scope of
medical assistance costs.
The medical assistance fee mainly covers the hospitalization expenses incurred by the aid recipient in the designated medical institution, the cost of long-term medication due to chronic diseases or the expenses
requiring long-term outpatient treatment due to serious and extremely serious diseases.
Strictly implement the national and provincial medical security treatment list system, and pay for drugs, medical consumables, and diagnosis and treatment items in accordance with relevant national and provincial regulations
.
The third is the medical assistance model
.
The dual assistance model of basic assistance and inclined assistance has been implemented for people in need, and the level of medical assistance for people in extreme poverty and orphans has been significantly improved, and it is expected to increase by about 10 percentage points
.
Among them, full assistance
will be provided to eligible medical expenses incurred by the hospitalization of medical assistance recipients suffering from serious mental disorders.
One-time medical assistance
is provided to patients who are seriously ill due to illness.
The "Implementation Measures" also improves the convenience of enjoying medical assistance: First, insurance participation is informatized
.
By strengthening departmental coordination, realizing information sharing and linkage among people in difficulty, and conducting real-time comparison and update, the medical insurance system automatically handles insurance renewal for people in difficulty, realizing the due insurance
.
The second is to realize a single system
for settlement.
Relying on the medical security information platform, the "one-stop service, one single settlement" of basic medical insurance, serious illness insurance and medical assistance is realized, and the needy people only need to pay the expenses that should be borne by themselves, and do not need to run errands and advance funds
.
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