The adjustment of the reimbursement standard for medical materials for basic medical insurance in Beijing will be officially implemented from today

  The cost of individual materials below 1,000 yuan is included in the basic medical insurance

  News from our newspaper (Reporter Xie Li) Recently, the Beijing Municipal Bureau of Medical Security issued the "Notice on Adjusting the Reimbursement Standards for Basic Medical Insurance Medical Materials". At that time, all individual expenses below 1,000 yuan will be included in the scope of basic medical insurance payment.

  It is understood that in order to further improve the city's basic medical insurance reimbursement standards for medical materials, improve the basic medical security level of the insured personnel, and reduce the burden of personal medical expenses, the Municipal Medical Insurance Bureau issued the "Regulations on the Management of Basic Medical Insurance for Urban Employees and Medical Service Facilities" Scope and Payment Standard Opinion Notice, to adjust the basic medical insurance reimbursement standard for medical materials.

The adjustment includes two aspects: on the one hand, the standard for all individual expenses to be included in the scope of medical insurance payment has been adjusted, from the original 500 yuan to 1,000 yuan.

On the other hand, the proportion of medical materials included in the payment scope of basic medical insurance has been adjusted. The proportion of medical materials with a single cost of more than 1,000 yuan (inclusive) included in the scope of basic medical insurance payment has been increased from 70% to 80%. 30% reduced to 20%.

  The implementation scope of the new policy is the city's basic medical insurance participants, including urban employees' basic medical insurance participants and urban and rural residents' basic medical insurance participants.

The city's publicly funded medical personnel shall follow the implementation.

The new policy will be officially implemented from January 1, 2023.

  It is reported that this policy adjustment does not include artificial organs, and artificial organs will implement the original reimbursement policy.

Medical materials other than artificial organs shall be implemented in accordance with the new policy.

In addition, when basic medical insurance insureds use selected products from centralized procurement, they shall follow the medical insurance reimbursement policy for selected products from centralized procurement.

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  The minimum payment standard for serious illness medical insurance is adjusted to 30,404 yuan

  News from our newspaper (Reporter Xie Li) The Beijing Municipal Medical Insurance Bureau recently issued the "Notice on Further Improving the City's Critical Illness Medical Insurance Policy", which clearly states that starting from 2023, the minimum payment standard for the city's critical illness medical insurance will be adjusted to 30,404 yuan.

For people in need, such as supporters in extreme poverty, objects of subsistence allowances, people with living difficulties, and people helping low-income families in urban and rural areas, the starting payment standard for serious illness medical insurance will be reduced by 50%.

  According to the Municipal Medical Insurance Bureau, in order to promote the complementary connection of the three systems of basic medical insurance, serious illness insurance and medical assistance, implement the principle of "insurance first and assistance later", and further improve the city's urban employee serious illness medical security mechanism and urban and rural residents' serious illness insurance system, since 2023 Starting from January 1, 2019, the starting payment standard for serious illness medical insurance in this city will be adjusted to 30,404 yuan.

After the basic medical insurance participants in this city enjoy the basic medical insurance benefits, the part of the self-paid medical expenses within the scope of the basic medical insurance policy that exceeds the minimum payment standard for serious illness medical insurance shall be included in the scope of serious illness medical insurance.

The objects of serious disease medical insurance are urban workers and urban and rural residents who participate in basic medical insurance in this city.

The cost of serious illness medical insurance is paid by the basic medical insurance funds for urban workers and urban and rural residents respectively.

  It is understood that the city's serious illness medical insurance implements "calculation by section and cumulative payment".

The basic medical insurance fund shall pay 60% of the personal self-pay medical expenses of less than 50,000 yuan (inclusive) for the part above the minimum payment standard (excluded); The fund pays 70%, with no upper limit.

For people in need, such as supporters in extreme poverty, objects of subsistence allowances, subsidized persons for living difficulties, and helpers for low-income families in urban and rural areas, the minimum payment standard for serious illness medical insurance will be reduced by 50%, and the part above the minimum payment standard (excluding) will add up to 50,000 The basic medical insurance fund pays 65% of the self-paid medical expenses within 50,000 yuan; the basic medical insurance fund pays 75% of the self-paid medical expenses exceeding 50,000 yuan.

  From January 1, 2023, the "one-stop" real-time settlement of the serious illness medical insurance expenses incurred by the basic medical insurance participants in the city at designated medical institutions.