The reporter learned from the National Medical Insurance Administration that today (2nd), five departments including the National Medical Insurance Administration, the Ministry of Education, and the National Health Commission issued a notice to launch a special campaign for children to participate in basic medical insurance.
By the end of 2024, more than 80% of newborns will be insured in the year of birth
Focusing on achieving the annual goal of more than 95% insurance coverage proposed in the "14th Five-Year Plan" for National Medical Security, the "Notice" clearly states that by the end of 2024, more than 80% of newborns will be insured in the year of birth.
By the end of the 14th Five-Year Plan period, the child insurance participation rate has increased steadily.
On the premise of keeping the child insurance policy relatively stable, focus on optimizing the insurance enrollment process for newborn children, simplifying the insurance registration process, improving services, putting forward targeted work requirements, and encouraging local exploration and innovation to improve the level of child insurance coverage. , protect children’s rights and interests and safeguard children’s health.
There will be 256 million insured children in 2023
Children are the hope of families and the future of the country and nation. Children's participation in basic medical insurance in accordance with the law is of great significance to ensuring the healthy growth of children. It is also an important guarantee for the happy life of millions of families.
Since the establishment of my country's urban and rural residents' medical insurance system, the number of insured children has increased steadily, with 256 million insured children in 2023.
The steady growth in the number of children participating in insurance has played a fundamental and fundamental role in protecting children's health rights.
But at the same time, there are also problems such as the numerous and long procedures for newborns to participate in insurance, a small number of parents who are not very aware of insurance, and some cities have not yet fully relaxed the household registration restrictions for resident children. It is necessary to further build consensus and form a joint effort among departments to promote children's insurance. Insurance participation levels have been further improved.
In order to safeguard children's rights and interests in medical security, the National Medical Insurance Administration, together with the Ministry of Education, the National Health Commission, the State Council Women and Children's Working Committee, and the All-China Women's Federation, studied and drafted the "Notice on Launching a Special Action for Children to Participate in Basic Medical Insurance."
Increase efforts to mobilize children to participate in insurance
Departments and units such as medical insurance, education, health, and women's federations at all levels must effectively increase publicity and mobilization efforts for insurance participation.
Medical insurance departments in various localities should mobilize childcare institutions, communities with childcare service functions, and employers that provide welfare childcare services to employees to strengthen insurance promotion for parents and other guardians of children, and promote and guide children to participate in basic medical insurance.
Medical insurance agencies at all levels should take the initiative to understand the insurance status of newborns when handling maternity medical expense reimbursement, and promptly publicize and mobilize insurance participation.
The medical insurance department should take the initiative to go deep into the community, etc., and focus on promoting policies suitable for children, so as to enhance parents' awareness of participating in basic medical insurance for their children in a timely manner.
Offices of women and children working committees at all levels should play their organizational, coordination, guidance, and supervision functions, and consolidate and increase the coverage of children's basic medical insurance for urban and rural residents as one of the key goals and tasks in implementing the "China Children's Development Outline (2021-2030)" .
Optimize the newborn insurance enrollment process
All localities should speed up the implementation of the integrated management of "birth as a matter of fact". For areas that have not yet been implemented, medical insurance, health and other departments should strengthen information sharing and promptly complete the insurance coverage for newborns.
In principle, newborns must participate in insurance and pay premiums according to regulations within 90 days after birth, and all medical expenses that meet the regulations incurred since the date of birth can be included in the scope of medical insurance reimbursement.
If individual coordination areas are inconsistent with the above regulations, they should be adjusted as soon as possible in accordance with the above regulations.
Encourage localities to explore the use of birth medical certificates to apply for newborn insurance, and apply for medical insurance codes through family accounts or handling agencies. Within 180 days after birth, the medical insurance codes can be used to directly seek medical treatment and settlement at designated medical institutions.
The medical insurance department instructs parents of newborns to promptly update their newborn’s insurance information after registering their newborn.
Carry out various types of medical assistance and insurance coverage for needy children who meet the funding requirements in a classified manner
On the basis of consolidating the level of hospitalization benefits, the level of outpatient medical insurance coverage for residents, including children, can be steadily improved based on the level of economic and social development and the affordability of the medical insurance fund.
Carry out the work of classifying and subsidizing the medical assistance and insurance for children in need who meet the funding conditions to ensure timely participation.
All localities should further implement the insurance policy for holding a residence permit, create conditions to relax the household registration restrictions for children to participate in insurance, and promote children with non-local household registration to participate in insurance in the place of permanent residence and student registration.
It is necessary to study and improve the incentive and restraint measures for insurance premiums, give full play to the role of family doctors, and include family doctors’ insurance mobilization services into the contracted service package.
Support insured employees to use their employee medical insurance personal accounts to pay personal contributions for their children to participate in resident medical insurance.
Support the development of pediatric medical services, protect children's health rights, and effectively improve the level of medical services.
Strengthen data sharing between departments
Medical insurance, education, health and other departments at all levels must coordinate and take the initiative to strengthen data sharing, timely and accurately grasp the insurance status of various types of children, and ensure that all children are covered.
It is necessary to continuously optimize the insurance enrollment process, and the medical insurance departments at the same level should register in the medical insurance information system at one time to reduce the number of errands for children's parents and other guardians to handle insurance; the medical insurance departments in the children's permanent residence, place of student registration, and place of household registration must coordinate and work together Co-management, breaking down data barriers, strengthening information sharing, timely analysis of the reasons why primary and secondary school students are not insured, and helping to coordinate solutions.
Medical insurance departments in various localities should proactively obtain information related to children such as planned immunization vaccination sites and village clinics, and promptly grasp the basic situation of children targeted for expansion.
In the next step, the National Medical Insurance Administration will work with the Ministry of Education, the National Health Commission, the Women and Children's Working Committee, the Women's Federation and other departments to guide and urge relevant departments in various places to carry out special actions for children to participate in basic medical insurance in accordance with the requirements of the "Notice" and effectively improve the coverage of children's insurance. level, protect children’s rights and interests, and safeguard children’s health.
(CCTV reporter Zhang Ping and Zheng Yizhe)