城镇居民大病险不设封顶线 Urban residents large seepage path do not set a top line

我省近期将制定下发相关实施意见，保障范围参照新农合大病保险 In the near future will develop in our province issued by relevant implementation opinions,The scope of protection with reference to the new agriculture close a serious illness insurance

　　我省(山东)农民已有大病保险，城镇居民啥时能享受这项政策？24日，在全省县级公立医院改革试点暨新农合大病保险工作电视会议上，省人社厅相关负责人表示，近期我省将制定下发城镇居民大病保险工作实施意见。与新农合大病保险个人最高补偿20万元不同，城镇居民大病保险原则上不设封顶线。

Our province(shandong)Farmers have a serious illness insurance,Urban residents when what can enjoy this policy?24,At or above the county level in the trial reform of public hospitals and new farming together a serious illness insurance work conference on TV,Provincial people club hall officials say,In the near future will develop in our province issued by urban residents a serious illness insurance work implementation opinions.With the new agriculture close a serious illness insurance individual's highest 200000 yuan different compensation,Urban residents a serious illness insurance does not set a top line.

　　日前，国家发改委、卫生部、财政部、人力资源和社会保障部等部门公布了《关于开展城乡居民大病保险工作的指导意见》。近日，我省启动了新农合大病保险工作，2013年起参合农民可享受大病保险，但这项政策暂未覆盖城镇居民。

a,The national development and reform commission/The ministry of health/The ministry of finance/Human resources and social security departments announced[About urban and rural residents to carry out a serious illness insurance work guiding opinions].recently,Our province launched new farming together a serious illness insurance work,Since 2013, ginseng adds up to farmer can enjoy a serious illness insurance,But the policy temporary not covering urban residents.

　　“我们城镇居民啥时候能有大病保险啊？”患有尿毒症的省城居民许先生问出了许多市民的心声。“像我们这些没有固定工作的，患上这种大病，即使有医保，还是负担不起。”许先生无奈地说。

"What time can we urban residents have a serious illness insurance ah?"With uremic provincial capital residents make a gentleman asked out many city residents heart."As we these no fixed work,Suffer from this kind of a serious illness,Even with health care,Still can't afford."Mr. Xu said helplessly.

　　据悉，济南市参保居民一个医疗年度内在一级医疗机构住院医疗的，个人负担20%，居民医疗保险基金负担80%，起付线为200元；在二级医疗机构医疗的，个人负担35%，医保负担65%，起付线为400元；在三级医疗机构医疗的，个人负担45%，医保负担55%，起付线为700元。但济南目前没有单独的大病保险制度。

It is reported,Jinan ginseng protect residents a medical annual internal level medical institutions of medical treatment of be in hospital,Individual responsibility 20%,Residents fund of medical treatment insurance burden 80%,The fu biao since the line for 200 yuan;In the secondary medical institutions of medical treatment,Individual responsibility 35%,Health-care burden 65%,The fu biao since the line for 400 yuan;In the tertiary medical institutions of medical treatment,Individual responsibility 45%,Health-care burden 55%,The fu biao since the line for 700 yuan.But jinan there is no single serious illness insurance system.

　　“我们正在加紧制定城镇居民大病保险工作的实施意见。”24日，省人社厅相关负责人表示，我省将很快启动城镇居民大病保险工作。

"We are hustling serious illness insurance work for urban residents of the implementation opinions."24,Provincial people club hall officials say,Our province will soon start town residents a serious illness insurance work.

　　“坚持低水平起步，合理确定大病保险筹资标准。”该负责人表示，城镇居民大病保险将参照新农合大病保险的相关政策，合理确定保障范围，同时做好与基本医疗保险的衔接。其中，将重点保障个人负担部分超过一定额度的合规住院大额医疗费用，“原则上不设封顶线，实际支付比例不低于50%。”(记者 李钢 邢振宇)

"Adhere to start from a lower standard,Reasonable serious illness insurance financing standard."This person in charge said,Urban residents will be a serious illness insurance with reference to the new agriculture close a serious illness insurance policies,Reasonably determine the scope of protection,At the same time do well with the basic medical insurance of cohesion.the,The focus will be on individual burden share more than a certain limit of compliance in hospital large medical expenses,"In principle, do not set a top line,The actual payment proportion is less than 50%."(Reporter LiGang XingZhenYu)

新农合大病险出台实施方案 自付超8000元 补偿不低于50% New farmers together big on seepage path plan FuChao since 8000 yuan ($) compensation not less than 50%

　　24日，我省正式印发新农合重大疾病医疗保险工作实施方案。其中规定，20类重大疾病医疗费用经新农合报销后，个人负担的合规费用超过8000元的部分补偿比例不低于50%。此外，新农合大病保险还可以像新农合一样，实现一站式即时结报。

24,Our province issued by the official new farming together major disease medical insurance work plan.The provision,20 kind of major disease medical expenses after new farming together after submit an expense account,Individual responsibility compliance costs more than 8000 yuan of part of the compensation ratio not less than 50%.In addition,New farmers close a serious illness insurance can also like new farming as close,Realize one-stop instant "report.

　　24日下发的《山东省新型农村合作医疗重大疾病医疗保险工作实施方案(试行)》要求，重大疾病实行定点医疗机构确诊制度，其中，血友病须在省级新农合定点医疗机构确诊；儿童白血病、儿童先天性心脏病、耐多药肺结核、慢性粒细胞白血病、重性精神疾病、艾滋病机会性感染须在市级及以上新农合定点医疗机构确诊；其他13类疾病须在县级及以上新农合定点医疗机构确诊。确诊后，医疗机构要为大病患者出具诊断证明。

24 the issued by[Shandong province new rural cooperative medical major disease medical insurance work plan(trial)]requirements,The major disease diagnosis system to nod medical establishment,the,Hemophilia must be in the provincial new farming to nod medical establishment combined diagnosis;Childhood leukemia/Congenital heart disease in children/Resistance to many medicine tuberculosis/Chronic myeloid leukemia/Heavy sexual mental illness/AIDS opportunistic infection must be in the municipal and above new farming to nod medical establishment combined diagnosis;Other 13 diseases should be more than at or above the county level and the new agriculture close fixed-point medical institutions diagnose.After diagnosis,Medical institutions to patients with a serious illness issue certificate of diagnosis.

　　对补偿比例问题，方案规定，2013年，20类重大疾病医疗费用经新农合报销后，个人负担的合规医疗费用超出8000元的部分补偿比例不低于50%，8000元以内(含8000元)的合规医疗费用给予一定比例补偿，具体补偿比例通过招标确定。2014年起，新农合大病保险补偿比例由省卫生行政部门与承办保险服务的商业保险机构通过竞争性谈判或公开招标确定。

For compensation proportion issues,Scheme provisions,In 2013,,20 kind of major disease medical expenses after new farming together after submit an expense account,Individual responsibility compliance medical expenses exceed $8000 compensation ratio of not less than 50%,Within 8000 yuan(Including 8000 yuan)Compliance medical treatment charge gives certain proportion compensation,Specific compensation ratio determined through bid invitation.Since 2014,New farmers close a serious illness insurance compensation ratio by the provincial administrative department of public health and undertake insurance service business insurance institutions through the competitive negotiation or open tender determine.

　　此外，参合居民在即时结报定点医疗机构住院治疗的，出院结算实行新农合报销与新农合大病保险补偿一站式即时结报。在不能实行即时结报的定点医疗机构住院治疗的，则需先到统筹地区新农合经办机构办理新农合报销，再到商业保险经办机构办理新农合大病保险补偿。(记者 李钢 实习生 魏冉)

In addition,Ginseng adds up to residents in real-time and report to nod medical establishment of hospitalization,Discharge settlement practice new farming close to submit an expense account and the new agriculture close a serious illness insurance compensation one-stop instant "report.In real-time and can not follow the fixed-point medical institutions of hospitalization,Must be first come as a whole the area new farming joint agency orgnaization deals with new farming close to submit an expense account,To commercial insurance agency orgnaization deals with new farming together a serious illness insurance compensation.(Reporter LiGang interns wei mannequins)