Tips on the Policy of Medical Insurance for Major Diseases in Jinhua City
Release time:
2020-08-14
Jinhua City critical illness medical insurance policy tips
1, Who should participate in critical illness insurance?
Jinhua City basic medical insurance for employees and basic medical insurance for urban and rural residents should participate in critical illness insurance, not to participate in the basic medical insurance, not to participate in the basic medical insurance alone.
The critical illness insurance benefits are consistent with the effective time of the basic medical insurance benefits, and if the basic medical insurance benefits are interrupted or terminated, the critical illness insurance benefits are interrupted or terminated at the same time.
2, Major illness insurance premium composition
Major illness insurance premium consists of basic premium and optional premium.
Basic premium. According to the government, the unit financing ratio 60% , the insured individual contribution ratio 40% to raise, and basic medical insurance premiums combined. The basic premium for 2018 is determined to be 50 yuan per person.
Option to pay premiums. The establishment of a major illness insurance optional premium program is to improve the ability to protect major illness insurance. The optional premium for each ,100 yuan is paid by individuals within the specified time, up to ,3 .
3, What are the benefits after taking part in serious illness insurance? If
fails to pay the optional premium or has been paid for less than three consecutive years, for the compliance medical expenses above the critical illness insurance minimum payment standard (2018 is 1.9 yuan), the critical illness insurance will be reimbursed 75% , with a maximum reimbursement of 40 yuan.
For those who have paid the premium for three consecutive years and 1 consecutive years, the reasonable medical expenses above the minimum payment standard (1.9 yuan in 2018 ) will be reimbursed for 75% for serious illness insurance, with a maximum reimbursement of 60 yuan; for those who choose to pay 2 for three consecutive years, the reasonable medical expenses above the minimum payment standard (1 yuan in 2018 ) will be reimbursed 80% for serious illness insurance, and the maximum reimbursement will be 80 yuan. For three consecutive years, choose to pay 3 copies, reasonable medical expenses above the minimum payment standard (yuan in 2018 ) will be reimbursed for.85% of by serious illness insurance, and the reimbursement amount will not be capped.
4, Poor People's Serious Illness Protection Inclination Mechanism
For the extremely poor and the minimum living security family members, all counties (cities, districts) can provide subsidies through medical assistance for the following compliant medical expenses. The specific personnel shall be determined by the civil affairs department.
For poor people and family members with minimum living security, each county (city, district) shall fully subsidize and pay elective premiums, and for marginal family members with minimum living security and other special difficulties stipulated by the people's government at or above the county level, at least elective premiums shall be paid with full subsidies. The specific number of subsidies shall be determined by each county (city, district).
Other people with special difficulties in Jinhua city refer to the severely disabled with certificates and the mentally ill with certificates, and the number of premium paid is determined to be 1 .
5, optional premium payment method
optional premium payment is consistent with the basic premium collection period, and the number of optional premium payments is selected by the individual during the collection period. Urban insured persons can go to urban 7 banks (ICBC, Bank of China, Agricultural Bank of China, China Construction Bank, Jinhua Bank, Chengtai Bank, Postal Savings Bank) to sign agreements to withhold and pay premiums from their contracted bank accounts. 2018 2# November and September, urban insured persons can also pay optional premiums to the financial public payment platform through Jinhua People's Society APP . Other counties (cities) insured personnel according to the county (city) social security agencies to arrange the way to pay.. If the optional premium is not paid within the collection period, it is allowed to pay in the year of serious illness insurance, and the corresponding treatment of the optional premium in this year is not enjoyed, and the payment period can be calculated continuously. Cross-year, as interrupted, again choose to pay, the payment period recalculated.
This year's optional premium collection period is determined to be 2018 1# December 8 to 5 .
Jinhua City Original Large Supplementary Medical Insurance and Major Illicit Disease Insurance Policy Connection
2017 For insured persons who have paid the original large supplementary medical insurance fee, if the number does not exceed 3 , the number of optional premium number for 2018 shall be determined according to the original number, if it is necessary to increase the number of copies, a new entrustment withholding agreement shall be signed. If it exceeds 3 copies, it shall be calculated as 3 copies.
The amount of 50% (hereinafter referred to as the amount of 50% ) of the original large supplementary medical insurance fees paid in 2017 is used to offset the premium paid by 2018 , and the shortfall is made up within the prescribed payment period. If the amount of 50% is more than ,300 yuan, will not be refunded in 2018 . If the treatment of the original large supplementary medical insurance system is higher than that of the serious illness insurance system, the settlement shall be made according to the original large supplementary medical insurance system.
Preferential Policies Remind
Year May Those who pay the optional premium before the end of June will be directly entitled to the treatment of paying for three consecutive years.
2018 5 March 31 , inpatient medical expenses settled before the optional premium payment (2018 1 September 1 to 2018 5 May 31 Sunrise Hospital) can be re-settled and enjoy the corresponding serious illness insurance optional payment treatment.
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