What medical reimbursement policies do low-income households enjoy?

What are the low-income medical assistance policies?

1, medical expenses reduction.

Poverty-stricken dependents, minimum living security personnel, and people with financial difficulties can enjoy the reduction of% of the basic operation fee,% of the examination fee for CT and MRI equipment, and% of the ordinary hospital bed fee.

2. Outpatient assistance.

Outpatient expenses incurred by urban and rural subsistence allowances and low-income people who do not enjoy the basic medical insurance for employees shall be reimbursed by the residents' basic medical insurance or the new rural cooperative medical system, and the personal burden shall be given medical assistance by the civil affairs department according to the proportion of 7%, and the annual assistance shall be capped.

3. Rescue of major diseases.

Outpatient or inpatient medical expenses caused by major diseases of social assistance objects. After reimbursement by medical insurance or the new rural cooperative medical system, the personal burden will be given by the civil affairs department at the rate of 7%, and the maximum amount of accumulated assistance for the whole year is 80,000 yuan.

There are many kinds of rescue diseases.

Malignant tumor, end-stage renal disease, severe mental illness, type I diabetes, congenital heart disease, leukemia, hemophilia, aplastic anemia, organ transplantation (heart, lung, liver, kidney); Multi-drug tuberculosis, acute myocardial infarction, cerebral infarction, hyperthyroidism, cleft lip and palate, AIDS opportunistic infection (new).

5. Maternity assistance.

Poor pregnant women who enjoy social assistance and hold the birth certificate issued by the health and family planning department of this Municipality will be given birth assistance by the civil affairs department according to the standards that the check-up assistance during pregnancy does not exceed RMB, the hospitalization assistance during normal delivery does not exceed RMB, and the hospitalization assistance during cesarean section does not exceed RMB.

6, hospital deposit reduction and immediate settlement.

Urban and rural residents and low-income people really need to be hospitalized. In designated medical institutions, you can enjoy 7% reduction of hospitalization deposit. Among them, urban "three noes" personnel, rural five-guarantee personnel and civil affairs department management personnel can enjoy the reduction or exemption of hospitalization deposit. The personal burden after reimbursement by medical insurance or the new rural cooperative medical system will be paid by designated medical institutions in proportion, and urban and rural low-income people can go through the discharge formalities only by paying the actual burden.

Minimum living security medical assistance object

Anyone who has permanent residence in this county and whose basic life is affected by medical treatment and meets one of the following conditions may apply for medical assistance.

1, urban subsistence allowance;

2, rural residents, five objects;

3. Other special difficulties require medical assistance. Urban residents (hereinafter referred to as "three noes" in cities and towns), rural five-guarantee recipients, key special care recipients and disabled people who have no source of income, no ability to work and can't support (support, raise) people are given priority to enjoy medical assistance under the same conditions.

Proportion of reimbursement for life medical assistance

Proportion of hospitalization reimbursement for low-income households: low-income households and low-income groups will be reimbursed according to the medical insurance types they participate in according to the principle of "insurance first and assistance later", and the rest can apply for medical assistance, that is, 60% will be reimbursed. Most of these people participated in the "one old" or unemployed residents' medical insurance, and the original hospitalization reimbursement amount was 60%; So these people are reimbursed 84%.

How much is the low-income medical assistance?

1. The medical expenses incurred by low-income residents in hospitalization, general outpatient service and special outpatient service are personal burdens after enjoying social security medical insurance benefits (excluding hospitalization deductible line), and after deducting the part that the reimbursement ratio is reduced due to the violation of medical insurance regulations and purely self-funded projects, it will be paid by the low-income medical assistance fund;

2, the basic medical insurance hospitalization Qifubiaozhun paid in full by the municipal medical assistance; After enjoying the social security maternity medical treatment according to the regulations, the minimum medical assistance fund will give a one-time subsidy according to 50% of the social security maternity medical treatment standard.

3, the minimum target per person per year to enjoy medical assistance is 80 thousand yuan (excluding the payment of social basic medical insurance).

How to apply for low-income medical assistance

It can be simply summarized as: individual application, township (street office) audit, and county-level civil affairs department approval.

1, application procedures. Urban and rural residents who hold local permanent residence, the per capita income of family members living together is lower than the local minimum living guarantee standard for urban and rural residents, and the family property status meets the minimum living guarantee conditions stipulated by the local people's government, have the right to apply for the minimum living guarantee directly to the township people's government (street office) where the household registration is located; Township People's governments (street offices) shall not refuse to accept it without justifiable reasons. Entrusted by the minimum living guarantee applicant, the village (neighborhood) committee may submit the application on its behalf. To apply for the minimum living guarantee, it is necessary to take the family as a unit, submit relevant materials in accordance with the regulations, state the family income and property status in writing, and sign by the applicant for confirmation.

In any of the following circumstances, the applicant may apply separately:

(1) adults with severe disabilities who have difficulties in living and lose their ability to work.

(2) Religious clergy who have been separated from their families and have lived independently in religious places for more than three years (including three years) and have difficulties in living.

2. Audit procedures. The township (town) people's government (street office) is the main body responsible for reviewing the application for minimum living security. With the assistance of the village (neighborhood) committee, organize village cadres, community subsistence allowances professionals and other staff to investigate and verify the applicant's family economic situation and real life one by one by means of information checking, field visits and neighborhood visits, and verify the authenticity and completeness of the application materials and statements in detail. After the investigation, the investigators shall fill in the family economic status.

3. Democratic appraisal. After the household survey, the Township People's Government (street offices), with the assistance of the village (neighborhood) committee, made democratic comments on the objectivity and authenticity of the survey results of the applicant's family economic situation in the village (community) as a unit.

4. Approval procedure. Civil affairs departments at the county level are responsible for the examination and approval of minimum living security. Before making a decision on examination and approval, it is necessary to conduct a comprehensive review of the investigation materials and audit opinions (including the results of democratic appraisal) reported by the township (town) people's government (street offices), and conduct spot checks at home in accordance with the proportion of not less than 30%; Under the authorization of the applicant, you can also check the economic status of the families applying for subsistence allowances reported by the township (town) (street office) through the family economic status check institution at the same level or at a higher level. It is strictly forbidden to directly bring any group or individual into the scope of minimum living guarantee without approval procedures.

5. Publicity procedures. In the process of examining and approving the minimum living guarantee for urban and rural residents, we should strictly implement the publicity system for examining and approving the minimum living guarantee, and standardize the content, form and time limit of publicity. The township (town) people's government (street offices) should set up a fixed publicity column in the resident and village (community) to publicize the minimum living security policy and approval process, as well as the county and township consultation hotline, and publicize the results of household survey, democratic appraisal and audit. The civil affairs department of the people's government at the county level shall announce the family members, income and amount of the minimum living guarantee object to the public through effective forms such as permanent public signs or electronic display screens in townships (towns, streets) and villages (communities). In the publicity, we should pay attention to protecting the personal privacy of the minimum living guarantee object, and it is strictly forbidden to disclose information unrelated to enjoying the minimum living guarantee.

6. Allocation procedure. The minimum living security funds for urban and rural residents shall be earmarked and closed, and distributed in the form of socialized distribution by banks. The minimum living security funds shall be paid directly to family account in accordance with the financial treasury management system, so as to ensure that the minimum living security funds are paid in full and on time.

How long will it take for the low-income medical assistance to come down?

Medical civil assistance shall be applied within the specified time every year. From the declaration to the end of the examination and approval, there is no specific provision, and there is no commitment of about three months. The amount of assistance is determined according to medical expenses and family difficulties, and there is no fixed standard.

How to apply for medical assistance for serious illness

To apply for medical assistance for serious illness, the object must first submit a written application, fill in the application form for urban and rural medical assistance, and provide the following supporting materials, as follows:

1. Original and photocopy of ID card and household registration book;

2. The original diagnosis name and valid medical invoice of the medical institution;

3, special care, subsistence allowances, disabled persons to provide the original and photocopy of the relevant documents, among them, retired and on-the-job workers need to provide proof of the unit's salary, laid-off workers need to provide unemployment certificates.

Take the above materials to the village Committee for preliminary examination, and submit the materials and audit opinions to the town civil affairs office for audit. After layers of examination and approval, those who meet the conditions for assistance can be issued by the Civil Affairs Bureau.

1. What policies do low-income households enjoy?

The treatment enjoyed by low-income households: low-income funds, medical subsidies for low-income households, school subsidies, housing and heating subsidies, and temporary assistance.

1, low premium.

2. Medical care: The low-income households will receive a medical card while applying for the minimum living allowance, and they will enjoy relevant assistance when they are hospitalized, and they will also enjoy medical assistance for serious illness or secondary medical assistance.

3. Going to school: In other words, students from Aberdeen families should enjoy partial tuition fee remission.

4. Housing: At present, only low-income households without housing can enjoy certain rental subsidies if they rent outside.

5. heating: enjoy partial reduction of heating costs.

6. Temporary relief: temporary subsidies uniformly distributed by the state. For example, if the price of vegetables rises, the state will uniformly distribute subsidies for vegetables. Then there are temporary personal subsidies issued by local civil affairs departments such as natural disasters and man-made disasters.

Low-income households refer to families whose per capita monthly income is lower than the minimum living standard of this Municipality and enjoy the national minimum living allowance.

Second, is there a difference between poor households and low-income households in seeing a doctor in a hospital?

There is no difference between poor households and low-income households in seeing a doctor in a hospital.

Conditions for identifying poor households in poverty alleviation:

1, major disaster, loss of living security;

2, the occurrence of major diseases, loss of ability to work, resulting in poverty due to illness;

3. Physical disability and inability to work;

4. Many children are studying in high schools or full-time colleges and universities.

5. Minor orphans;

6. Two families with difficulties are tied up;

7. The families of martyrs came from poor families, old party member and old village cadres.

Determine the conditions of low-income families:

1, a resident (village) with no source of income, no ability to work, no dependents or dependents.

2 residents who have received unemployment benefits or have not been re-employed after the expiration of unemployment benefits, and the per capita income of their families is lower than the minimum living standard.

3. Residents whose family income is still lower than the security standard after on-the-job workers and laid-off workers receive wages or minimum wages, basic living expenses and retirees receive pensions. According to the relevant provisions of the state to enjoy preferential treatment, the pension and quota supplement are not included in the family income.

3. How much medical expenses can the low-income households overdraw in advance?

Low-income and low-income groups intend to be reimbursed according to the medical insurance types they participate in according to the principle of "insurance first, then assistance", and the rest can apply for medical assistance, that is, reimbursement of%. It is understood that most of these people participate in the "old" or unemployed residents' medical insurance, and the original hospitalization reimbursement amount is%; So these people are reimbursed 8%. In addition, outpatient expenses can be calculated according to hospitalization expenses: outpatient medical expenses for taking anti-rejection drugs after radiotherapy and chemotherapy, renal dialysis and kidney transplantation (including combined liver and kidney transplantation); Emergency observation and hospitalization, medical expenses incurred within 7 days before hospitalization; To observe the medical expenses of emergency rescue patients who died within 7 days before their death.

Legal basis: Article 26 of the Social Insurance Law of People's Republic of China (PRC), the treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Article 25 The state establishes and improves the basic medical insurance system for urban residents. The basic medical insurance for urban residents combines individual contributions with government subsidies. People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.