In order to effectively prevent poverty and return to poverty due to illness, the Opinions on Deepening the Reform of Medical Security System issued by the Central Committee of the Communist Party of China and the State Council were implemented to help Zaozhuang improve the multi-level medical security system. Directed by Zaozhuang Medical Insurance Bureau, supervised by Zaozhuang Supervision Branch of Bank of China Insurance Regulatory Commission, and jointly underwritten by Zaozhuang Central Branch of China Pacific Life Insurance Co., Ltd. and several insurance companies, the "Zao Bao Hui" project was officially launched.
"Jujube Bao Hui" project benefits the people with low threshold and high insurance coverage. Its characteristics of not limiting health status are particularly friendly to serious diseases, as long as Zaozhuang's basic medical insurance meets the purchase conditions. "Jujube Bao Hui", as the exclusive security welfare of Zaozhuang citizens, is closely related to the needs of citizens, with comprehensive security, showing three characteristics, and the maximum security can reach 365,438+10,000 yuan. Bao Hui medical insurance is paid by individual account, and can be insured and compensated for illness, regardless of age and occupation. The premium is 99 yuan/person/year, and the personal medical insurance account can pay for the whole family.
I. Responsibility 1
Cost guarantee within the overall scope of hospitalization medical insurance. During the insured period, the medical expenses incurred by the insured in the hospitalization of designated medical institutions for medical insurance within the scope of the basic medical insurance policy, after being reimbursed by the basic medical insurance, serious illness insurance, preferential poverty alleviation insurance, etc., shall be paid by the individual according to the agreed proportion. (excluding the self-sufficient part of Class B).
Two. Responsibility 2
The expenses beyond the overall scope of hospitalization medical insurance guarantee During the insurance period, the necessary and reasonable medical expenses (including self-care, out-of-price, out-of-catalog pure self-expense, except special drugs) outside the overall scope of basic medical insurance incurred by the insured in the designated medical institutions of medical insurance shall be paid according to the agreed proportion.
Three. Responsibility 3
Outpatient specific high drug safety. During the insurance period, the insured needs to use 1 6 kinds of special drugs in the Catalogue of Special and High-priced Drugs in Zaohuibao Outpatient Department (Annex1) which meet the disease indications, usage and dosage, and purchase them in the designated hospital outpatient department or pharmacy, and the expenses incurred will be paid according to the agreed proportion after deducting the agreed deductible.
Four. Responsibility 4
Drug guarantee for rare diseases. During the insurance period, the insured was diagnosed and prescribed by a specialist (Note 4) in a designated tertiary hospital in Zaozhuang City due to illness, and purchased the specific rare disease drugs in the Catalogue of Rare Diseases Drugs in Bao Hui, Zaozhuang (Annex 2) in a designated retail drugstore, and paid according to the agreed proportion after deducting the agreed deductible.