According to the requirements of national insurance, all people who meet the requirements of participating in residents' medical insurance must participate in the insurance.
2. What is the payment standard for urban and rural residents in Xingtai in 2022?
In 2022, the individual payment standard of medical insurance for urban and rural residents will be 320 yuan, and the long-term care insurance will be charged in 5 yuan per person according to regulations.
3. How should Xingtai urban and rural residents pay for insurance?
Insured residents can withhold and pay at the neighborhood committees and village committees where their household registration is located, or pay by paying attention to Hebei Taxation, the official WeChat account of Xingtai Medical Insurance Bureau or the designated window of the tax department.
4. How do residents who are insured for the first time get insured?
New insured residents need to go to the medical insurance agency where the household registration is located to handle the new insurance procedures. After the resident medical insurance agency pushes the insurance information to the tax department, it will pay the fee according to the requirements of the tax department.
5. What should newborns pay attention to when participating in insurance?
202 1 registered newborns enjoy the welfare of 202165438+February 3 1. For example, newborns born on 202 1 will not be able to re-apply for neonatal insurance and enjoy treatment on 202 1 if they do not register for neonatal insurance but apply for insurance directly in 2022.
6. When will urban and rural residents begin to enjoy treatment in 2022?
Residents who pay insurance premiums during the centralized collection period will enjoy normal treatment from June 65438+1 October1. Residents who pay insurance premiums overdue shall enjoy treatment from the date of payment by the tax authorities.
7. What should I do if I can't find the information when I pay?
No personnel information can be found at the time of payment, and payment cannot be made normally. I should hold my ID card to the resident medical insurance agency of the original insured place for information inquiry. If there is any information error, the corresponding information should be modified. After the improvement, the resident medical insurance agency will push it to the tax department, and the tax department will pay the fee after adding people. If you really can't find the previous insurance information, you need to go to the medical insurance department to add personnel.
8. In 2022, after the urban and rural residents in Xingtai City are insured normally, what is the hospitalization deductible line and reimbursement ratio?
Since September 2002 1 and1,the policy of "no place in the province" has been implemented, and all medical records in different places in the province have been completely cancelled. When seeking medical treatment in other co-ordination areas in the province, the deductible line will no longer be raised, the reimbursement ratio will be reduced, and the policy of equal treatment will be implemented in medical institutions at the same level.
Inpatient deductible line: the first-level medical institution in the province 100 yuan, the second-level medical institution in 400 yuan, and the third-level medical institution 1000 yuan; Medical institutions outside the province normally put on record 2500 yuan.
Within the scope of the policy, the proportion of medical expenses paid is: 90% for first-class medical institutions, 80% for second-class medical institutions and 65% for third-class medical institutions in the province; 50% of medical institutions transferred to other provinces for normal filing. The maximum annual payment of the basic medical insurance for urban and rural residents is 6.5438+0.5 million yuan.
The reimbursement rate for medical treatment outside the province without filing procedures is 3000 yuan and 40%.
9. In 2022, after the urban and rural residents in Xingtai City are insured normally, what is the reimbursement ratio of general outpatient service?
There is no deductible line for outpatient co-ordination, and the reimbursement rate is 60%. The reimbursement rate of Chinese medicine technology and Chinese herbal pieces in the catalogue is 80%. The annual maximum limit line of outpatient co-ordination is 400 yuan, and the maximum payment limit at village level is 70 yuan. Family members can't use it together.
10. How to declare special chronic diseases in outpatient department?
Insured residents can use WeChat official account "Hebei Medical Insurance Bureau" → public service → Hebei smart medical insurance platform → personal network hall → on-site special declaration, or WeChat official account "Xingtai Medical Insurance Bureau" → business handling → Hebei smart medical insurance platform → personal network hall → on-site special declaration.
After passing the identification, they will be treated in the designated hospitals for chronic diseases in the city and the designated hospitals above the second level in the province, and will be reimbursed immediately.
1 1.2022 What treatment do urban and rural residents in Xingtai enjoy for special chronic diseases?
After the outpatients with special chronic diseases are recognized, they belong to outpatient examination and diagnosis when they seek medical treatment. The Qifubiaozhun for drugs within the scope of outpatient special chronic diseases is in 400 yuan, and the proportion of overall fund payment is 60%. Suffering from various outpatient special chronic diseases, only one deductible is deducted, and the maximum is not more than 1 10,000 yuan/year.
12. what is the reimbursement limit for special chronic diseases and specific diseases in outpatient department?
1, the diabetes limit is 4500 yuan; 2, cerebral hemorrhage, cerebral infarction, cerebral thrombosis limit of 3000 yuan; 3, chronic obstructive emphysema limit 2500 yuan; 4, chronic moderate and severe viral hepatitis limit 3000 yuan; 5, tuberculosis limit 2000 yuan; 6, mental illness limit 1000 yuan; 7. AIDS is limited to 7,000 yuan; 8, high-risk hypertension grade III and the upper limit of 3000 yuan; 9. Heart disease complicated with cardiac insufficiency is limited to Grade II, with an upper limit of 3,000 yuan; 10, the limit after coronary artery stent implantation for coronary heart disease is 3000 yuan; 1 1, the limit of Alzheimer's disease is 4,000 yuan; 12, the limit of nephrotic syndrome is 2000 yuan; 13, myasthenia gravis is limited to 3000 yuan; 14, epilepsy limit is 3000 yuan; 15, the decompensated stage of liver cirrhosis is 4000 yuan; 16, Parkinson's syndrome limit 10000 yuan; 17, systemic lupus erythematosus limit 10000 yuan; 18, limit of aplastic anemia 10000 yuan; 19, malignant tumor limit 10000 yuan; 20, hemophilia limit 1 ten thousand yuan; 2 1, and the limit of anti-rejection treatment after organ transplantation is 10000 yuan; 22, chronic renal failure limit 1 ten thousand yuan.
13.2022 how to reimburse the maternity after the urban and rural residents in Xingtai city are insured normally? What are the specific standards?
The medical expenses incurred by the insured residents in hospital delivery within the scope of the family planning policy shall be included in the payment scope of the hospitalization pooling fund of the basic medical insurance for urban and rural residents, and the maximum payment limit shall be set. The specific criteria are: singleton 500 yuan, multiple births 800 yuan, 2,000 yuan for singleton by caesarean section and 2,500 yuan for multiple births by caesarean section.
14.2022 Can the outpatient consultation fee be reimbursed after the urban and rural residents in Xingtai are insured normally? How to reimburse?
When the insured payer holds the social security card to see a doctor in the general outpatient department of a public designated medical institution, the medical insurance pooling fund will pay the outpatient treatment fee according to the prescribed medical insurance reimbursement standard. Among them, the reimbursement standards for TCM syndrome differentiation and treatment are: the municipal designated medical institutions that implement provincial-level charging standards reimburse 20 yuan, and the municipal designated medical institutions that implement municipal-level charging standards reimburse 16 yuan; Other outpatient expense reimbursement standards are: provincial designated medical institutions 14 yuan, and municipal designated medical institutions 9 yuan.
15. What is the coverage period of critical illness insurance?
Within the administrative area of Xingtai City, the time limit for urban and rural residents to participate in insurance in that year is a natural year.
16.2022 What is the reimbursement ratio of the serious illness insurance for urban and rural residents in Xingtai after normal participation?
Ordinary insured people. The deductible line of serious illness insurance for urban and rural residents in Xingtai City is 1 10,000 yuan, and the ceiling line is 500,000 yuan per person per year. Pay in installments according to the following proportions: 60% to 6,543,800 yuan from the deductible; 65438+100000 yuan to 200000 yuan to pay 65%; More than 200,000 yuan is given to 70% of the top line.
The poor people who initially set up files and set up cards. The proportion of poverty-stricken people with the establishment of the card was increased by 5 percentage points, and the deductible line and the capping line were cancelled. The adjustment of the poverty alleviation policy of medical security shall be implemented in accordance with the relevant documents of provinces and cities.
17. What is the "two diseases" policy of medical insurance for urban and rural residents?
Urban and rural residents with hypertension and diabetes can apply for outpatient treatment of "two diseases" in public medical institutions designated by secondary and below medical insurance, and the responsible doctors can be included in the scope of protection of "two diseases" after approval. The reimbursement rate within the scope of the drug policy for lowering blood pressure and blood sugar in the outpatient department of the insured object is 50%, and there is no deductible. The maximum payment limit of the overall fund is 225 yuan/year/person for hypertension and 375 yuan/year/person for diabetes.
18. How to handle the inter-provincial medical treatment and hospitalization record?
Through WeChat official account "Hebei Medical Insurance Bureau"-Hebei Smart Medical Insurance-registration-cross-provincial medical record, or through WeChat official account "Xingtai Medical Insurance Bureau"-business handling-Hebei Smart Medical Insurance-registration-cross-provincial medical record, the record can be realized after discharge. The filing date needs to be filled in on the day of hospitalization or a few days in advance. If you fail to report immediately after discharge due to special reasons and return to the insured place for reimbursement, the individual will pay all the expenses in advance. After the discharge settlement, you should go through the reimbursement procedures with the reimbursement materials to the insurance agency within 30 days.
Policy consultation telephone number for urban and rural residents: Municipal Medical Insurance Center 3690050.
Information system consultation telephone number: Municipal Bureau Information Office 2626898