The deductible was reduced from 18,000 yuan to 16,000 yuan, and the "Spike Age Kang" was upgraded again in 2022

Text, photo/ Yangcheng Evening News all-media reporter Zhou Cong

On October 26, the Information Office of the Guangzhou Municipal People's Government held the 151st press conference in 2021 at the Guangzhou Smart City Operation Center, focusing on the release of the 2022 Guangzhou "Sui Shi Kang" commercial supplementary health insurance.

Deng Youman, Secretary of the Party Group of Guangzhou Medical Security Bureau, and the relevant person in charge of the Guangdong Branch of Chinese Life Insurance Co., Ltd., the chief insurer, released the relevant content of the 2022 Guangzhou "Sui Shi Kang" commercial supplementary health insurance.

Expand the reach of the population

In December 2020, Guangzhou Innovated pilot "Sui Shi Kang" commercial supplementary health insurance with Guangzhou characteristics. Guangzhou medical insurance insured insurance and claims are not limited to age, not limited to pre-existing symptoms, self-funded drugs are not limited to the scope of diseases, unlimited drug varieties reimbursement, focusing on the protection of self-paid medical expenses outside the scope of the medical insurance directory and personal out-of-pocket expenses within the scope of the medical insurance directory, and through the medical insurance system to achieve one-stop settlement.

In 2022, "Sui Shi Kang" will carry out insurance fees from November 1, 2021 to December 31, 2021, and the payment of benefits will begin on January 1, 2022. Deng Youman, Secretary of the Party Group of guangzhou Medical Security Bureau, introduced: On the basis of 2021, "Sui Shi Kang" will launch an upgraded version to further expand the scale of insurance, ensure the sustainability of projects, and improve the level of treatment.

In 2022, "Sui Shi Kang" basically achieved full coverage of Guangzhou's permanent residents. Persons who meet any of the following conditions can voluntarily apply for insurance.

First, those who have household registration in this city but do not participate in medical insurance in this city, such as the elderly who have moved their hukou to this city with their children, and those whose household registration in this city has gone to school and work in other places.

The second is to apply for and hold a residence permit in the city for 2 consecutive years, regardless of the restrictions of household registration and medical insurance, such as residents who have lived, worked and studied in the city for a long time.

The third is the personnel identified by the relevant departments of the city as seeing righteous and courageous deeds within the administrative region of the city. At the same time, it donates the premium of "Sui Shi Kang" to the centenarians and the brave people among the insured, and provides one-on-one exclusive services.

Added group insurance model

In 2022, the insurance methods of "Sui Shi Kang" include group insurance and individual insurance, of which enterprises and public institutions, individual economic organizations, social groups and other employers and collective economic organizations or villagers' committees can apply for insurance fees for those who belong to the applicable groups of "Sui Shi Kang". "Sui Shi Kang", which is "guided by the government and operated by the business", belongs to supplementary medical insurance, and the premium can be paid before tax when the enterprise group is insured, which is one of the measures to benefit enterprises and heat enterprises.

By optimizing insurance and realizing the diversification of insurance application methods, the coverage and participation rate of "Sui Shi Kang" can be comprehensively improved, and the benign and sustainable development of "Sui Shi Kang" can be guaranteed.

Improve treatment and add preferential treatment policies

Moderately reduce the deductible. The three treatments of "Sui Shi Kang" basic medical expenses for inpatient and outpatient specific diseases, inpatient self-paid drug expenses and inspection and examination costs, outpatient use of state-negotiated drugs and designated innovative drugs self-payment compensation, the deductible is reduced from 18,000 yuan to 16,000 yuan, and the deductible for other self-paid drug cost compensation in outpatient clinics is reduced from 50,000 yuan to 45,000 yuan. The reduction of the deductible, on the one hand, allows more insured people to enjoy reimbursement, and it is expected that about 20,000 people will enjoy new treatment; on the other hand, more will be reimbursed by the insured people who have already enjoyed corresponding treatment, further reducing the burden of medical expenses of the insured people, improving the level and accessibility of treatment protection, and allowing more people to really benefit.

Add preferential treatment policies for special groups.

First, for patients with schizophrenia who are on the list of long-acting injection treatment for schizophrenia patients identified by the municipal health department, who take drugs irregularly or have schizophrenia of level 3 or above, the cost of using long-acting injections will be reimbursed 100% of the personal burden after medical insurance reimbursement, there is no deductible, there is no annual maximum payment limit, promote social harmony and stability, strengthen the responsibility of "Sui Shi Kang", improve the level of mental health service capacity and social governance modernization level in Guangzhou, and help the construction of "Safe Guangzhou";

Second, the relevant departments of the city have identified the righteous courage as personnel in the administrative region of the city, because the righteous courage suffered personal injury, during the treatment period of medical expenses, nursing expenses and other compliant medical expenses, the personal burden part will be reimbursed 100%, there is no deductible, the maximum annual payment limit of 100,000 yuan. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)

Source | Yangcheng Evening News Yangcheng Pie

Editor-in-charge | Chen Qian