The reporter learned from Hunan Medical Insurance Bureau on the 7th that the Bureau, together with Hunan banking and Insurance Regulatory Bureau and other relevant departments, formulated the measures for the implementation of serious illness insurance for urban and rural residents in Hunan Province. The measures will be implemented from January 1, 2022, stipulating that urban and rural residents with basic medical insurance can enjoy serious illness insurance. After deducting the starting line of serious illness insurance, the maximum reimbursement proportion will reach 85%. The annual compensation limit of serious illness insurance will be increased by 100000 yuan to 400000 yuan compared with the previous period, and the serious illness insurance will not be capped for the extremely poor, the objects of subsistence allowances and the people returning to poverty. The method specifies that the payment scope of serious illness insurance is: the total hospitalization medical expenses of insured personnel exclude all self paid expenses other than the "three directories" of basic medical insurance, and the self paid expenses reimbursed by the basic medical insurance policy for urban and rural residents; The insured's medical expenses within the policy scope of accidental injuries without third party liability and traffic accidents without commercial insurance claims, as well as the medical expenses recognized by relevant departments and excluded by the third party in proportion, shall be included in the basic medical insurance payment (including the accidental injury insurance managed by commercial insurance entrusted by the medical insurance Department) according to the provisions of the basic medical insurance policy, The remaining medical expenses within the policy scope shall be included in the payment scope of serious illness insurance; The out of pocket expenses of outpatient service (including general outpatient service and special outpatient service), the out of pocket part of drugs paid by a single line, and other medical expenses not paid according to the basic medical insurance policy are not included in the payment scope of serious illness insurance. The Measures stipulate that for the medical expenses within the policy scope of the accumulated personal burden of the insured within a natural year, after deducting the starting line of serious illness insurance, the accumulated compensation shall be divided into four sections: 60% for the part of 0 to 30000 yuan (inclusive), 65% for the part of 30000 yuan to 80000 yuan (inclusive), 75% for the part of 80000 yuan to 150000 yuan (inclusive), and 85% for the part of 150000 yuan. After deducting the starting line of serious illness insurance, the reimbursement proportion of each section will be increased by 5 percentage points respectively. (outlook new era)
Edit：Yuanqi Tang Responsible editor：Xiao Yu
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