How Do I Write an Expense Reimbursement Policy?

"Second reimbursement" refers to residents of urban residents' medical insurance or NCMS. If there was a high cost of seeing a doctor in the previous year, in addition to the normal reimbursement, major illness insurance can be reported again, and there is no cap line. ^{[1] In} general, the reimbursement is reimbursed by the unit where the citizen is located.

Reimbursement

On January 1, 2014, the Beijing Municipal Government Information Office issued the Trial Measures for the Critical Illness Insurance of Urban and Rural Residents in Beijing. This new policy was implemented on January 1 and benefited 4.14 million people. ^[1]

Addressing poverty due to illness

Establishing a major illness insurance system is a task of the city's medical reform work in 2013, which was included in the municipal government's project. On December 24, 2013, the municipal government executive meeting discussed and approved the city and rural residents' major illness insurance policy, which was officially announced yesterday.

According to the Municipal Medical Reform Office, in recent years, the basic medical insurance treatment for urban and rural residents in this city has significantly improved. The per capita funding standard has increased from 180 yuan in 2008 to 680 yuan in 2012. However, it is undeniable that some people are suffering from major diseases, After the catastrophic medical expenses occurred, they fell into the plight of being sick due to illness and returning to poverty due to illness, and some people even had to give up treatment. The public's heavy burden of medical expenses for serious illnesses is still relatively strong.

Urban and rural residents' critical illness insurance is a supplement to medical insurance. It is an institutional arrangement that further protects the high medical expenses and catastrophic expenses incurred by the masses due to major diseases. In order to minimize the incidence of poverty due to illness and return to poverty due to illness, the municipal government decided that this new policy does not set a cap line, so that patients with serious illness can get as much compensation as possible, and reduce the burden on individuals and families. ^[1]

Financial investment does not increase the burden on residents

After the increase of medical insurance, where will the increased funding come from? Director Han Xiaofang made it clear that this part will be financed. The government's per capita investment is increasing every year. In 2014, the per capita funding will reach 1,000 yuan, and the government's per capita investment is 860-900 yuan.

Critical illness medical insurance

Can be used with medical assistance

When encountering difficult and special conditions, residents often take medicine beyond the scope of medical insurance, and cannot enjoy the medical insurance policy for serious diseases. How will they get assistance? Director Han Xiaofang said that this is a problem that the level of protection is still limited at this stage, and major illness medical insurance can only solve some basic problems.

Residents' health insurance and NCMS staff

Who can enjoy this benefit policy? Han Xiaofang, director of the Municipal Medical Reform Office, introduced that these measures apply to those who participate in the basic medical insurance for urban residents and new rural cooperative medical care in this city.

There are three main types of medical insurance in this city. One is the basic medical insurance for urban employees, the other is the basic medical insurance for urban residents with one old, one small and unemployed resident, and the other is a new rural cooperative medical system with peasants as the main body. . The critical illness insurance covers the latter two categories.

This is because on the one hand, the reimbursement ratio and capping line of employee medical insurance are relatively high, and poverty caused by serious illness is very rare; on the other hand, most of the poverty caused by illness occurs in groups such as the elderly, children and farmers. The difficulties of these people. The total number of these two types of participants is 4.14 million.

Where does the funding for critical illness insurance come from? Urban residents 'critical illness insurance funds are pooled across the city, and the urban residents' basic medical insurance fund is allocated according to the 5% of the current year's funding standard; rural residents 'critical illness insurance funds are implemented by the district and county, and the districts and counties' new rural cooperative medical funds are based on the 5% Quota allocation. In 2014, the per capita funding standards for urban residents' medical insurance and the New Rural Cooperative Medical Service will be raised from the current 680 yuan to 1,000 yuan. Allocating funds for major illness medical insurance at a rate of 5% will raise the per capita funding standard for major illness insurance to 50 yuan.

More than 4 million people each have a funding standard of 50 yuan, and the total funding for critical illness insurance in 2014 was more than 200 million yuan. The critical illness insurance fund is included in the special financial account of the Social Security Fund, which is separately accounted for and the special fund is used exclusively. ^[1]

1. Does this insurance resident need to pay extra?

The insurance funds are directly transferred from the urban residents' medical insurance and the new rural cooperative medical system, and there is no need for residents to pay extra.

2. Do I need to keep the medical documents for 2013?

The person in charge of the Municipal Human Resources and Social Security Bureau stated that it is not necessary to retain the documents to participate in the medical insurance for urban residents, and then reimbursement according to the implementation rules based on the records in the medical insurance reimbursement system. Residents who meet the reimbursement policy will be notified to the relevant agencies. Since NRCMS personnel are not networked in some districts and counties, they may need to keep relevant documents.

3. There are still many high expenses in treatment that are outside the scope of medical insurance reimbursement. Can these major illness insurances be reported?

Major illness medical insurance can only be reimbursed for items in the medical insurance directory, mainly to protect basic medical care. If there are still difficulties, this city also has a medical assistance system for civil affairs departments that can help. In the future, with the development of the economy, the scope of reimbursement for medical insurance will expand, and the scope of critical illness insurance will also expand. ^[1]