Since the 18th National Congress of the Communist Party of China, great changes have taken place in the lives of residents along the Yellow River in Qinghai. China Life Insurance Co., Ltd. (hereinafter referred to as “China Life Insurance”) Qinghai Branch is based on the main insurance business, actively serves the construction of a multi-level social security system, and fulfills its original mission of “protecting the people’s better life” with practical actions.
Saving money for medical treatment
Serious illness medical insurance assistance helped him
The sun shines on the clear Gequ River with sparkling waves, and the mood of 27-year-old Lamaojie in Rijin Village, Dawu Township, Maqin County, Guoluo Tibetan Autonomous Prefecture is also clearer like the river water.
“50% of my medical expenses will be reimbursed in 2021, and 87% of my medical expenses will be reimbursed in 2022. I feel more at ease when I see a doctor.” This is a real help for La Maojie, who has been ill for 8 years. In 2015, 19-year-old La Maojie often felt headaches and could not eat. He went to the hospital for examination and found that there was a kidney problem. He was diagnosed with uremia, so he started dialysis treatment. “Cure the child’s illness is more important than anything else.” The family took him to various hospitals inside and outside the province for treatment, and finally decided to replace his kidney. While waiting for treatment, a suitable kidney source was not found for two years. The mother worried about her son’s health and proposed to donate a kidney to the child.
“I don’t want to.” La Maojie didn’t want to hurt his mother, but her mother insisted again and again. In 2017, the mother and son entered the operating room, and La Maojie’s right kidney was replaced with his mother’s. He was hospitalized for more than 4 years. In order to treat him, the family sold their cattle and sheep and spent all their savings. After the operation, he needs to take anti-rejection drugs for a long time, and the medical expenses will cost about 100,000 yuan a year. After learning about his situation, the relevant local authorities applied for a subsistence allowance for him, and 90% of hospitalization expenses can be reimbursed, which greatly relieved the pressure on family medical expenses.
“Treatment can’t be stopped. I heard that the government has a serious illness relief policy. Let’s try it.” Relatives and friends told the Lamaojie family the good news they heard during the policy promotion activities, and helped them apply.
“I really got the application, and from 10,000 yuan to 100,000 yuan, depending on the medical situation, more and more assistance was given.” In 2018, La Maojie, who was still seeking medical treatment in other places, successfully applied for it with the suggestions and help of relatives and friends. Serious illness medical insurance assistance. Lamaojie said that although the repeated hospitalization and continuous medication cost a lot these years, the relief policy has given their family great help, and the family has not become impoverished due to illness.
Cai Zhongji, an auditor at the medical insurance window of the Maqin County Government Service Hall, an employee of China Life Insurance Maqin Branch, often audits La Maojie. She said that when she saw La Maojie bring the reimbursement information to the window for the first time this year, she felt sorry for him. Glad that his condition has improved.
Allow patients to receive reimbursement as soon as possible
As a pilot province of medical reform, Qinghai Province took the lead in implementing provincial-level overall planning of basic medical insurance for urban and rural residents, realizing the “five unifications” of insurance coverage, policy benefits, fund management, handling services, and information systems, as well as the unified collection, unified expenditure, and unified management of funds .
It is understood that the medical insurance department of Qinghai Province continues to do a good job in the overall planning of medical insurance for urban and rural residents, focusing on improving benefits and optimizing services. In 2022, Qinghai Province will once again adjust the financing standards for medical insurance for urban and rural residents, and the per capita financing standard for medical insurance for urban and rural residents will be raised to 1,030 yuan. The per capita financing standard for critical illness insurance for urban and rural residents is 95 yuan, and individuals who participate in the insurance do not pay. The scope of payment has been expanded from designated medical institutions at the first level and below to all designated medical institutions; the fund payment ratios of designated medical institutions at the second level and below and at the third level have reached 70% and 50% respectively. Every insured urban and rural resident can enjoy an increase in the annual outpatient medical insurance amount, and there are many more medical institutions to choose from, which brings immediate benefits.
At the same time, the “green channel” for people in need to participate in insurance and pay fees is unblocked, and insurance participation is not restricted by the centralized payment period, ensuring that insurance participation can be processed at any time, subsidies can be implemented in a timely manner, and immediate benefits can be enjoyed, effectively preventing and defusing the risk of returning to poverty due to illness.
Patients are in a hurry to spend money to see a doctor. Cai Zhongji, as the medical insurance approval handler, often works overtime, just to get the reimbursement for the patients as soon as possible. According to her introduction, in 2012, the medical insurance settlement method in Guoluo Prefecture was manual settlement, and the settlement statement system was not uniform, and reimbursement had to go to three departments, and it took a long time for patients to receive reimbursement. In 2016, the basic medical insurance for urban and rural residents in Guoluo Prefecture was reimbursed within 5 working days, which greatly improved the settlement accuracy and shortened the settlement time. In 2018, the medical security information platform in Qinghai Province was launched, which truly reduced the number of people traveling.
Save money, save manpower, save time
Gaile, a herdsman in Dehelong Village, Songduo Town, Zhiqing County, Jiuzhi County, has been in constant contact with Yang Zhi, a staff member of the Maqin Branch of China Life Insurance who works at the Government Service Center of Jiuzhi County, to settle medical expenses due to his family’s continuous illnesses. Reimbursement matters.
On March 14, Yang Zhi was busy solving problems for the public, so Gaile took his wife’s hospital bill and other materials to reimburse the expenses. “In 2020, family members will be reimbursed 44.44% when they go to see a doctor in Aba, Sichuan. Now, with the new medical insurance ‘one card’ policy, the reimbursement rate can reach 70% no matter whether they are in Qinghai or Sichuan. This is very good.” He said. Last year, I earned about 40,000 yuan from grazing. Coupled with the medical insurance for urban residents, the pressure on the family to see a doctor was greatly reduced.
Zhiqing Songduo Town is close to Sichuan, and residents have the habit of seeking medical treatment across provinces. The “one card” for medical insurance allows local residents to enjoy real benefits of medical insurance.
According to Yang Zhi, in March this year, the medical insurance “one card” no longer restricts conditions such as age for medical treatment in other places. Generally, people who see a doctor can enjoy a 70% reimbursement rate in the Aba area of Sichuan Province, and a 60% reimbursement rate for seeing a doctor in Chengdu. At the same time, the local area is vast and sparsely populated, and the “one card” solves the problem of difficulties for the masses to handle affairs. “It takes more than 100 kilometers to drive from Wosai Township, which is the closest to Jiuzhi County, to the government service center. Through the medical record filing in other places, there are no additional procedures, or even a client or a phone call, and the medical record filing in other places can be completed without running. It has saved a lot of work for the masses,” Yang Zhi said.
From the faces of people recovering from a serious illness, what they see is the peace of mind brought to them by the medical insurance policy and the peace of mind that they don’t have to worry about not being able to afford medical expenses. The continuously optimized medical insurance policy is adding a life insurance for more people in need, sending convenience and benefits to the most suitable place.