Children's medical insurance: give children a guarantee

"When Mr. Zhang came to Shanghai, Mr. Zhang was only two years old, he was unfortunately diagnosed with leukemia. I hope everyone can help them and give them a hope!"

"My daughter is 9 months old, with biliary atresia. She is from I have been seeing a doctor since the full moon, using all my savings and doing hundreds of thousands of operations. This is a big sum of money for ordinary wages like us. My husband and I also want to give up, but every day. I don’t want to let my daughter die! I hope that good people can help us!”

In recent years, this kind of “children are seriously ill, parents can’t afford huge medical expenses, and they are socially kind people including media people. The incident of spontaneous donation has emerged in our sights.

When we are sympathetic, compassionate, and feel the true feelings of the world, we also lament the lack of basic medical security for children. In the absence of protection, "even if you sell a house to sell land, you have to pay more for your child to see a doctor" has become the biggest wish of the parents of sick children.

Children's medical insurance is important in protecting the disease. On June 10 this year, the Ministry of Health issued the "Opinions on Piloting the Work of Improving the Medical Insurance Level of Children's Major Diseases", requiring all localities to give priority to several types of children's health and medical expenses. The treatment of major diseases that are better after treatment will be carried out to improve the medical security level of children with major diseases.

This pilot work requires that children with acute leukemia and congenital heart disease should be treated from 0 to 14 weeks, and children with acute lymphoblastic leukemia, childhood acute promyelocytic leukemia, and children's congenitality should be preferred. Six cases including atrial septal defect, congenital ventricular septal defect in children, congenital patent ductus arteriosus in children, and congenital pulmonary stenosis in children were tested. All localities may also increase the number of pilot diseases according to the ability of local medical funds to pay.

At the same time, all localities calculate and limit the reasonable medical expenses of the corresponding diseases according to the standardized diagnosis and treatment plan of the pilot diseases. On the basis of the limited fees, the NCMS and the Medical Relief Fund will pay for the disease and significantly increase the proportion of reimbursement.

In principle, the compensation ratio of NCMS to the pilot disease of children with major diseases should reach about 70% of the limited cost of this (zone), and medical assistance will compensate the eligible patients again. The compensation rate is not less than 20% of the limited expenses. %. The participating patients will see the prescribed medical institutions in the corresponding designated medical institutions in this district, and enjoy the prescribed compensation.

City Children's medical insurance has been basically rolled out. At present, the vast majority of children and adolescents living in various cities have been able to enjoy medical insurance.

In the major cities, the basic medical security for children, although most of them do not involve the reimbursement of the general emergency expenses for children and adolescents, most of them have basic guarantees for major diseases of children. Moreover, such children's medical insurance families have low fees and the amount of protection is still high.

We comprehensively compare the basic medical security measures for children and adolescents in various regions. It can be seen that most of the city's children's medical insurance can guarantee the hospitalization expenses of children and adolescents, and there are also leukemia and hemophilia with high incidence in this group. The cost of specialist (general disease) outpatient services for major diseases such as cancer, although the coverage of major diseases for children is not completely the same, but the ideas are similar. In terms of payment, government subsidies and individual family contributions are jointly completed. For low-income families, low-income families, and families with special hardships, they will be given welfare support for underpayment or exemption of medical insurance for children. In terms of reimbursement quotas, the proportions and total amounts given by different regions are not the same (see the attached table for details). Of course, parents should understand clearly that whether it is reimbursement of 50%, or 80% or 100%, it is for the scope of medications within the scope of social insurance and the standards for miscellaneous medical expenses, if the medications, instruments, If the nursing expenses exceed the scope of the adult social security catalogue or the scope of the children's medical insurance medication list and social security standards, then the parents must bear the expenses beyond the scope of reimbursement. What do you need after you have a child's medical insurance? "So, after the children of the child have taken care of the basic medical insurance for children, what kind of commercial insurance do parents need to buy for their children?" Parents with strong protection awareness may ask such questions. . Because children's medical insurance has a high degree of protection for children with serious illnesses and hospitalization, it is no longer necessary for families who have already insured to purchase hospitalization reimbursement insurance for their children. If you are concerned that the cost of treatment for major illnesses may exceed the maximum reimbursement for children's health insurance, you can purchase the major illness insurance for children in an appropriate amount to help meet the risk of huge medical expenses in the future. In short, no matter which area you live in, whether it is a city or not, we recommend that parents must remember to pay on time (there are usually only two or three months of unified insured time each year), and the children are included in the social security hospitalization and major illness coverage. If there are children's medical insurance in the nature of mutual funds sponsored by organizations such as the Red Cross, they should also participate to improve the level of protection.