Our hospital has become the only designated hospital for reimbursement of chronic diseases (special diseases) for urban and rural residents in Linqing City.
In order to further improve the level of basic medical insurance and ensure the demand of outpatient chronic diseases of the insured, since 2015, the reimbursement categories of outpatient chronic diseases of our hospital have been increased from 16 to 21, including: outpatient radiotherapy for malignant tumors; dialysis treatment for renal failure; antirejection treatment for organ transplantation; leukemia; hemophilia; Parkinson's syndrome; severe hepatitis, cirrhosis; chronic aplastic anemia; systemic lupus erythematosus (one of heart, lung, kidney, liver and nervous system); rheumatoid arthritis; and chronic diseases (special diseases) of Linqing City. anemia; systemic lupus erythematosus (with one of heart, lung, kidney, liver and nervous system complications); rheumatoid arthritis (active stage); diabetes mellitus (with co-infections or with one of heart, kidney, liver and nervous system complications); hypertension stage III (with one of heart, brain and kidney complications); cerebrovascular disease (cerebral hemorrhage, cerebral infarction, cerebral vascular malformations); tuberculosis (within the treatment course); myasthenia gravis; coronary heart disease. . The five new diseases are: dilated cardiomyopathy, rheumatic heart disease, chronic pulmonary heart disease, cerebral palsy, and severe mental illness.
For outpatient radiotherapy for malignant tumors, dialysis treatment for renal failure, anti-rejection treatment for organ transplantation, leukemia, hemophilia, severe mental illness, cardiac stenting, cardiac bypass surgery, etc. can be declared at any time and identified once a month. Former urban residents with common diseases can go to our hospital's medical insurance office to get an application form for declaration, which will be appraised once a year in May and September. Former New Farmers' Cooperative patients can bring relevant materials to their township hospital's cooperative management office for declaration and appraisal once a year in May and September.
The reimbursement rate for outpatient chronic diseases in our hospital has also been greatly increased from the previous 50% to 65%. For some special diseases, such as hemophilia, the reimbursement rate has been increased from 70% to 75%, routine hemodialysis has been increased from 78% to 80%, and the reimbursement rate for peritoneal dialysis and hemofiltration is 70%. Among them, outpatient radiotherapy for malignant tumors, dialysis treatment for renal failure, anti-rejection treatment for organ transplantation, leukemia, hemophilia, and outpatient medical expenses for severe mental illnesses have a maximum payment limit of 120,000 yuan (according to the maximum payment limit for inpatient hospitalization), and the maximum payment limit for outpatient medical expenses for other illnesses is 10,000 yuan per year, which greatly reduces the burden on the patients' medical care.
(Wang Ziying Chen Denghong)
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