Nkhani

Pa Juni 28, ofesi ya inshuwaransi yachipatala ya Hebei Province idapereka chidziwitso pakuyendetsa ntchito yoyesa kuphatikiza zinthu zina zachipatala ndi zinthu zina zachipatala pamalipiro a inshuwaransi yazachipatala pachigawo chachigawo, ndipo adaganiza zogwira ntchito yoyesa kuphatikizirapo zinthu zina za chithandizo chamankhwala ndi zogulira zachipatala pamalipiro a inshuwaransi yazachipatala pamlingo wachigawo.

Malinga ndi zomwe zili pachidziwitsochi, ndalama zachipatala zomwe anthu omwe ali ndi inshuwaransi pachigawo chachigawo m'mabungwe azachipatala omwe asankhidwa kuchigawo komanso zolipirira nthawi ndi nthawi za omwe ali ndi inshuwaransi pachigawo chachigawo zikuphatikizidwa muzoyeserera.

Chidziwitsochi chikuwonetsa kuti zinthu zolipirira zatsopano ndi zogwiritsidwa ntchito zimawonjezeredwa. Zinthu za 50 zachipatala ndi 242 zogwiritsidwa ntchito zachipatala zikuphatikizidwa mu malipiro a inshuwaransi yachipatala ndipo zimayendetsedwa molingana ndi gulu B. Pazinthu zachipatala zomwe zili ndi mtengo wochepa, mtengo wochepa udzatengedwa ngati malipiro a inshuwalansi ya zachipatala; Pazinthu zogulira zamankhwala zokhala ndi mtengo wochepera, mtengo wocheperawo udzatengedwa ngati mulingo wolipira wa inshuwaransi yachipatala.

Ndikofunikira kulinganiza mfundo yodzilipirira pawokha pakuzindikira matenda a inshuwaransi yachipatala ndi ntchito zochizira komanso zogwiritsidwa ntchito pazigawo. Pamaziko akugwiritsa ntchito mfundo ndi malire amitengo ya kabuku ka matenda ndi chithandizo chamankhwala ndi malo othandizira azachipatala a inshuwaransi yoyambira yachipatala m'chigawo cha Hebei komanso mndandanda wazoyang'anira zinthu zotayidwa zomwe zimaperekedwa padera m'chigawo cha Hebei (mtundu wa 2021), "kalasi a ” Kuzindikira ndi kuchiza zinthu ndi zogwiritsidwa ntchito sizimayika gawo la kudzilipira pasadakhale, ndipo zimalipidwa ndi thumba lophatikiza inshuwaransi yachipatala molingana ndi malamulo; Pazinthu za "kalasi B" za matenda ndi mankhwala ndi zogwiritsidwa ntchito, inshuwaransi idzayamba kulipira 10% payekha, ndipo kwa iwo omwe akugwira nawo ntchito yothandizira boma (kapena 10% yowonjezera), anthu ena sayenera kulipira yekha; "Kalasi C" kapena "kudzipangira ndalama" zinthu ndi mankhwala ndi zogwiritsidwa ntchito ziyenera kunyamulidwa ndi inshuwaransi.

Chidziwitsochi chikugogomezeranso kuti ofesi ya inshuwaransi yachipatala idzalimbitsa kuyang'anira ndi kuyang'anira zinthu zothandizira zachipatala ndi zinthu zomwe zimagwiritsidwa ntchito pachipatala, komanso kuyankhulana panthawi yake ndi akuluakulu akuluakulu a mabungwe azachipatala oyenerera ndikudziwitsa chigawo chonse ngati kuli kofunikira kwa chiwerengero chachikulu cha odwala paokha. kuwononga ndalama, kugwiritsira ntchito mopitirira muyeso kwa zinthu zodzilipirira nokha ndi mabungwe azachipatala ndi kugwiritsa ntchito mopanda nzeru zinthu zodzipezera ndalama.

M'mbuyomu, zogulira zamtengo wapatali m'madera ambiri mdziko muno makamaka zidadalira ntchito zowunikira komanso chithandizo chamankhwala pakuwongolera malipiro a inshuwaransi yazachipatala, ndipo ndi zigawo zochepa zokha zomwe zidapanga maupangiri osiyana a inshuwaransi yachipatala malinga ndi mitundu yazakudya. Mu 2020, National Medical Insurance Bureau idapereka Njira Zosakhalitsa zoyendetsera zinthu zachipatala za inshuwaransi yoyambira yachipatala (Draft for comments), ikufuna kutengera kasamalidwe kakatundu kazinthu zogwiritsidwa ntchito.

Mu Novembala chaka chatha, Bungwe la National Medical Insurance Bureau linapereka Njira Zosakhalitsa za kasamalidwe kamalipiro a zinthu zachipatala za inshuwaransi yachipatala yofunikira (Draft for comments), idakonzanso zikalata zomwe tazitchula pamwambapa potengera malingaliro ambiri amagulu onse, ndikuwerenga ndikulemba. tsatanetsatane wa kutchula dzina la "inshuwaransi yazachipatala common name" yazachipatala za inshuwaransi yachipatala (Zolemba za ndemanga).