National Healthcare Security Administration: By the end of 2026, achieve instant settlement funds accounting for more than 80% of the monthly settlement funds of local healthcare security funds.
Settlement funds cover employees' medical insurance funds (including maternity insurance) and urban and rural residents' medical insurance funds. In areas with conditions, exploration can be made to include funds such as major disease insurance funds and medical assistance funds in the scope of immediate settlement. Settlement funds cover regular outpatient, outpatient for chronic and severe diseases, hospitalization, childbirth, and pharmacy expenses.
On October 16th, the National Healthcare Security Administration Office issued a notice on the comprehensive promotion of the instant settlement reform of medical insurance funds to expand coverage and improve quality. By the end of 2026, it aims to achieve that more than 80% of the monthly settlement funds of local medical insurance funds are settled instantly. The settlement funds cover employee medical insurance funds (including maternity insurance) and urban and rural resident medical insurance funds, and some areas can explore including major illness insurance funds, medical assistance funds, etc. in the scope of instant settlement where conditions permit. The settlement funds cover ordinary outpatient, outpatient slow special illness, inpatient, maternity, pharmacy drug purchase and other medical expenses. It can gradually explore including out-of-town medical expenses in the scope of instant settlement.
This article is selected from the official website of the National Medical Insurance Administration; GMTEight editor: Chen Xiaoyi.
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