高质量完成“十四五”规划丨“十四五”医保基金支出12.13万亿元 我国医保事业提质扩面

Core Insights - The "14th Five-Year Plan" aims to enhance the national medical insurance system, achieving a stable coverage rate of approximately 95% and a cumulative expenditure of 12.13 trillion yuan, with an annual growth rate of 9.1% [1][3] Group 1: Medical Insurance Coverage - By 2024, nearly 200 million medical visits will benefit from insurance reimbursement, representing a 1.6 times increase compared to 2020 [3] - As of June 2025, 253 million people are expected to participate in maternity insurance, with cumulative expenditures reaching 438.3 billion yuan and benefits enjoyed by 96.14 million people [3] Group 2: Long-term Care and Elderly Support - A long-term care insurance system is being established, with 190 million participants expected by the end of 2024, addressing the needs of disabled individuals [3] - Over 95% of village clinics will be included in the insurance system, facilitating access to medical services for the elderly [3] Group 3: Medical Institutions and Cross-Province Services - By June 2025, the number of designated medical institutions for insurance will reach 1.1 million, expanding the coverage of employee insurance to include close relatives [4] - The number of cross-province designated medical institutions has reached 644,000, benefiting 560 million medical visits and reducing out-of-pocket expenses by 590 billion yuan [4] Group 4: Support for New Medical Technologies - A total of 402 new drugs have been added to the insurance catalog since the beginning of the "14th Five-Year Plan," with ongoing reforms in payment methods to promote new technologies and equipment in clinical applications [4] Group 5: Poverty Alleviation and Future Directions - Medical assistance policies have benefited 673 million rural low-income individuals, alleviating over 650 billion yuan in medical expenses [5] - The National Medical Insurance Administration aims to manage insurance funds effectively while supporting the development of the pharmaceutical industry and enhancing the availability of safe and efficient medical products and services [5]