【“十四五”高质量发展答卷】提质扩面广覆盖 多层次医保体系惠民生

Core Insights - The healthcare insurance system in China is set to cover nearly 20 billion medical reimbursements from 2021 to 2024, with 2024 figures projected to be 1.6 times that of 2020 [1] - The system aims to enhance quality and expand coverage, focusing on vulnerable groups including the elderly and children, while providing targeted support for low-income populations [1][11] Group 1: Childcare and Maternal Health - The healthcare insurance system is strengthening maternity insurance, with 253 million participants and cumulative expenditures of 438.3 billion yuan, benefiting 96.14 million people by June 2025 [3] - Newborns can now enroll in basic health insurance using their birth certificates, and nearly 60% of regions provide direct maternity benefits to female employees [3] Group 2: Elderly Care - 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 requiring long-term care [5] Group 3: General Health Coverage - The employee health insurance system has expanded its outpatient mutual aid mechanism, allowing personal accounts to cover near relatives, with over half of the regions implementing this nationwide [7] Group 4: Chronic Disease Management - Ten types of outpatient chronic diseases can now be reimbursed directly across provinces, benefiting 560 million people and reducing out-of-pocket expenses by 590 billion yuan [9] - The dynamic adjustment of the healthcare drug list has led to the inclusion of 402 new drugs since the start of the 14th Five-Year Plan [9] Group 5: Support for Low-Income Populations - The healthcare insurance policies have benefited 673 million low-income individuals in rural areas, alleviating over 650 billion yuan in medical expenses [11]