山东实现生育医疗费省内异地就医直接结算 异地生娃报销不用“来回跑”

Core Insights - The provincial medical insurance bureau is focusing on addressing public concerns in medical insurance services and is actively reforming the medical insurance system to build a multi-tiered medical insurance framework [1][2][3] Group 1: Long-term Care Insurance - The province has established a long-term care insurance system that integrates urban and rural areas, expanding coverage to include both employed and resident populations, with 55.7 million insured individuals as of August [1] - Seven cities have included rehabilitation assistive device rental fees in long-term care insurance payments, benefiting 3,215 disabled individuals and resulting in over 6.7 million yuan in fund expenditures [1] Group 2: Unemployment Insurance - Policies have been improved for unemployment insurance, allowing the unemployment insurance fund to cover medical insurance contributions for unemployed individuals, facilitating easier access to maternity medical expense reimbursements [2] - The system allows for direct payment of maternity benefits to unemployed individuals' bank accounts after hospital discharge [2] Group 3: Major Illness Insurance - The province is adjusting major illness insurance policies based on the fund's capacity, with pilot programs in four cities to combine resident major illness insurance and employee high-cost medical expense subsidies [2] Group 4: Cross-Region Medical Settlement - The provincial medical insurance bureau is implementing measures to streamline cross-region medical settlements, achieving full coverage for direct settlement of maternity medical expenses across 18 planning areas by the end of July [3] - As of September, 376 medical institutions have been connected for cross-region settlements, with 1,174 cases processed and 6.6 million yuan advanced [3] Group 5: Grassroots Medical Services - The bureau is promoting the distribution of quality and affordable medical services to grassroots levels, with over 33,000 participating units in the collective procurement of medicines, an increase of 4,435 units compared to the end of 2024 [3] Group 6: Efficient Medical Insurance Services - The province has implemented a "one-stop" service model for 27 medical insurance administrative services, allowing residents to access these services at any local medical insurance office without discrimination [4] - An AI customer service system has been launched on the provincial medical insurance bureau's website and social media for continuous support [4]