丝路古城民生暖 大病保险十年守护

Core Insights - The article highlights the significant impact of the major illness insurance policy implemented in Kashgar since 2015, which aims to alleviate the financial burden of high medical costs for families [1][3] Group 1: Policy Overview - The major illness insurance is government-led and commercially operated, with projected premiums of 65 yuan for urban employees and 155 yuan for rural residents by 2025 [2] - The policy features differentiated coverage: a threshold of 16,000 yuan for employees with an 80% reimbursement rate and a cap of 700,000 yuan; for ordinary residents, the threshold is 9,200 yuan with the same reimbursement rate and a cap of 300,000 yuan [2] - Special provisions for vulnerable groups include a reduced threshold of 4,600 yuan and an increased reimbursement rate of 85% without a cap [2] Group 2: Implementation and Impact - Since its inception, over 1.17 million claims have been processed, with total payouts reaching 3.19 billion yuan, demonstrating the program's effectiveness in reducing financial anxiety for families facing serious illnesses [3] - The insurance company has established a specialized medical inspection team to monitor fund usage and prevent wasteful spending, ensuring the protection of public funds [3] - The long-term sustainability of the insurance program relies on precise funding standards, risk-sharing mechanisms, and close monitoring of healthcare payment reforms [3]