95%、80%、70%……全国医保系统持续完善制度功能 群众健康有“医”靠

Group 1 - By 2025, the national medical insurance system will continue to improve its functions, with basic insurance coverage stable at 95% and reimbursement rates for employee and resident insurance at approximately 80% and 70% respectively, enhancing public health welfare [1] - In 2025, the reimbursement rate for rural disadvantaged groups will exceed 90%, with all 31 provinces and regions achieving intra-provincial pooling of employee insurance personal accounts and 337 areas realizing inter-provincial pooling [1] - Currently, 95% of pooling areas directly distribute maternity benefits to insured individuals, with 31 provinces including assisted reproductive projects in medical insurance, and 7 provinces achieving "no out-of-pocket" expenses for inpatient childbirth [3] Group 2 - In 2025, 114 new drugs will be added to the medical insurance catalog, and the National Medical Insurance Administration will establish a commercial health insurance innovative drug catalog, including 19 highly innovative drugs that significantly benefit patients [5] - Over the past five years, through big data models and intelligent regulatory subsystems, the medical insurance fund has recovered losses of 9.5 billion yuan, with over 100 billion drug traceability codes collected to combat illegal activities [7] - By 2025, 1.25 billion people will have activated their medical insurance codes for medical treatment and drug purchases, with plans to build the world's largest medical insurance imaging cloud, aiming for nationwide interoperability of imaging data by the end of 2027 [7]