城乡居民医保“保”啥？ 长沙市医保局详解来了

Core Points - The deadline for the payment of urban and rural residents' medical insurance in Hunan Province is January 31, 2026, highlighting the urgency for residents to enroll and understand their benefits [1] Group 1: Ordinary Outpatient Benefits - Insured individuals can receive reimbursement for medical expenses incurred at designated grassroots medical institutions for ordinary outpatient services, making healthcare more accessible and affordable [1] - Special outpatient treatment for chronic diseases such as hypertension and diabetes allows for reimbursement after recognition of the condition, easing the financial burden of long-term treatment [1] - The reimbursement ratio for the "two diseases" special medication is set at 70%, with annual payment limits of 360 yuan for hypertension and 600 yuan for diabetes, totaling 960 yuan if both conditions are present [1] Group 2: Inpatient Benefits - Medical expenses incurred during hospitalization at designated hospitals are reimbursed under the basic medical insurance, alleviating the financial pressure of serious illnesses [2] Group 3: Major Illness Insurance Benefits - Patients whose medical expenses exceed the basic insurance coverage can access major illness insurance benefits once their out-of-pocket costs reach the threshold of 18,000 yuan, with a reduced threshold of 9,000 yuan for vulnerable populations [3] Group 4: Medical Assistance Benefits - Eligible individuals, such as low-income households and those in extreme poverty, can receive assistance for their out-of-pocket medical expenses after basic and major illness insurance reimbursements, further reducing their financial burden [4]