"我父亲的退休金除了看病吃药，剩下的不够请个保姆。"家住北京市石景山区的刘女士道出了一些 失能家庭面临的困境。刘女士的父亲因帕金森病生活无法自理，母亲年迈体弱，她与丈夫都是独生子 女，工作与照顾幼子让他们疲于奔命。 "我们面临的选择是，要么一个人辞职回家，要么请个保姆，无论哪种，生活压力都会增加。"刘女 士家面临的困境，正是长期护理保险制度（以下简称"长护险制度"）试图破解的核心难题。 长护险试点成效显著 民政部的数据显示，截至2024年末，全国65周岁及以上老年人口达2.2亿人，占总人口的15.6%。其 中，失能老人总数预计超过4000万人。随着生活和医疗水平持续提升，人均预期寿命的延长，未来失能 老人的数量还会继续增加。专业的机构护理费用高昂，动辄每月数千甚至上万元，成为许多普通家庭 的"不可承受之重"。 第三，长护险的核心是"服务"，而非简单的"现金补贴"。但目前我国专业的护理服务供给严重不 足，合格的养老护理员缺口巨大，且面临着社会地位低、劳动强度大、收入不高的职业困境。同时，提 供专业照护的养老机构"一床难求"，而社区、居家护理服务网络尚不完善。这导致可能出现"虽有保 险，却无服务可买"的尴尬局面， ...

在政策性长护险"保基本、兜底线"基础上，商业长护险可为失能人员提供更高水平、更广范围、更具个 性化的护理保障，助力构建"基本+补充"的多层次保障格局。 步入老龄化社会后，我国人口老龄化程度处于高速增长态势，很多失能失智老年人面临护理保障缺口， 建立契合国民实际需求的长护险制度越发具有紧迫性和必要性。北京商报记者注意到，近期推动政策性 长护险和商业长护险发展的政策信号均持续释放。具体来说，国家医保局近期发布《国家长期护理保险 服务项目目录（试行）》（以下简称《长护服务目录》），明确了长护险基金支付的36项基本服务项 目，涵盖生活照料、专业护理、健康管理三大类，包括清洁护理、饮食照料、压疮预防、康复训练、心 理支持等具体内容，并对服务频次、技术规范作出细化规定。国家医保局表示，《长护服务目录》的出 台，有助于规范长护服务行为，提升服务质量，稳定保障长期护理保险待遇享受人员权益，更好保障长 期护理保险基金平稳运行。 "一人失能，全家失衡"，这句在养老场景中反复出现的感慨，道尽了千万家庭面对失能老人的沉重负 担。随着我国老龄化进程持续加深，这一困境正从个体家庭问题逐渐演变为社会共性痛点。据了解，我 国失能失智老年群体 ...

Core Viewpoint - The establishment of the National Long-term Care Insurance (LTCI) system is progressing towards a nationwide framework, with the release of the "National Long-term Care Insurance Service Project Directory (Trial)" marking a new phase of standardization and normalization in LTCI service system construction [2][3]. Summary by Categories LTCI Service Framework - The LTCI system aims to provide basic living care and related medical services for long-term disabled individuals, similar to other social insurance systems, and is referred to as the "sixth insurance" in social security [3]. - The plan is to establish a comprehensive urban-rural LTCI system within approximately three years, focusing on a shared funding mechanism and a fair treatment guarantee mechanism [3][4]. Service Project Directory - The directory includes 36 service items categorized into two main types: 20 items for daily living care and 16 items for medical care [4][5]. - Daily living care services encompass assistance with daily activities such as eating, toileting, hygiene, dressing, and maintaining basic living abilities [4][9]. - Medical care services include basic medical care closely related to daily living care, such as general check-ups, basic care, specialized care, and rehabilitation [5][10]. Implementation and Transition - The LTCI system will differentiate responsibilities between LTCI funds and basic medical insurance funds, ensuring that costs for services listed in the directory are covered by the LTCI fund [6]. - Pilot cities that have established their own service project directories must align with the national directory within three years, while new regions must adhere to the national standards from the outset [6][8].

Core Viewpoint - The National Healthcare Security Administration has issued a trial version of the National Long-term Care Insurance Service Project Directory, which includes 36 service items funded by the long-term care insurance fund, while also initiating a special rectification of medical insurance fund management to combat fraud [1][2]. Group 1: Long-term Care Insurance Development - Japan implemented the Long-term Care Insurance Law in 1997, establishing a mandatory nationwide care insurance system, which diversified the elderly care service system [1]. - Prior to the implementation of the Long-term Care Insurance Law, Japan's elderly care services relied heavily on public institutions and a few non-profit organizations, leading to a lack of competition and inefficiency [1]. - The introduction of the Long-term Care Insurance Law allowed private enterprises to participate in service provision, significantly increasing the number of care service institutions and creating a competitive market structure [1]. Group 2: China's Long-term Care Insurance Pilot - China officially launched the long-term care insurance pilot in 2016, covering 15 cities and 2 key provinces, focusing on providing support for severely disabled individuals under employee medical insurance [2]. - Various cities have explored diverse service models, with some focusing on institutional care and others emphasizing home-based services to meet daily care and medical needs of the elderly [2]. - These explorations have accumulated valuable experience for system improvement, leading to a rapid increase in demand for high-quality elderly care supplies as the long-term care insurance system expands [2]. Group 3: Financial Projections - In 2023, the number of individuals covered by long-term care insurance is projected to be 18.331 million, with a total medical insurance enrollment of 1.33389 billion [3]. - The long-term care insurance fund revenue for 2023 is estimated at 24.4 billion yuan, with an average per capita contribution of 133 yuan [3]. - If the long-term care insurance is expanded to cover all medical insurance participants, the revenue scale could reach 177.3 billion yuan, and if it matches the average revenue ratio of similar systems in the US, Japan, Germany, and France, it could reach 633.3 billion yuan [3].

Core Viewpoint - The long-term care insurance (LTCI) system in China is transitioning from local trials to a nationwide framework, significantly impacting family welfare related to elderly care and disability support [1][5][14]. Group 1: Implementation and Coverage - The LTCI system is set to cover more individuals, with a clear timeline for nationwide implementation by the end of 2025, as indicated by various local governments [5][10]. - As of September 2023, the National Medical Insurance Administration has issued a trial service project catalog, refining the scope of LTCI coverage [6][24]. - The LTCI is designed to provide basic life care and medical services for long-term disabled individuals, similar to other social insurance systems [4][14]. Group 2: Financial Structure and Contributions - The funding mechanism for LTCI involves contributions from individuals, employers, medical insurance funds, and local government finances, aiming to create a sustainable support network for the elderly and disabled [7][19]. - The contribution rates for LTCI are expected to be lower than other social insurance programs, with a proposed rate around 0.3% [18][19]. - In trial cities, the personal contribution is relatively low, with examples showing annual contributions ranging from 100 to 200 yuan, depending on local policies [19][21]. Group 3: Benefits and Services - Families with disabled members can receive monthly subsidies ranging from 800 to 1700 yuan, depending on the level of care required [23][24]. - The LTCI system includes a variety of services such as home care, rehabilitation support, and specialized medical assistance, which are crucial for families facing caregiving challenges [23][24]. - The introduction of home care services is expected to alleviate the burden on families, as seen in the case of a family benefiting from these services [3][12]. Group 4: Challenges and Future Outlook - Despite the progress, the LTCI system faces challenges in meeting the growing demand for care services due to the increasing elderly population, projected to exceed 20% by 2032 [13][15]. - The slow rollout of the LTCI system has been attributed to funding difficulties and inconsistent standards across regions [15][18]. - Future developments will focus on expanding coverage to include unemployed urban and rural residents, with a gradual increase in contribution rates over the next five years [20][21].

Core Insights - The long-term care insurance (LTCI) system in China is transitioning from local trials to a nationwide implementation, aiming to provide essential support for families dealing with long-term disabilities [3][4][10] - The LTCI is designed to alleviate the financial and emotional burdens on families caring for disabled individuals, with a focus on home care services [2][8][20] Policy Development - The LTCI system has been piloted for nine years and is now set for national rollout, with various regions like Guizhou and Tianjin actively developing implementation plans [4][5][7] - The National Medical Insurance Administration has issued a service project directory, clarifying the payment scope and enhancing the system's design [4][10] Financial Structure - The LTCI funding mechanism involves contributions from individuals, employers, and government subsidies, with a proposed low contribution rate of around 0.3% [13][15][18] - Current pilot cities have varying funding standards, with personal contributions typically between 100 to 200 yuan annually, and the government providing significant subsidies [16][19] Coverage and Benefits - The LTCI aims to cover a broad demographic, starting with urban employees and gradually including rural residents and retirees [17][18] - Benefits for eligible individuals include monthly subsidies ranging from 800 to 1700 yuan, depending on the level of care required [20][21] Service Expansion - The LTCI will expand to include home care services, allowing families to choose from a range of professional care options [20][21] - The system is expected to evolve to include smart care services and assistive devices in the future [21]

Core Insights - The long-term care insurance (LTCI) system in China is transitioning from local trials to a nationwide implementation, aiming to provide essential support for families dealing with long-term disabilities [3][9][10] - The LTCI is designed to alleviate the financial and emotional burden on families caring for disabled individuals, with a focus on home care services [2][7][19] Group 1: Implementation and Coverage - As of April 1, 2025, Karamay City will introduce home care services under the LTCI, expanding the existing care subsidy [2][7] - The LTCI system is expected to cover more individuals, with a clear timeline for nationwide rollout, including specific plans from regions like Guizhou and Ningxia [3][6][12] - The National Medical Insurance Administration has issued a service project directory for LTCI, refining the payment scope and service details [3][20] Group 2: Financial Structure and Contributions - The LTCI funding mechanism involves contributions from individuals, employers, and government subsidies, with a proposed rate of around 0.3% for contributions [12][14][15] - In Karamay, the LTCI premium for urban residents has significantly decreased from 342 yuan to 53 yuan, a reduction of 84.5% [15] - The funding structure aims to balance contributions among various stakeholders, including retired individuals who will also be required to contribute [17][18] Group 3: Service Scope and Benefits - The LTCI provides a range of services, including basic life care and medical support, with monthly subsidies varying based on the level of disability [19][20] - The introduction of home care services is expected to improve the quality of care for disabled individuals, reducing the burden on family caregivers [8][19] - The system is designed to adapt to the growing elderly population, with projections indicating that by 2024, 15.6% of the population will be aged 65 and above [8]

Core Viewpoint - The National Healthcare Security Administration has released the "National Long-term Care Insurance Service Project Directory (Trial)" to standardize long-term care services and improve service quality, covering 36 service items categorized into daily living care and medical care [1][2]. Summary by Sections Service Project Content - The directory includes 36 service items, divided into 20 daily living care projects (e.g., dietary care, hygiene care) and 16 medical care projects (e.g., basic nursing, rehabilitation) [2][5]. - Service costs included in the directory will be covered by the long-term care insurance fund, while basic medical insurance will not cover costs related to medical care projects listed in the directory [2][5]. Management of Service Directory - The National Healthcare Security Administration is responsible for the creation, adjustment, and publication of the service directory, establishing a dynamic adjustment mechanism for regular updates [4][5]. - Local regions must align their existing directories with the national one within approximately three years, ensuring consistency in project codes and names [6][7]. Implementation of the Service Directory - Local healthcare departments are required to lead the implementation of the directory by the end of December 2025, ensuring proper payment management and service quality supervision [7][8]. - The directory aims to enhance the efficiency of fund usage and ensure that the benefits for insured individuals meet basic care needs [7][8]. Coverage and Financial Aspects - The long-term care insurance system currently covers 190 million people, with expenditures exceeding 85 billion yuan [2][4]. - The directory is part of a broader strategy by the central government to address population aging and improve the social security system [2][4].

Core Viewpoint - The National Healthcare Security Administration (NHSA) has issued the first national directory for long-term care insurance services, which includes 36 service items aimed at standardizing the long-term care insurance system in China [2][4]. Summary by Categories Long-term Care Insurance Service Directory - The directory is divided into two main categories: daily living care and medical care, encompassing a total of 36 service items [2]. - Daily living care includes 8 categories such as dietary care, excretion care, and safety care, covering 20 specific tasks like assistance with eating, bathing, and functional training [2]. - Medical care includes 4 categories such as general examination care and rehabilitation, covering 16 specific tasks like suctioning and cognitive function training [2]. Implementation and Transition - A transition period of approximately 3 years has been set for regions that have already piloted long-term care insurance to align with the national directory [3]. - New regions implementing long-term care insurance must strictly adhere to the national directory without arbitrary adjustments [3]. Future Developments - The NHSA plans to explore the inclusion of smart services and supportive assistive devices into the payment scope based on demographic changes and system development [4]. - Since the pilot program began in 2016, nearly 1.9 billion people are enrolled in long-term care insurance, with over 100 billion yuan raised and more than 85 billion yuan spent [4]. Principles of Directory Development - The directory development is based on three principles: ensuring basic coverage, demand-oriented service, and coordinated transition with existing pilot projects [4]. Financial Responsibility - The NHSA has clarified the financial responsibilities between long-term care insurance and basic medical insurance, stating that costs related to medical care in the directory will be covered by the long-term care insurance fund [5].

Group 1 - The National Healthcare Security Administration released the "National Long-term Care Insurance Service Project Directory (Trial)" to standardize long-term care services and improve service quality [1][2] - The directory includes 36 service items categorized into 20 living care items (e.g., dietary care, excretion care, cleaning care) and 16 medical care items (e.g., general examination care, basic nursing, specialized nursing, rehabilitation) [1] - Long-term care insurance fund will cover the costs of services included in the directory, while basic medical insurance fund will not cover these costs [1][2] Group 2 - The establishment of a long-term care insurance system is a significant decision by the central government to address population aging and improve the social security system [2] - Currently, the long-term care insurance system covers 190 million people, with expenditures exceeding 85 billion yuan [2]