长期护理保险制度

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人保财险:因地制宜打造长期护理险十大模式
Ren Min Ri Bao· 2025-09-18 21:47
Core Viewpoint - The establishment of a long-term care insurance system is a crucial measure to address the challenges of an aging population in China, with China People's Property Insurance Company (PICC) actively participating in pilot projects and developing various models for long-term care insurance [1] Group 1: Long-term Care Insurance Participation - As of June 2025, PICC has undertaken 117 long-term care insurance projects, covering 58 cities across 20 provinces [1] - PICC participates in 32 out of 49 national pilot cities for long-term care insurance, maintaining a participation rate of 65.3%, leading the industry [1] Group 2: Service Models - Jiangsu Nantong has established a "three-level" convenient service network to address the distance and technology usage issues for disabled individuals in rural areas [2] - Jiangsu Huai'an has developed a smart service center with various facilities to meet the needs of insured individuals, including an APP experience area and a monitoring center [2] - Jiangsu Nanjing has implemented a cross-regional service model allowing users to enjoy benefits based on their residence while adhering to the standards of their insurance location [3] Group 3: Management and Operations - Zhejiang Huzhou has created a digital management platform for comprehensive oversight of care services, integrating with the provincial smart medical insurance platform [4] - Shandong Yantai has established a dynamic assessment mechanism for disability, conducting unannounced inspections to ensure proper management and prevent over or under-provision of benefits [5] Group 4: Comprehensive Insurance Solutions - Zhejiang Jinhua has designed a comprehensive insurance package that includes various risk coverages related to long-term care, extending to newborn disability insurance and flexible employment insurance [6] - Hainan has provided hospitalization care for approximately 54,000 impoverished individuals, with total claims exceeding 33.35 million yuan [8] Group 5: Collaborative Development - Shandong Dezhou has innovated a collaborative model combining care insurance with supportive services, partnering with local healthcare institutions to enhance service delivery [8] - Sichuan Chengdu has developed an integrated service model that combines insurance with healthcare services, creating a multi-faceted support system for care [8] - Hebei Xingtai has initiated a village doctor management model to enhance rural care services, facilitating cooperation between village doctors and designated care service companies [8] Group 6: Future Directions - PICC aims to continue enhancing service quality and fund management while iterating on its insurance solutions to contribute to a multi-tiered social security system [9]
商务部等九部门:加快推进长期护理保险制度建设
Bei Jing Shang Bao· 2025-09-16 10:55
北京商报讯(记者 胡永新)9月16日,商务部等九部门联合印发的《关于扩大服务消费的若干政策措施》提出,加快推进长期护理保险制度建设,扩大长期 护理保险制度覆盖面。加强对养老护理、家政服务、长期照护等领域从业人员培养培训,落实有关支持政策。 ...
商务部等9部门印发《关于扩大服务消费的若干政策措施》的通知
Shang Wu Bu Wang Zhan· 2025-09-16 08:55
服务消费是促进民生改善的重要支撑,也是消费转型升级的重要方向,在推动经济高质量发展中发挥重 要作用。为贯彻落实党中央、国务院决策部署,更大力度提振消费、扩大内需,提出以下措施。 一、培育服务消费促进平台 (一)实施服务消费提质惠民行动。印发《服务消费提质惠民行动工作方案》,从加强政策支持、搭建 平台载体、扩大对外开放、强化标准引领、优化消费环境等方面提出工作举措。持续深化"购在中国"品 牌打造,开展"服务消费季"系列促消费活动,围绕贴近群众生活、需求潜力大、带动作用强的重点领域 开展服务消费促进活动,培育服务消费品牌,打造服务消费热点。(商务部牵头) (二)开展消费新业态新模式新场景试点城市建设。积极发展首发经济,推动创新和丰富服务消费场 景,支持优质消费资源与知名IP跨界合作,打造一批商旅文体健融合的消费新场景,培育一批新型消费 龙头企业。(财政部、商务部按职责分工负责) (九)有条件的地方可结合实际对普惠托育机构给予场地支持和适当运营补助。支持有条件的幼儿园招 收2—3岁幼儿,发展社区嵌入式托育、家庭托育点,鼓励用人单位提供托育服务,并按相关规定给予政 策支持。(发展改革、教育、财政、卫生健康主管部门,工 ...
保障民生走在前!中国人寿探索打造长护险“三高”经办服务新范式
Xin Lang Cai Jing· 2025-09-11 02:39
Core Insights - The long-term care insurance (LTCI) policy has significantly alleviated the burden on families caring for elderly individuals with disabilities, as evidenced by testimonials from beneficiaries like Liu Granny [1] - The implementation of LTCI is crucial in addressing the challenges posed by an aging population in China, with projections indicating that by the end of 2024, the elderly population (aged 60 and above) will reach 310 million, accounting for 22% of the total population [1] - The Chinese government is actively promoting the establishment of a long-term care insurance system as part of its strategy to improve social security and support for vulnerable elderly groups [1] Company Involvement - China Life Insurance Company has been proactive in participating in the national LTCI pilot program, having engaged in 80 LTCI projects by the end of last year, covering over 7.3 million insured individuals in Shandong province [2] - The company has established standardized comprehensive service centers and has been involved in disability assessments and policy training, thereby enhancing service delivery and supporting the national strategy to address population aging [2] - In January 2024, China Life's Jining branch won the bid to manage LTCI for over 1.5 million residents and employees in Jining, demonstrating its commitment to high-quality service delivery [5] Service Innovation - The Jining branch of China Life has implemented a new service model for LTCI, which has been recognized as one of the top ten innovative products in elder care finance [3] - The company has developed a multi-tiered management service strategy focusing on key areas such as institutional access, disability assessments, and service management to ensure efficient and effective LTCI operations [7] - A comprehensive evaluation service system has been established to ensure fair and objective assessments of disability levels, thereby ensuring that the right beneficiaries receive the LTCI benefits [8] Community Engagement - China Life has organized various community outreach activities, including health check-ups and policy awareness campaigns, to promote LTCI and enhance public understanding of the program [9] - The company has also introduced innovative insurance products, such as accident insurance for caregivers, to address the specific needs of care institutions and personnel [9] - By integrating various insurance programs, China Life aims to improve resource utilization and provide greater convenience to insured individuals [9] Overall Impact - The collaboration between commercial insurance providers like China Life and government agencies has led to improved service efficiency and increased satisfaction among insured individuals [11] - The LTCI initiative is seen as a win-win situation, benefiting the government, insurance institutions, and the elderly population [11] - The ongoing efforts to enhance the LTCI management service system aim to expand coverage and ensure high-quality service delivery for the elderly [11]
“一人失能,全家失衡”难题,这样破解(大健康观察)
Ren Min Ri Bao Hai Wai Ban· 2025-09-01 22:57
Core Viewpoint - The long-term care insurance (LTCI) system in China is evolving to address the increasing demand for care services for the elderly, particularly those with disabilities or dementia, as the traditional family caregiving model weakens under modern societal pressures [4][5][6]. Group 1: Current Situation and Challenges - Over 45 million elderly individuals in China require long-term care, with one in six elderly people needing assistance [4]. - The traditional family structure, characterized by the "421" model, places significant caregiving burdens on younger generations, leading to increased stress and challenges in providing adequate care [4][5]. - Rural areas face acute challenges in elderly care due to a lack of resources and professional services, resulting in a situation where families struggle to provide care [6][9]. Group 2: Policy Implementation and Impact - Various regions are piloting LTCI programs to alleviate the burden of elderly care, with a focus on integrating care services into existing healthcare frameworks [5][8]. - In Kaifeng, the introduction of LTCI has led to significant financial relief for families, with reimbursements covering up to 65% of care costs, allowing access to professional care facilities [5][6]. - The LTCI system has been expanding since its initial pilot in 2016, with nearly 1.9 billion people enrolled and over 850 billion yuan spent on care services [13]. Group 3: Innovations in Care Delivery - The transformation of community health centers into LTCI service providers is gaining traction, allowing for better utilization of resources and addressing the dual challenges of underused hospital beds and the need for elderly care [7][8]. - In Xuzhou, the integration of LTCI services into local healthcare facilities has resulted in a significant increase in occupancy rates and service provision, demonstrating a successful model for rural healthcare [8][10]. - The establishment of home-based care services is becoming more common, with healthcare professionals providing regular visits to assist families in managing care for elderly relatives [9][10]. Group 4: Funding and Sustainability - The LTCI system relies on a multi-source funding model, combining contributions from individuals, government subsidies, and social funds to create a sustainable financial framework [11][12]. - In Longkou, the annual contribution for LTCI is as low as 30 yuan for workers, making it accessible while ensuring that over 1,300 disabled elderly individuals benefit from the program [11][12].
【省医保局】陕西首期长期照护师培训班在汉中开班
Shan Xi Ri Bao· 2025-08-27 22:41
Core Insights - The first long-term care nurse vocational skills training class in Shaanxi Province commenced in Hanzhong City, organized by the Shaanxi Provincial Medical Security Bureau and the Hanzhong City Medical Security Bureau [1] - The training lasts for 6 days and includes 60 class hours, attracting 50 nursing professionals from designated long-term care service institutions [1] - The training employs a "theory explanation + real demonstration + interactive practice" teaching model, focusing on over 10 core skills such as cleaning care, dietary nursing, and emergency handling [1] - Hanzhong City was designated as a pilot city for the national long-term care insurance system in 2020, being the only pilot city in the province [1] - The city has developed a multi-layered service system centered on "government-led, commercial insurance management, institutional care, and assistive device support" to meet the long-term care service needs of the elderly population [1] - As of June this year, long-term care services in Hanzhong City have covered 403,900 insured workers and provided services to over 3,700 severely disabled individuals [1] Future Plans - Hanzhong City plans to explore the establishment of a scientific, socialized, and diversified long-term care nurse skills training and talent evaluation system [2] - The city aims to expand the career development pathways for skilled personnel and enhance the service capacity of long-term care [2] - These efforts are intended to contribute to the improvement of the long-term care insurance system and the protection of the rights and interests of insured individuals [2]
三年左右全国铺开 长护险筹资难题待解
Sou Hu Cai Jing· 2025-08-27 18:14
[ 第一财经采访的长护险业内人士普遍认为,长护险全国落地面临筹资和服务供给等方面的不足,可持 续的长护险制度需要建立稳定多元的筹资渠道,从地方试点的情况来看,采用依靠医疗保险统筹基金划 拨作为单一筹资渠道的城市是极少数,大部分城市采用的是个人缴费、用人单位缴费、医保基金划转以 及财政补贴等多渠道的筹资方式。 ] 试点已满九年的长期护理保险(下称"长护险")制度即将结束试点阶段,开始在全国范围内全面实施。 近日,国家医保局在四川成都举办全国加快推进长护险制度建设培训班,部署开启全面实施长护险的相 关工作。 第一财经从业内人士处获悉,长护险全国落地的"时间表"确定,在前期试点的基础上,将用三年左右基 本建立覆盖全民、统筹城乡、公平适度、科学规范,适应我国国情的长护险制度。同时也不会"一刀 切",而是充分评估地方条件后分步分批实施。 央地密集部署长护险落地 8月15日,全国医疗保障工作年中座谈会将"全面实施长护险"列入了下一步医保部门的九大任务清单 中。 会议要求,合理规划配置定点长护服务机构,支持引导基层医疗机构提供长期护理服务,鼓励商保机构 开发保障功能相衔接的商业长护险产品。推进长期照护师培训和职业技能等级认 ...
多地长护险试点创新服务模式
Jin Rong Shi Bao· 2025-08-27 02:41
Core Viewpoint - The national medical insurance meeting emphasizes the comprehensive implementation of long-term care insurance to address the needs of the elderly and disabled population in China [1] Group 1: Long-term Care Insurance Implementation - The meeting highlighted the need for reasonable planning and allocation of designated long-term care service institutions, encouraging grassroots medical institutions to provide long-term care services [1] - The initiative aims to promote the development of commercial long-term care insurance products that align with public insurance [1] - Training for long-term care workers and recognition of their skills will be prioritized to enhance service quality [1] Group 2: Case Studies and Impact - A case in Chongqing illustrates how proactive outreach by long-term care insurance staff can significantly alleviate family caregiving burdens, as seen with an elderly teacher whose family faced severe health challenges [2] - The fifth national survey indicates that approximately 35 million elderly individuals in China are disabled, highlighting the critical need for long-term care services [3] Group 3: Quality Assurance and Regulation - In Shandong, a smart regulatory platform has been established to ensure the authenticity and quality of long-term care services, allowing real-time tracking of service delivery [4] - The platform requires care providers to upload service details and receive confirmation from family members, ensuring compliance with service standards [4] - Since the launch of the long-term care insurance pilot in July 2023, measures have been taken to eliminate fraudulent claims, with 389 individuals no longer receiving benefits due to recovery or death [5]
多地试点扩面 社保“第六险”或加速铺开
Xin Hua Wang· 2025-08-12 06:28
作为社保"第六险"的长期护理保险正加速铺开。今年政府工作报告提出,稳步推进长期护理保险制 度试点。记者了解到,北京市确定今年全面推行长期护理保险,将试点从石景山区推向全市。此外,重 庆市、徐州市等多地也明确今年起将长期护理保险试点扩大到全市,实现制度保障的全覆盖。 记者采访获悉,长期护理保险(简称"长护险")试点5年多来,提高了失能人员的生活质量、减轻 了失能人员家庭的经济负担。不过在试点过程中,也出现个人缴费意愿不足、评估标准不统一、筹资机 制较单一等问题,亟待加快完善顶层设计,调动各方面积极性,更好满足老年人养老需求。 长护险破解照护难、费用高 76岁的北京市石景山区居民唐女士患有高血压和冠心病,近三年里2次出现脑梗塞,1年前因摔倒导 致失能,长期卧床,因情绪低落,夜间还有严重的失眠。自从享受长期护理保险待遇后,专业护理人员 定期上门服务,明显改善了老人身心状态。而长期护理保险政策不仅没有增加家庭开销,还减轻了一家 人的生活负担。 长护险是经评定达到规定失能等级的长期失能人员,为其基本生活照料和与基本生活密切相关的医 疗护理提供服务或资金保障的社会保险制度,也被称为社保"第六险"。 2016年6月,人社部 ...
长护险制度 综合效应凸显
Jin Rong Shi Bao· 2025-08-08 07:04
随着我国人口老龄化程度持续加深,失能老人的照护难题成为社会关注的焦点。面对家中老人的失 能困境,许多家庭在照护与经济的双重压力下艰难前行。 长护险的核心价值还体现在构建专业化、标准化的服务体系。 2022年,人社部将"长期照护师"纳入国家职业分类大典,并组织职业技能等级认定。今年4月19 日,全国首场长期照护师初级工(五级)考试在江苏南通长护产业园举行,首批100名考生参加考试。4 月28日,81名考试合格的考生获得了可在全国范围内联网查询的长期照护师职业等级证书,成为我国首 批持证上岗的长期照护师。通过专业的培训,他们将日常照料从"体力活"升级为"技术活"。"实操考试 中协助进食的项目,我在日常工作中接触比较少。通过这次准备考试,我掌握了这项技能。"首批持证 上岗的王汝芳在接受采访时曾表示,经过这段时间的系统培训和反复练习,她掌握了更多的专业技能, 以后能够更加专业、规范地照顾失能老人。 3月20日,上海市长宁区医保局召开了2025年长护险工作会议,评定了从三星到五星的多家服务机 构,明确提出"支付更便捷、服务更精准、评价更科学"的目标。通过星级评定机制,上海抚理奉泰护理 站等5家机构获评五星,其提供的协助 ...