来源：中国医疗保险 2025年是很不平凡的一年，我国医疗保障体系在服务人口高质量发展和中国式现代化中向新向优发展， 展现强大的制度韧性和民生温度。站在岁末回望，这一年涌现的众多热词，如一个个生动的切片，记录 下医保改革的进程、治理水平提升的风向，共同"拼"绘出一幅以人民健康为中心的奋斗图景。以 下，"中国医疗保险"为您解读2025年医疗保障领域的十大热词。 热词1："1+3+N" 国家医保局一直强调要健全"1+3+N"多层次医疗保障体系。具体来说，"1"是构建以全国统一的医保信 息平台、医保大数据为核心的医保基础设施及服务能力；"3"是完善基本医疗保险、大病保险、医疗救 助三重梯次减负的基本医疗保障制度体系；"N"是引导支持商业健康保险、慈善捐赠、医疗互助、工会 职工互助等其他保障力量发挥作用。 近年来，国家医保局持续推进"1+3+N"多层次医疗保障体系建设，基本医保、大病保险、医疗救助三重 基本医疗保障制度进一步巩固提升。职工医保、居民医保政策范围内住院费用报销比例分别达到80%和 70%左右，普遍开展普通门诊统筹和门诊慢性病、特殊疾病保障，减轻参保人员门诊医疗费用负担。大 病保险进一步减负，城乡居民大病保 ...

Core Viewpoint - The article discusses the implementation of a comprehensive set of measures in Beijing aimed at enhancing fertility support policies and creating a family-friendly society, focusing on various aspects such as financial support, childcare services, and housing policies [1][10]. Summary by Category Financial Support - A new childbirth subsidy system will be established in Beijing, providing annual subsidies of 3,600 yuan per child for families with children under three years old, starting from January 1, 2025 [2][11]. - The measures aim to reduce short-term financial burdens on families, particularly benefiting middle and low-income groups through direct cash subsidies and insurance coverage [11]. Childcare Services - The measures propose to strengthen the childcare service system by increasing the supply of public childcare spaces and establishing a dynamic adjustment mechanism for pricing and financial subsidies [6][7]. - The goal is to achieve a ratio of 4.5 childcare spaces per 1,000 population for children under three by 2025, with at least 60% of these spaces being affordable [7]. Housing Policies - Families with multiple underage children will receive priority in public rental housing allocations, and there will be support for increasing housing loan limits for families with many children [8][9]. - The measures also include provisions for families to withdraw housing provident fund contributions based on actual rent paid, easing the housing burden for multi-child families [8][11]. Education Support - The measures emphasize optimizing educational resource allocation and promoting free preschool education, while ensuring that siblings from the same family can attend the same school [8][11]. - There will be an increase in the supply of kindergarten places and support for after-school services in primary and secondary schools [8]. Employment and Labor Rights - The measures include provisions to enhance labor protections for women, particularly those who are pregnant or breastfeeding, and to support their re-employment after childbirth [8][11]. - The inclusion of unemployed individuals receiving unemployment insurance in the maternity insurance system is aimed at providing comprehensive support during childbirth [3][10]. Healthcare Services - The measures call for the establishment of at least one critical newborn rescue center in each district and the expansion of pediatric services in hospitals [5]. - There will be an emphasis on improving the quality of pediatric healthcare and ensuring that children's medications are included in insurance coverage [5].

Core Viewpoint - The National Healthcare Security Administration emphasizes the importance of the maternity insurance system as a key component of the reproductive support policy framework, aiming to foster a pro-natal society [1] Summary by Relevant Sections Coverage Expansion - The maternity insurance coverage is set to reach 253 million people by June 2025 [1] Improvement of Medical Expense Coverage - During the 14th Five-Year Plan period, a total of 96.14 million people have benefited from various maternity insurance benefits, with cumulative fund expenditures reaching 438.3 billion yuan [1] Expansion of Coverage Content - All 31 provinces (regions, municipalities) and the Xinjiang Production and Construction Corps have included assisted reproductive technology in reimbursement, with over 1 million people expected to benefit in 2024 [1] - Some provinces have also included pain relief during childbirth in the reimbursement scope, alleviating the burden and pain for pregnant women [1] Optimization of Management Services - The administration is exploring allowing newborns to participate in basic medical insurance using birth certificates, and aims to process maternity allowance applications within 10 working days, with over 60% of regions already implementing direct payments to individuals [1]

Core Viewpoint - The Chinese government is enhancing the direct issuance of maternity benefits to insured women, aiming to create a more supportive environment for childbirth and address the financial pressures faced by working mothers [1][4][5]. Group 1: Policy Implementation - As of June 12, nearly 60% of the national insurance areas have implemented direct payments of maternity benefits to individuals [1][4]. - The maternity benefits are funded by the maternity insurance system, not by the employers of the insured women [1][3]. - The average maternity benefit for insured women in 2024 is projected to exceed 26,000 yuan, with total expenditures on maternity insurance benefits reaching 143.1 billion yuan [4]. Group 2: Process Improvement - The process for claiming maternity benefits has been streamlined, eliminating the need for various documents such as marriage certificates and birth permits, which previously delayed payments [4][12]. - In regions where direct payments have been implemented, women can now apply for maternity benefits online, significantly reducing the processing time from 20 days to 10 days [9][12]. - The new system allows women to receive maternity benefits directly into their bank accounts without needing to leave their homes during the postpartum period [12][14]. Group 3: Future Directions - The National Healthcare Security Administration plans to promote the direct issuance of maternity benefits in more regions across the country [4][15]. - There is a call for further improvements in maternity policies, including the potential for automatic benefit issuance and enhanced support for families facing challenges in childbirth [15][17]. - The ongoing exploration of increasing maternity subsidies and extending maternity leave is seen as essential for creating a more family-friendly environment and attracting talent [17].