本报乌鲁木齐讯（全媒体记者 郑娅莉） "多亏医保干部上门提醒，我才没错过今年的参保缴费。现在看 病有保障，心里很踏实！"2月24日，图木舒克市民王凌凌说。这是兵团医疗保障局依托医保大数据，扎 实推进"一人一档"参保数据库建设、推动参保服务从"人找政策"向"政策找人"转变的生动写照。 近年来，兵团构建兵、师、团、连四级联动服务体系，建成全民参保数据库，逐步实现从"群众跑 腿"到"数据跑路"、从"被动受理"向"主动服务"的升级。在2026年度居民医保集中征缴期内，兵团居民 医保缴费人数达126.57万人，参保巩固率达105.46%，位居全国前列。 兵团医疗保障局相关负责人介绍，近年来，兵团各级医保部门深入推进全民参保计划，紧盯扩面目标， 通过摸清底数、锁定人群、拓展宣传，强化与民政、教育、公安等部门协作，建立数据共享机制，精准 掌握各类人群参保状态；对符合条件的困难群众及时标识资助参保身份，筑牢防返贫保障网。"十四 五"以来，兵团累计为42.41万人次困难群众资助参保0.7亿元，实施医疗救助37.16万人次，支出救助资 金2.4亿元。 为更好服务职工群众，兵团医保部门推出多项创新举措：针对新生儿，打通卫健、税务、 ...

跨省临时外出就医人员，指临时外出，但因病因急诊需要在外省看病的参保人员。比如，因病情需 要，由本地医院转诊到北京、上海等医院的患者；去北京旅游时突发急性阑尾炎需要急诊手术的游客； 以及患有恶性肿瘤、器官移植、罕见病及精神类疾病等重大疾病患者。 便利参保者舒心过长假 海南发布异地就医备案指南 "临时去外地旅游，突然生病了医保给报销吗?""我要去省外出差一段时间，万一不舒服怎么 办?""爸妈从老家来帮我带孩子，看病能直接刷医保卡吗?"针对类似情形的问题，春节长假前夕，海南 省社会保险服务中心(省医疗保险服务中心)发布海南异地就医备案指南，让参保者便利舒心地过长假。 据了解，异地就医人员可分为三大类型： 跨省异地长期居住人员，指长期在参保地以外的地方居住、生活、工作的人员。比如，退休后搬到 子女所在城市生活的父母(异地安置退休人员)、长期在外地帮子女带娃的"老漂族"、被公司长期派驻外 省工作的员工等。 那么，该如何备案?"住院和门诊慢特病需要备案；普通门诊跨省直接结算，无需备案(针对海南参 保人)。"海南省社会保险服务中心(省医疗保险服务中心)有关负责人提醒，参保者采取线上办方式，请 先阅读提示内容，确保上传的材料 ...

《若干措施》提出，强化数据安全防护。加强数据共享利用全过程安全防护及运行监督，完善应急响应 与数据预警机制，筑牢数据安全风险防线，切实保护参保人个人信息及资金安全，确保数据合法合规共 享使用。 北京商报讯（记者 胡永新）2月12日，北京市医保局、北京金融监管局等部门联合发布《北京市支持商 业健康保险高质量发展的若干措施》（以下简称《若干措施》），在优化商业健康保险结算模式方面， 《若干措施》提出，建立便捷高效结算机制。结合商业保险业务实际、技术支撑能力及不同保险产品特 性，科学选择安全高效技术路线，推动医保商保"一站式"结算，帮助自愿参与该机制运行的商业保险公 司降低运营管理成本，提升理赔效率。支持西城区"医保+商保"清分结算中心建设，推进央地医保与商 保同步清分联动，形成示范效应。 ...

Core Viewpoint - The National Healthcare Security Administration (NHSA) has issued a notice to accelerate the cultivation and open support for large-scale applications in the medical security field, aiming to better integrate health protection and economic development functions [1][2]. Group 1: Scene Development and Application - The NHSA has collected a range of scenarios covering basic medical insurance, maternity insurance, medical assistance, and long-term care insurance, establishing a dynamic and regularly updated scenario database [1]. - The notice encourages the regular collection of scenarios related to medical technology advancements, optimization of convenient services, enhancement of management capabilities, cross-sector collaboration, and comprehensive value evaluation in the medical insurance field [1][2]. - Local medical insurance departments are encouraged to propose scenarios that reflect regional characteristics, address practical challenges, and have potential for promotion [1]. Group 2: Participation and Risk Management - Various entities, including enterprises, universities, research institutes, medical institutions, commercial health insurance organizations, mutual aid organizations, and charitable organizations, are encouraged to participate in the application of medical insurance scenarios [2]. - The NHSA will assess mature scenarios in the database and release a list of medical insurance scenarios in batches [2]. - A risk prevention mechanism will be established to prevent regulatory loopholes, ensuring a coordinated approach to scenario application and promoting steady and orderly development while avoiding redundant construction [2].

Core Viewpoint - The National Healthcare Security Administration (NHSA) is promoting the construction of high-value small incision scenarios to facilitate the large-scale application of new technologies, products, and business models in the healthcare insurance sector, addressing urgent issues faced by the public in this area [1] Group 1: Policy and Initiatives - The NHSA encourages various entities, including enterprises, universities, research institutions, medical organizations, commercial health insurance institutions, mutual aid organizations, and charitable organizations, to participate in the application of scenarios in the healthcare insurance field [1] - A list of urgently needed scenarios will be published to create replicable and promotable benchmark cases, serving the digital development of healthcare insurance and promoting economic and social development [1] Group 2: Service Improvement - By publicly addressing urgent issues faced by the public in healthcare insurance, the NHSA aims to enhance the level of healthcare services [1] - The focus will be on improving payment experiences for patients through the promotion of various payment methods such as facial recognition, QR code payments, mobile payments, and credit payments, attracting participation from medical and financial institutions [1] Group 3: Industry Impact - The cultivation and opening of scenarios in the healthcare insurance sector will effectively connect pricing, procurement, payment, service, regulation, and real-world comprehensive value evaluation, playing a positive role in creating industrial development opportunities and leading health consumption upgrades [1]

关键词阅读：医保 长护险 责任编辑：栎树 2026年2月2日，国家医疗保障局召开全国医疗保障系统党风廉政建设和反腐败工作视频会议。会议要 求，要健全多层次医疗保障体系，巩固全民参保成果，完善生育保险制度，全面推行长期护理保险，推 动医保影像互通互认，持续优化医保经办管理服务；注重务实求实真抓实干，稳妥推进基本医保省级统 筹，全面推进医保基金即时结算、直接结算、同步结算，深化医保支付方式改革、医疗服务价格改革， 开展真实世界医保综合价值评价试点，加强多层次目录管理，全链条支持创新药和医疗器械发展；及时 防范化解风险挑战，深化医保基金管理突出问题专项整治，严肃查处基金赤字问题，严厉打击欺诈骗保 行为，严守意识形态安全底线。 ...

Core Viewpoint - The National Healthcare Security Administration has issued a notification to accelerate the cultivation and opening of scenarios in the medical insurance sector, aiming to enhance the application of basic medical insurance, maternity insurance, medical assistance, and long-term care insurance. Group 1: Notification Requirements - Emphasis on demand orientation to address urgent issues in the medical insurance sector and improve service levels [2] - Promotion of open cooperation among various stakeholders, including enterprises, universities, research institutions, and charitable organizations [2] - Focus on demonstration and leading examples to create replicable and scalable cases for the digital transformation of medical insurance [2] - Commitment to safety and control by establishing risk prevention mechanisms to ensure orderly development [2] Group 2: Positive Impacts on Life - Improvement in medical insurance service levels by publicly addressing urgent issues and encouraging collaborative solutions [3][4] - Creation of industrial development opportunities through initiatives like the construction of a national medical imaging cloud, which will enhance data storage and transmission industries [5] - Promotion of health consumption upgrades by aligning with national strategies to expand domestic demand, leveraging the rise in service consumption as GDP per capita increases [6][7]

Group 1 - The city is focusing on enhancing medical insurance services, improving maternity-friendly policies, and reducing medical expenses for citizens in 2026 [1] - In the previous year, the total expenditure of the basic medical insurance fund reached 8.61 billion, with 447 million spent on major illness insurance benefiting 1.202 million people [1] - The city aims to deepen the "three-tiered guarantee" system, integrating various resources to meet diverse insurance needs [1] Group 2 - The "Long-term Care Insurance Quality Improvement Action" has been included in the city's 2026 livelihood projects, aiming to enhance the "bedside bathing" service brand [2] - The city will implement the 2025 National Basic Medical Insurance Drug Directory to improve coverage for critical areas such as cancer and chronic diseases [2] - A modern nursing service system will be established, focusing on dignity for disabled individuals through a combination of basic care and customized medical services [2] Group 3 - The city plans to create a convenient payment system integrating various payment methods to streamline the medical service process [3] - A comprehensive regulatory mechanism for the medical insurance fund will be established, ensuring traceability of drugs throughout their lifecycle [3] - Big data models will be utilized to detect illegal activities related to medical insurance fund usage, safeguarding public funds [3]

One of the biggest financial shocks retired Americans tend to face is healthcare costs. A lot of people incorrectly assume that health coverage through Medicare is free, only to realize there are numerous out-of-pocket costs involved. Some of those costs relate to deductibles and coinsurance. But Medicare Part B also charges a monthly premium that tends to increase from year to year. Where to invest $1,000 right now? Our analyst team just revealed what they believe are the 10 best stocks to buy right now, ...

全面构建"州—县—乡—村"四级医保经办服务体系，积极推进"高效办成一件事"和"全省通办"事项落 地；将17项医保业务下沉至乡镇服务窗口，依托村委会、村级卫生室设立385个村级医保代办点，14项 高频经办事项实现就近办结或帮代办。同时，充分发挥银行网点覆盖优势，通过与合作银行签订协议明 确"医银一体化"服务清单，将参保登记等19项高频事项授权银行直接办理或帮办引办。截至目前，已设 立33个医保经办服务代办点，医保经办"15分钟医保便民服务圈"服务效能持续提升。 通过开展"一把手走流程"活动，海西精准聚焦群众高频需求和服务盲区优化办事流程，实现企业女职工 生育津贴直接发放至个人。创新推行"延时办结""容缺受理"服务模式，将医保关系转移接续审核时限从 15个工作日压缩至7个工作日，累计解决各类服务堵点问题18个，办事效率大幅提升。 本报海西讯 （记者 李庆玲） 2025年，海西蒙古族藏族自治州医疗保障局紧扣"医保基金管理年"工作部 署，在落实医保政策、强化基金监管的同时，聚焦群众办事需求，通过服务提速、体系搭建、渠道拓 展、智慧赋能和基层延伸五大举措，推动医保服务提质增效，让"智慧医保"的便利惠及千家万户。 在"智 ...