聚焦"一老一小"群体，力促"直达快享"。系统性整合高血压、糖尿病等门诊慢特病病种至26种，实施分 级分类保障，年惠及老年患者超60万人次。全面推进长期护理保险制度，建制后将进一步减轻重度失能 人员家庭照护负担；在促进生育保障方面，将取卵术、胚胎培养等9项辅助生殖技术纳入医保支付范 围，报销比例达50%，每年为2000多个家庭减轻生育费用负担500余万元。生育津贴发放由"企业中 转"变为"个人直享"。"十四五"期间，生育保险累计为39.28万人次参保职工支付待遇17.97亿元。居民生 育医疗费用纳入基本医保报销范围，政策范围内住院分娩费用医保基金支付比例达70%以上。 强化资助参保，兜牢"保障底线"。将特困人员、低保对象、返贫致贫人口等精准标识于医保平台，并进 行动态更新，确保不重不漏。对特困人员进行全额资助，个人"零缴费"。对低保对象等实行定额资助， 大幅减轻个人负担。"十四五"期间，累计资助参保农村低收入人口达247.27万人次，支出参保资助资金 5.7亿元。 完善三重制度，化解"就医之忧"。提高财政补助与个人筹资标准，提升门诊统筹支付额度与基本医保待 遇。统一城乡居民大病保险起付标准，对困难群众实施"一降 ...

Core Insights - The central government has invested over 3 trillion yuan since 2018 to enhance health insurance coverage for residents, ensuring better security for vulnerable groups and more convenient medical services [1] - By 2025, the total number of residents benefiting from health insurance is expected to exceed 18 billion person-times, with significant financial support from the government [1] Group 1: Financial Support for Health Insurance - From 2018 to 2025, the central government has allocated a total of 2.87 trillion yuan for urban and rural residents' basic medical insurance subsidies, benefiting participants in the insurance scheme [1] - By 2025, the average total funding for urban and rural residents' basic medical insurance is projected to be 1,100 yuan per person, with government subsidies accounting for over 60% of this amount [1] Group 2: Medical Assistance and Coverage - The central government has provided 237.5 billion yuan for urban and rural medical assistance from 2018 to 2025, supporting 79.16 million people in participating in basic medical insurance in 2024 [1] - The reimbursement rate for rural low-income populations and those who have escaped poverty remains stable at over 90%, with insurance participation rates exceeding 99% [1] Group 3: Improvement in Medical Service Levels - From 2019 to 2025, the central government has allocated 27.6 billion yuan for enhancing medical service capabilities, leading to the establishment of a unified national health insurance information platform [2] - Over 1.2 billion people have benefited from the convenient medical insurance code, and the number of cross-province direct settlement cases has increased by 110 times [2] - The number of designated medical institutions for cross-province hospitalization has grown from 27,600 to 80,000 [2]

12月17日，据国家医保局消息，党中央、国务院始终把人民健康放在优先发展的战略位置，不断加大医 保领域财政投入规模。2018年以来，中央财政累计投入超3万亿元。一笔笔真金白银不断汇聚，让居民 参保更有保障、困难群众更加安心、医保服务更加便捷。 提升医保服务水平的目的是落实为民服务宗旨。各级医保部门通过医疗保障服务能力建设资金补短板、 强弱项，固底板、扬优势，帮助参保人就医、购药、报销更便捷、更高效。2019-2025年，中央财政累 计安排医疗保障服务能力建设资金276亿元。在资金支持下，全国统一的医保信息平台全面建成使用， 超12亿人享受医保码便捷就医，医保信息平台日均结算量超2800万人次，住院费用结算系统平均响应时 间仅0.8秒。经办服务能力有效提升，目前超9成的高频医保经办事项可以线上办理，9成以上乡镇（街 道）能够为群众提供"家门口"的医保经办服务。跨省异地就医直接结算规模不断扩大，2019-2025年， 全国跨省异地就医直接结算人次增长了110倍，住院费用跨省联网定点医疗机构数量由2.76万家增长至8 万家。 一、财政补助居民医保力度不断加大 各级医保、财政部门心系困难群众，通过医疗救助补助资金切实 ...

新华社北京12月3日电 题：健全多层次医疗保障体系 筑牢民生保障底线——访国家医保局局长章 轲 新华社记者彭韵佳 医保，关系每个参保人的切身利益。党的二十届四中全会审议通过的《中共中央关于制定国民经济 和社会发展第十五个五年规划的建议》（以下简称《建议》），提出"健全多层次医疗保障体系""推进 基本医疗保险省级统筹"等系列部署。 如何健全多层次医疗保障体系？如何让医保改革成果更好惠及群众健康？新华社记者专访了国家医 保局局长章轲。 破解看病难、看病贵问题取得突破性进展 问："十四五"时期，医疗保障制度改革如何提升百姓获得感？ 答：党的十八大以来，全民医疗保障制度改革持续推进，参保质量明显提升，人民群众医保获得感 显著提高。 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，城乡居民大病保险保障水平在基本医保基础上提高10到15个百分点。健全统一规范的医 疗救助制度。 ...

原标题：贯彻落实党的二十届四中全会精神权威访谈|健全多层次医疗保障体系 筑牢民生保障底线—— 访国家医保局局长章轲 新华社北京12月3日电（新华社记者 彭韵佳）医保，关系每个参保人的切身利益。党的二十届四中全会 审议通过的《中共中央关于制定国民经济和社会发展第十五个五年规划的建议》（以下简称《建 议》），提出"健全多层次医疗保障体系""推进基本医疗保险省级统筹"等系列部署。 如何健全多层次医疗保障体系？如何让医保改革成果更好惠及群众健康？新华社记者专访了国家医保局 局长章轲。 破解看病难、看病贵问题取得突破性进展 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，城乡居民大病保险保障水平在基本医保基础上提高10到15个百分点。健全统一规范的医疗 救助制度。 以"减负、提质、便民"为导向，多举措强化保障实效。"十四五"期间，医保基金累计支出超13万亿元， 惠及近200亿 ...

Group 1 - The core point of the article is that the China Securities Regulatory Commission has accepted the overseas listing application of QingSong Health Corporation, allowing the company to issue up to 36,496,400 ordinary shares on the Hong Kong Stock Exchange [1] - QingSong Health Corporation is a comprehensive health service enterprise focused on digital health management and insurance technology, covering areas such as health insurance, medical assistance, chronic disease management, and health service network construction [1] - The company aims to provide users with convenient and affordable health protection and services [1]

Core Insights - The China Securities Regulatory Commission has officially accepted the filing for the overseas listing of QingSong Health Corporation, marking a significant step in the company's progress towards an IPO in Hong Kong [1] Company Overview - QingSong Health Corporation is a comprehensive health service enterprise focused on digital health management and insurance technology, offering services in health insurance, medical assistance, chronic disease management, and health service network construction [1] Listing Details - The company plans to issue no more than 36,496,400 ordinary shares on the main board of the Hong Kong Stock Exchange [1] - This filing indicates substantial progress in the company's journey towards public offering and listing [1]

Group 1 - The core point of the article is that QingSong Health Corporation has received formal acceptance of its overseas listing application from the China Securities Regulatory Commission, marking a significant step in its process to go public in Hong Kong [1] - QingSong Health Corporation plans to issue no more than 36,496,400 ordinary shares on the main board of the Hong Kong Stock Exchange [1] - The company focuses on digital health management and insurance technology, providing services in health insurance, medical assistance, chronic disease management, and health service network construction [1] Group 2 - The listing application signifies substantial progress in QingSong Health Corporation's efforts to establish a public offering and listing [1] - The company aims to offer convenient and affordable health protection and services to its users [1]

Core Insights - The article highlights the importance of secondary reimbursement in China's medical insurance system, which is often overlooked by insured individuals, leading to significant financial losses [3][6]. Group 1: Current Status of Secondary Reimbursement - As of the first quarter of 2025, only 27.3% of eligible medical expenses were actually claimed for secondary reimbursement, indicating a lack of awareness among insured individuals [3]. - The secondary reimbursement system is part of a multi-tiered medical insurance framework, including major illness insurance, medical assistance, supplementary medical insurance, and employee personal accounts [4][5]. Group 2: Mechanisms of Secondary Reimbursement - Major illness insurance allows for reimbursement of 50% of medical expenses exceeding 50% of the local per capita disposable income, with no cap on the reimbursement amount [4]. - Medical assistance provided 873 billion yuan in funding in 2024, benefiting nearly 39.67 million people, with additional support for low-income households [4]. - Supplementary medical insurance has been established in 27 provinces, increasing reimbursement rates from 50% to an average of 70% for outpatient services [4]. Group 3: Challenges in Awareness and Application - A survey indicated that only 36% of insured individuals had a basic understanding of secondary reimbursement policies, and only 22% were aware of the specific application process [6]. - The complexity of the application process, requiring various documents and differing policies across regions, contributes to the low application rates [6]. Group 4: Efforts to Simplify Processes - The National Medical Insurance Administration has implemented a one-stop settlement reform, with 219 cities achieving this by June 2025, allowing for automatic calculation and settlement of various insurance claims [7]. Group 5: Maximizing Secondary Reimbursement Benefits - Insured individuals are encouraged to actively seek information about policies, retain all medical receipts, and inquire about eligibility for secondary reimbursement during hospital visits [9]. - Special provisions exist for certain demographics, such as higher reimbursement rates for individuals under 25 and additional benefits for seniors over 65 [9]. Group 6: Future Outlook and Policy Optimization - The 2025 work plan aims to increase the reimbursement rate for major illness insurance, lower the threshold for claims, and simplify application procedures, with a target of raising the application rate to over 50% [11]. - The total scale of the national medical insurance fund reached 3.2 trillion yuan in 2024, with 6.3% allocated for secondary reimbursement, indicating a focus on improving fund efficiency [11].

Core Viewpoint - The article emphasizes the significant advancements in China's healthcare insurance system during the "14th Five-Year Plan" period, focusing on improving coverage, reducing medical expenses for citizens, and enhancing the overall quality of healthcare services [1][2]. Group 1: Universal Coverage - The national basic medical insurance coverage rate has stabilized at around 95% during the "14th Five-Year Plan" period, with nearly 20 billion instances of insurance reimbursement expected from 2021 to 2024 [2]. - The introduction of measures such as allowing newborns to enroll in insurance using their birth certificates and expanding the coverage of maternity insurance aims to enhance accessibility [3]. Group 2: Benefit Expansion - By June 2025, approximately 253 million people are projected to participate in maternity insurance, with cumulative expenditures reaching 438.3 billion yuan, benefiting over 96.14 million instances [3]. - Various medical assistance policies have benefited 673 million rural low-income individuals, alleviating medical expenses by over 650 billion yuan [3]. Group 3: Healthcare Service Improvement - The introduction of the "medical insurance wallet" allows insured individuals to transfer personal account funds to family members for medical expenses, breaking provincial limitations [4]. - The number of designated medical institutions has reached 1.1 million, and the total number of drugs in the insurance catalog has reached 3,159, further reducing the financial burden on citizens [5]. Group 4: Technological Advancements - The establishment of a unified national medical insurance information platform has significantly improved service efficiency, enabling cross-province handling of high-frequency matters [6]. - The regulatory framework for medical insurance funds has been fully established, recovering over 100 billion yuan in misused funds [6]. Group 5: Future Outlook - The National Medical Insurance Administration aims to continue managing and utilizing medical insurance funds effectively, supporting the development of the pharmaceutical industry and contributing to the overall health of the population [7].