"十五五"规划建议提出，推行长期护理保险，健全失能失智老年人照护体系，扩大康复护理、安宁疗护 服务供给。 2016年国家启动长期护理保险制度试点，2020年试点工作稳妥有序扩大至49个城市……9年来，试点工 作总体进展顺利，阶段目标基本实现。 ——编 者 数据显示，目前我国有超4500万失能失智老年人，长期护理保险有助于应对"一人失能、全家失衡"的社 会难题，为失能人群及其家庭带来了希望。 长护险如何购买、如何理赔？参保者能享受哪些服务和保障？针对失能老年人等群体有什么便利化举 措？ 报销一定比例医疗服务费，缓解失能老人家庭压力 "大爷，按摩完感觉好一些了吧？该吸氧了。"护工陈小亮扶着82岁的老人王保安坐了起来，把吸氧管伸 到他的鼻下。家住山西晋城市城区的王保安，患有肺气肿等多种疾病，不能正常走路、双手时常颤抖。 老人此前参保了长护险，2024年4月申请了长护险待遇，选择了居家和上门护理叠加的模式。 应对"一人失能、全家失衡" 长护险守护失能人群幸福(民生一线·关注长期护理保险) 自成为试点城市以来，青岛逐步完成长护险从职工到居民、从城市到农村、从失能到失智、从医疗护理 到生活照料的探索。像刘爱英这样的失能老 ...

Core Insights - The article highlights the importance of long-term care insurance (LTCI) in addressing the needs of elderly individuals with disabilities and dementia, emphasizing its role in enhancing the caregiving system and expanding rehabilitation and palliative care services [1] Group 1: Long-Term Care Insurance Overview - Long-term care insurance is a significant social insurance system in China aimed at providing care services for individuals who are unable to care for themselves due to aging, illness, or disability, recognized as the "sixth insurance" after five major social insurances [1] - Eligible individuals can choose to receive care services at designated institutions or through home care provided by these institutions [1] Group 2: Implementation in Ningbo - Ningbo has been a pilot city for LTCI since 2017, and in 2023, it expanded the coverage to include all age groups of insured individuals, establishing a comprehensive system for funding, demand assessment, benefit payment, service provision, and management [2] - An individual named Wu Haoliang, classified as a severe disability level I, pays only 30 yuan annually to receive 20 hours of home care services each month [2] Group 3: Impact on Individuals - The article illustrates the positive impact of LTCI on individuals like Wu Haoliang, who, despite facing severe health challenges, found hope and support through professional care services [2][3] - The professional caregivers, such as Dai Xingdi, play a crucial role in not only providing physical care but also in supporting the psychological well-being of the individuals they care for, highlighting the difference between professional care and family care [3] - Over 47,000 individuals in Ningbo have benefited from LTCI, with more than 6% of them being individuals under 60 years old with severe disabilities, showcasing the program's broad and inclusive nature [3]

Core Insights - The article discusses the emergence of long-term care insurance (LTCI) in China as a solution to the challenges posed by an aging population, aiming to alleviate family burdens and stimulate a multi-billion dollar care industry [4][5][6]. Group 1: Long-term Care Insurance Overview - Long-term care insurance is being implemented nationwide in China, with pilot programs already in place in regions like Zhejiang and Hainan [4]. - The primary goal of LTCI is to reimburse care costs for individuals with disabilities or dementia, thereby reducing the financial strain on families [4]. Group 2: Funding Challenges - The main obstacle to LTCI's success is funding, which currently relies on the transfer of medical insurance funds and government subsidies, leading to inconsistent coverage levels across different regions [5]. - There is a need for innovative solutions to enhance funding, including shared financial responsibility between employees and employers, government support for residents, and utilizing dormant funds in personal medical accounts [5]. Group 3: Collaborative Approaches - A multi-faceted approach is suggested, involving collaboration between commercial insurance, charitable funds, and the establishment of a new framework that combines basic insurance with social supplements [5]. - The implementation of digital monitoring through big data is recommended to ensure transparency in fund allocation and prevent fraudulent claims [5]. Group 4: Future Outlook - With improved systems, transparent regulations, and professional care services, the vision of "aging with dignity" in China can become a reality rather than a distant dream [6][7].

优化长护险筹资机制，让机制运转更高效，监管体系更透明，长护险才能真正守护"老有所养"。 优化长护险筹资机制，首先要减负。一方面，可根据不同群体建立差异化缴费机制，职工群体由单位与 个人共同分担，城乡居民由政府与个人共担，明确各方主体责任；另一方面，打通资金流通壁垒，提高 资金利用效率，允许医保个人账户余额支付保费。同时通过连续参保激励机制、真实案例宣传等方式增 强公众信任与参保意愿，让居民感到长护险是保障，而非额外负担。 构建多层次保障体系，引导多元主体共同参与。在基本长护险制度基础上，鼓励商业保险公司开发多样 化长护险产品，满足群众差异化需求。同时，发挥慈善基金、福彩公益金等社会力量的补充作用，建 立"基本保险为主体、商业保险和公益基金为补充"的多元协同机制，让更多资源共同汇入养老与护理服 务领域。 优化资金管理，健全监管和绩效评估体系。长护险资金量大、周期长，必须做到"用得其所"。在设立专 业机构负责资金分配与监管工作的同时，也需第三方审计与动态评估制度的协同配合，防止虚假护理、 套取补贴等现象。此外，还应加快推进数字化监管，利用大数据对资金流向、服务质量进行实时监测， 确保每一分资金都切实用于失能群体的 ...

Core Viewpoint - The Long-term Care Insurance (LTCI) system in China is transitioning from pilot programs to nationwide implementation, aiming to provide essential care for the disabled population, which has been accelerated in recent years [1][2][5]. Summary by Sections Long-term Care Insurance Overview - LTCI, known as the "sixth social insurance," has covered approximately 188 million people since its pilot launch in 2015, with recent efforts to expand its reach to more families [2][5]. - The system aims to support individuals with long-term disabilities by providing basic living care and medical services [3][4]. Implementation in Changzhou - Changzhou, a city with a significant aging population (29.7% aged 60 and above by 2024), has fully implemented LTCI since 2022, following a pilot in 2019 [4]. - The city employs a "social-commercial cooperation" model for LTCI, enhancing operational efficiency through partnerships with insurance companies [4]. - As of now, around 25,000 disabled individuals in Changzhou benefit from LTCI, with services including home care and financial support for caregiving [3][4]. Nationwide Expansion - Since 2016, LTCI has been piloted in 15 cities, expanding to 49 cities by 2020, with nearly 1.88 billion participants and 1.4625 million receiving benefits by the end of 2024 [5][6]. - Recent government policies have emphasized the need for a standardized and accelerated establishment of LTCI across the country [6]. Funding Mechanism - The LTCI fund is projected to have a total income of 24.415 billion yuan and expenditures of 13.108 billion yuan in 2024, indicating a stable financial operation [7]. - Funding sources include personal contributions, medical insurance allocations, fiscal subsidies, and employer contributions, with a shift towards a more diversified funding model anticipated [7]. Coverage and Inclusivity - Current coverage primarily includes urban employees and residents under basic medical insurance, with plans to extend benefits to retirees, flexible workers, and unemployed residents [8]. - The LTCI system is designed to be independent and standardized, ensuring equitable access to benefits for all citizens [8]. Challenges and Future Directions - The LTCI system faces challenges related to regional disparities and the "last mile" issue, particularly for disabled individuals who relocate [9][10]. - Efforts are underway to establish inter-provincial service recognition and direct settlement mechanisms to address these challenges [9]. - The involvement of commercial insurance is seen as crucial for enhancing risk management and service integration within the LTCI framework [11].

央视网：我国失能失智老人面临的核心痛点是什么？长护险主要解决哪些社保覆盖不到的难题？ 胡宏伟：我国老龄化形势严峻：老年人口规模大、增速快，高龄老人多，家庭失能照护负担沉重，失能照护面临资金筹集和服务不足的双重挑战。 而现 有的社会保险体系功能并未覆盖失能照护服务的经济支持。 在此背景下，长护险应运而生，主要为失能人群报销一定比例或额度的专业护理服务费用，包括机构护理和上门服务等，从而减轻家庭压力，推动医养结 合，促进相关产业发展。 央视网：截至2023年，我国长护险试点已覆盖49个城市，累计支出超过850亿元。2024年，定点服务机构达8837家，护理人员29.28万人。请问试点阶段有 哪些成果和经验可推广？ 胡宏伟：整体来看，试点成果显著：一是初步建立了制度框架；二是减轻了家庭负担，多数地区政策规定报销比例为70%左右；三是带动了护理产业发 展，创造相关就业岗位，推动养老服务业专业化发展。 截至2023年底，我国60岁以上老年人口已达2.97亿，其中失能、失智老年人约4500万。国内老龄化进程加速与医疗资源结构性短缺的矛盾，加剧了老年人 带病生存的困境。 自2016年起，我国在49个城市启动长期护理保险（简 ...

Core Insights - The aging population in China is driving the demand for diversified pension security, prompting the insurance industry to innovate products and services to meet the needs of the elderly and their families [1][3] Group 1: Policy Developments - The Beijing Civil Affairs Bureau issued guidelines to enhance comprehensive liability insurance for elderly care institutions, covering accidental injuries, legal fees, and third-party liabilities [1][2] - The implementation of these guidelines signifies a move towards ensuring comprehensive insurance coverage for elderly care facilities, with similar initiatives reported in regions like Xinjiang, Hebei, and Shanghai [1][2] Group 2: Insurance Products - Elderly care liability insurance compensates for economic liabilities incurred by care institutions due to accidents involving residents, covering personal injury, legal fees, and rescue costs [2] - The introduction of long-term care insurance (LTCI) is crucial as the number of elderly individuals requiring long-term care increases, with over 1.8 billion people expected to be insured by the end of 2024 [3] Group 3: Market Innovations - The market is seeing innovations such as dedicated commercial pension insurance and inclusive health insurance products that cater to the elderly, enhancing their financial security [4] - The People's Bank of China and other departments are promoting the development of pension insurance pillars and encouraging innovation in commercial annuity products to better serve the aging population [4] Group 4: Challenges and Recommendations - The pension finance system faces challenges such as disparities in basic pension benefits, low coverage of enterprise annuities, and complexity in third-pillar products [5] - Experts suggest leveraging financial technology to reconstruct the pension ecosystem, emphasizing the need for personalized asset allocation and a service platform that is both age-friendly and trustworthy [5]

[ 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 ...

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定。引导长期护理服务 下沉，提升居家、社区照护服务的可及性和可适性。 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。 试点地区也在进一步完善长护险制度。据"上海发布"，8月25日，上海市委副书记、市长龚正主持召开 市政府常务会议，会议原则同意适当提高长护险养老机构照护费用支付标准并指出，适当提高长护险支 付标准，核心目的是减轻养老机构中失能老人负担，让失能老人 ...

在前期试点的基础上，将用三年左右基本建立长护险制度。 目前49个国家试点城市中，很多城市都是从职工医保起步，逐步覆盖到城乡居民，还有部分城市从2016 年启动试点以来至今尚未将城乡居民纳入长护险。 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定。引导长期护理服务 下沉，提升居家、社区照护服务的可及性和可适性。 一周之后的8月22日，国家医保局在长护险首批试点城市四川成都举办上述培训班。 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 ...