Core Insights - The "Shaanxi Universal Health Insurance" has gained significant attention and participation from citizens, with the enrollment period closing on December 31, 2025 [1] Group 1: Coverage and Benefits - The 2026 edition of "Shaanxi Universal Health Insurance" covers three main areas: out-of-pocket expenses within the insurance scheme, self-paid medical costs, and specific high-cost medications [2] - Two insurance plans are available: a basic plan costing 89 yuan with coverage up to 2 million yuan and an upgraded plan costing 169 yuan with coverage up to 5 million yuan, offering more extensive services and higher reimbursement rates [2] - Five key optimizations have been made, including reductions in out-of-pocket expenses and improvements in the coverage of pre-existing conditions and specific medications [2] Group 2: Enrollment and Claims Process - Family discounts are available for renewals without claims or for families enrolling three or more members at once, with the upgraded plan priced at 136 yuan per person per year [2] - The claims process is streamlined, allowing for immediate reimbursement for amounts up to 5,000 yuan upon discharge from partnered medical institutions, minimizing the need for upfront payments [2] - Enrollment is open to all residents of Shaanxi Province, regardless of age, occupation, or health status, as long as they are covered by basic medical insurance [3] Group 3: Payment Options - The program supports the use of personal medical insurance account balances for family members' premiums, eliminating the need for additional cash payments [3]

Core Points - The "Shaanxi Universal Health Insurance" was officially launched on October 15, 2023, as a government-guided supplementary medical insurance that effectively connects with basic medical insurance, offering coverage options of 200 million and 500 million yuan [1][3] - The program aims to alleviate the financial burden of medical expenses for patients and has shown significant social benefits over its three years of operation, with over 15 million claims and a total payout exceeding 411 million yuan [2][4] Government Support - The initiative has received strong support from various government bodies, enhancing the accessibility and fairness of medical services in Shaanxi [2][4] - It addresses issues related to the high costs of medical care and the risk of impoverishment for vulnerable groups [4] Product Features - The insurance offers two plans: a basic plan at 89 yuan with coverage up to 200 million yuan, and an upgraded plan at 169 yuan with coverage up to 500 million yuan, including various health management services [5][8] - Key optimizations include reduced deductibles for out-of-pocket expenses and improved coverage for pre-existing conditions and specific high-cost medications [5][8] Accessibility and Convenience - The program allows all basic medical insurance participants and new residents in Shaanxi to enroll without restrictions based on age, health status, or occupation [11] - A one-stop claims process is available, enabling immediate payouts upon discharge from hospitals affiliated with the program, enhancing user experience [9][11] Family and Community Benefits - The insurance promotes family coverage by allowing the use of individual medical accounts for family members, facilitating easier access to insurance [8][11] - Continuous enrollment and family group policies offer discounts, encouraging long-term participation in the program [8]

Core Points - The implementation of the "T+1" instant settlement system for medical insurance in Yulin City marks a significant advancement in the efficiency of medical fund settlements, reducing the settlement cycle from a maximum of 30 days to 24 hours [1][2] - The new system alleviates the financial pressure on hospitals by ensuring timely reimbursement, with the first transaction amounting to 278,400 yuan successfully credited to a hospital account [1] - Yulin City is one of the first pilot cities for the national basic medical insurance fund instant settlement reform, establishing a comprehensive "instant settlement" system that integrates various processes [1] Summary by Sections Instant Settlement System - Yulin City's medical insurance "T+1" instant settlement system has officially launched, allowing for next-day payments instead of monthly disbursements [1] - The system aims to enhance the efficiency of medical fund settlements and reduce the financial burden on healthcare institutions [1] Financial Impact - Prior to the reform, hospitals faced an average monthly advance payment of over 10 million yuan for medical insurance funds, which has now been significantly reduced [1] - As of now, 8 medical institutions in Yulin have completed instant settlement applications for a total of 3,471 cases, with medical expenses amounting to 34.62 million yuan and actual medical insurance fund disbursements of 10.27 million yuan [2] Integration with Other Insurance Programs - Since 2023, Yulin City has achieved a "one-stop" synchronous settlement for the Shaanxi Universal Health Insurance, basic medical insurance, major illness insurance, and medical assistance [2] - By the end of April this year, 90 medical institutions at the secondary level and above in Yulin City are capable of conducting synchronous settlements for the Shaanxi Universal Health Insurance [2]