大额补充保险筹资方式及保障效果——基于文山州职工医保的实践.pdfVIP

器翻幢管理平台 大额补充保险筹资方式及保障效果 一一基于文山州职工医保的实践 何仕高 (丈山州医疗保险基金管理中心文山州 663000) 【摘要】丈山州职工大额补充保险实行单位与个人共同缴费政策。用人单位按上年社平工资的 0.4% 缴纳，个人缴纳部分由原来单位代扣代缴改为从个人账户中划缴，年缴纳 84 元。稳定的资金来源增强了 大额补充保险的保障能力，已使 7000 多个重病患者家庭减轻了医疗费用负担。以费用为标准判定重病的 科学性也在实践中得到验证。 【关键词】大额补充保险;资金来源;保障效果;建议 【中国分类号】 f840.684 C913.7 【文献标识码】 A 【文章编号】 1674-3830(2013)11-56-2 doi: 10. 369/j. issn. 1674-3830.2013. 11 . 14 The Serious Disease Supplemental Insurance Financing Model and the Effectiveness Analysis Shigao He (Wenshan Zhuang and Miao Autonomous Prefecture Medical Insurance Fund Administrative Center, Wenshan Zhuang and Miao Autonomous Prefecture,663000) lAbstractl The Serious Disease Supplemental Insurance Financing Model in Wenshan state is based on the employer and individual co-pa严nent policy. The employers pay 0.4% of the average social wage of last year. The individual pa严nent were given oy individual account with an anually pa严nent of 84 Yuans instead of by the employers. The stable capital source guπanted the ability to support the serious diseases finacially and have reduced the medical expense burden in than 7000 families which have patietns with serious disease. The scientific features that determine a serious disease based on its expense is confirmed. Key wordsl serious illness supplement insurance, sources of funds, effect of guarantee, suggestion 1 基本情况 本医疗保险人数的 98%0 2012 年， 2.1 实行四个统一 云南文山州职工基本医保原有 9 职工参保患者住院达 31542 人次， 2010 年 10 月，州人民政府出 个县级统筹地区。 2001 年 1 月实施 占参保人数的 18% ，其中进入大额 台职工大额补充医保州