Table 1 Policy details of NCMS in 2008 and 2013
2008 | 2013 | |
|---|---|---|
Target population | Rural residents | Rural residents |
Risk-pooling unit | County | County |
Enrolment, % | 90.1% | 98.7% |
Total premium per person (Yuan) | 50 | 300 |
Government subsidy per person (Yuan) | 40 | 250 |
Individual contribution (Yuan) | 10 | 50 |
Benefit design | ||
Reimbursement for inpatient care | ||
Reimbursement ceiling (Yuan) | 10,000 per capita | 150,000 per capita |
Deductible/reimbursement ratea (Yuan/%) | ||
Township health centers | 50/50–60% | 0/90–100% |
County hospitals | 200–500/40–50% | 200–500/70–80% |
Municipal hospital | 1000/30–40% | 1000/60% |
Provincial hospital | 1500/20–30% | 1500/50% |
Reimbursement for outpatient care | ||
Reimbursement ceiling (Yuan) | NA (Outpatient pooling fund has not been established in 2008. It began in 2009.) | 20,000 per capita |
Reimbursement ratea | NA | 70% in village clinics and 60% in township health centers. |
Special disease of outpatient (Ceiling, Yuan/reimbursement ratea, %) | 3 types of critical illness and 11 types of chronic diseases of outpatient. (1000/50%) | 3 types of critical illness and 13 types of chronic diseases of outpatient. (20,000/60%) |
Reimbursement method | Later reimbursement | Immediate reimbursement and later reimbursement |