The National Healthcare Security Administration (NHSA) and the Ministry of Finance (MoF) have jointly issued a set of guiding opinions on “Expanding the Pilot Program for the Long-term Care Insurance System.” The document emphasizes that the long-term care insurance system should prioritize addressing the long-term care security needs of severely disabled individuals. It outlines responsibilities and explores mutual assistance funding methods to ensure the financial security for the basic living and related medical care of long-term disabled individuals.
The pilot program will initially target the insured population under the urban employee Basic Medical Insurance (BMI) scheme, focusing on the basic care needs of severely disabled individuals, with a priority on eligible elderly and severely disabled individuals. Where conditions allow, the pilot program may gradually expand to include other insured individuals.
Funding will primarily come from contributions by enterprises and individuals, typically shared in a 1:1 ratio. The enterprise contribution base is the total salary of employees, which can be deducted from their basic medical insurance premiums initially. The individual payment base is based on personal salary income, which can be withheld from their employee basic medical insurance personal account. Regions with the necessary conditions may explore additional financing channels, including financial support, to aid in paying for the special difficulties faced by retired employees.
Eligible disabled insured individuals, who have been diagnosed and treated by medical or rehabilitation institutions in a standardized manner and have been disabled for over six months, can enjoy the relevant benefits of long-term care insurance after assessment and recognition. Differentiated treatment and protection policies will be implemented based on various nursing levels and service delivery methods, with an emphasis on encouraging the use of home and community nursing services. For nursing service fees that meet regulations, the fund’s overall payment level is controlled at around 70%.
The document calls for establishing a basic policy framework for the growth and protection insurance system during the 14th Five Year Plan period. It envisions a robust regulatory mechanism for long-term care insurance funds, optimized service management, and encourages social participation in long-term care insurance services. The 12 pilot cities with established long-term care insurance systems and the two key provinces, Jilin and Shandong, will continue their pilot programs. Each of the 14 provinces that have not yet launched the pilot program will add one new city, to be initiated and implemented within this year, with a pilot period of two years. Regions are not permitted to independently expand the pilot scope.- Flcube.com
