告别复杂报销程序 困难群众医疗费即时减免

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霸者站群 发表于 2017-7-4 00:50:35
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    南都讯 南方日报记者 李强 实习生 周潺方晨 广东省民政厅、财政厅、人社厅、卫计委近日联合发出《关于开展城乡困难群众医疗救助和优抚医疗费“一站式”结算服务的通知》(下称《通知》),困难群众在医院看病,将可即时得到医疗费用减免,而不用再经过复杂的报销程序审批。

    “一站式”服务实现“即时救助”

    《通知》指出,医疗救助“一站式”服务的对象包括:参加基本医疗保险的城乡低保对象、农村五保户、城镇“三无”人员、县级以上人民政府认定并在民政部门备案的其他救助对象。

    优抚医疗费“一站式”服务对象包括:退出现役的残疾军人、在乡复员军人(含红军失散人员)、带病回乡退伍军人,享受国家定期抚恤的烈士遗属、因公牺牲军人遗属、病故军人遗属和享受国家定期补助的参战涉核退役人员等优抚对象,以及县级以上政府规定的且在民政部门备案的其他特殊困难人员。

    据了解,服务对象在户籍所在地的基本医疗保险定点医疗机构(下称“定点医疗机构”)就医所发生的医保政策范围内的医疗费用,经相关保障制度补偿后的个人自付部分,按对象分类给予一定比例的救助。

    上述对象在定点医疗机构就医时,实行基本医疗保险和基本医疗救助、优抚对象医疗补助同步结算的“一站式”服务,即实现“即时救助”。享受低保救助的优抚对象应先进行优抚医疗费结算再进行医疗救助补助。

    “五保”“三无”人员免收住院押金

    《通知》强调,加大医疗救助和优抚医疗费补助力度,农村五保对象、城镇“三无”人员免收住院押金,取消医疗救助起付线。逐步降低或取消低保对象、优抚对象的医疗救助起付线和住院押金,逐步提高医疗救助封顶线。对患重特大疾病的农村五保对象、城镇“三无”人员等特困人员,做好诊前医疗救助,确保其能得到及时医治。

    《通知》还要求,按照当地城乡最低生活保障标准人月增加14%的比例,安排本级医疗救助资金预算;从地方留存的社会福利彩票公益金中按20%的比例,列支医疗救助金;积极发动社会力量募集医疗救助资金,充分发挥各级财政和社会资金的使用效益。医疗救助资金实行专账管理,不得挪用、挤占和超比例结余,年度结余不得超过本年度筹资总额的10%,累计结余不得超过15%。

    月底完成相关信息系统建设

    据了解,城乡医疗救助结算标准是:服务对象在户籍所在地市、县(市、区)内定点医疗机构就医,基本医疗保险政策范围内医疗费用的自付部分,农村五保户、城镇“三无”人员实行基本医疗费用(含门诊、住院)全额救助;城乡低保对象基本医疗救助比例2013年不低于60%,2015年达到70%以上。

    优抚医疗费结算标准按照民政部以及各地有关优抚对象医疗费报销的相关政策标准执行。

    《通知》要求,各市、县(市、区)于今年10月30日前完成本级医疗救助和优抚医疗费“一站式”结算信息系统的建设和联网。该系统将与医保信息系统对接,以实现医疗费用同步结算。

    医疗救助“一站式”服务

    服务对象:参加基本医疗保险的城乡低保对象、农村五保户、城镇“三无”人员、县级以上人民政府认定并在民政部门备案的其他救助对象。

    城乡医疗救助结算标准:服务对象在户籍所在地市、县(市、区)内定点医疗机构就医,基本医疗保险政策范围内医疗费用的自付部分,农村五保户、城镇“三无”人员实行基本医疗费用(含门诊、住院)全额救助;城乡低保对象基本医疗救助比例2013年不低于60%,2015年达到70%以上。



        
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yXCp8Tyo0 发表于 2017-7-4 20:21:38

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gucws 发表于 2017-7-8 20:23:50
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jgmsz 发表于 2017-7-12 16:32:31
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雪安鲲 发表于 2017-7-12 17:09:12
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凡长勤 发表于 2017-7-12 17:12:35
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传胜纯 发表于 2017-7-12 17:27:52
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才东权 发表于 2017-7-12 17:36:59
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