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新农合跨省就医可微信直接结算 每人平均少垫付七千余元

2017-09-07 15:22:00   央广网

央广网北京9月7日消息(记者孙冰洁)异地就医,如何报销?曾经困扰不少患者,对于人数众多的进城务工人员来说,更是一大难题。随着新农合跨省就医直接结算的推出,正在改变这一局面。截至今年八月末,全国共开通1518家跨省就医定点医疗机构,覆盖31个省(区、市),18235人实现新农合跨省就医直接结算,平均每人减少垫付7677.5元。

1518家跨省就医定点医疗机构可直接结算,覆盖31个省

8月底的一天,身在广东打工的吴磊(化名)突发急性胰腺炎,因为觉得广东的医院费用贵,他转而回到老家贵州习水入院治疗,一天后,当地医院因无法医治,主动提出将其转诊到四川省西南医科大学附属中医医院。

8月30日,吴磊正式入院。9月5日,基本康复的吴磊在该院办理出院手续,令他没想到的是,虽然不在户籍地就诊,但在结算时,他收到了新农合直接报销费用4258元,大病保险直接报销4401.83元,报销补偿比例达到了91.8%。

而吴磊也成为了全国“新农合+大病医保”跨省就医“一站式”结算的首个受益者。

“真是没想到,这下既解决了我到贵州习水报销的费用,又减轻了住院个人垫付的负担,很高兴。”吴磊说。

同样在8月,患有严重心脏病的西藏姑娘降央卓玛(化名),根据西藏自治区第二人民医院的转诊建议,来到北京协和医院就诊,就医总费用8.4万元,而按照新农合跨省就医联网结算政策,降央卓玛个人仅支付了3万,报销比例接近65%。

实际上,无论吴磊还是降央卓玛,都只是新农合异地就医直接结算政策的缩影。

据记者从国家卫计委处了解,截至8月底,新农合省内异地就医直接结算已覆盖辽宁、吉林、海南、四川等九省份的1.5亿参合人口,全国共开通1518家跨省就医定点医疗机构,覆盖31个省(区、市)。有191.4万人实现了新农合省内异地就医直接结算,平均每名患者减少垫付5496.3元;新农合跨省就医联网结算则达到了18235人,平均每人减少垫付7677.5元。

 哪些人可以进行跨省就医直接结算?

新农合跨省就医联网结报,意味着参合患者到省外的“跨省定点医疗机构”住院时,在出院时可在医院结算窗口直接结算,患者只需支付自付费用,其余费用则由跨省定点医疗机构先行垫付。

“这改变了以前参合患者需缴纳全部医疗费用,然后再回参合第报销的结算方式,不仅少垫钱,还能少跑腿。”在国家卫计委基层司监察专员聂春雷看来,经规范转诊后的新农合跨省就医患者除了享受以上好处之外,还可适量减少部分住院押金,减轻就医负担。

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