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人社部回应跨省异地就医 是否意味着医保全国漫游

2017-09-27 04:47:52   

中新网北京9月27日电 跨省异地就医直接结算进展如何?将惠及哪些人群?具体要走什么样的程序?是否意味着医保全国漫游?人社部26日回应并解读了有关跨省异地就医直接结算的四大热点问题。

北京一家医院门口悬挂着开通跨省异地就医直接结算的横幅。中新网记者 李金磊 摄

总体进展如何?

“全国联网和跨省异地就医结算工作进展顺利,国家异地就医结算系统联通各地。”人社部社会保险事业管理中心主任唐霁松表示,用一句比较形象的话说,就是高速公路已经修通,凡是符合条件的参保人员跨省异地就医住院费用都可以借助这一系统实现直接结算,不必先自己垫资再回参保地报销了。

据介绍,截至9月25日,已全面联通所有统筹地区、覆盖城镇职工、城乡居民各类医保制度,服务异地安置退休、异地长期居住、常驻异地工作和异地转诊四类跨省就医人群,开通了7226家跨省异地就医住院医疗费用直接结算定点医疗机构。

唐霁松透露,已实现跨省住院医疗费用直接结算4.1万人次,基金支付5.6亿元,平均为每人次患者减少垫付1.36万元。9个月来,全国跨省异地就医结算系统运行平稳。

资料图:北医三院的发药窗口。中新网记者 张尼 摄

将惠及哪些人群?

跨省异地就医直接结算将惠及哪些人群?对此,唐霁松表示,现在从人群的范围看,全国联网结算工作,最开始的群体是先从参加城镇职工的异地安置的退休人员起步。现在根据工作管理的范围和服务能力,以及人民群众的要求,不断扩大受益群体的范围,努力实现参保人员的全覆盖。

说得直白一点,无论是在异地长期居住、生活还是工作,还是因客观需要转诊到异地住院,都可以享受医保直接结算 。”唐霁松说。

据介绍,从目前进行的已经结算人员的结构分析,异地安置的退休人员占整个人群的39%,异地长期居住人员占10.3%,常驻异地的工作人员,比如一些驻外的办事处等等,或者是在外地的急诊就医人员达到1.6%,异地转诊人员占到49.1%。现在异地就医结算的群体呈现出多样性。

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