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跨省就医记得先去参保地“备案”
2017-09-06 07:22:49 中国青年网
本报讯(记者章鸽 实习生刘志成 通讯员彭燕娥 金睿)9月1日起,武汉城乡居民基本医保制度实现全城统筹,同时,异地就医住院费用也实现了直接结算,网民纷纷为这一系列社保新政点赞。5日下午,为解答市民在办理新参保手续时遇到的问题并解读新政,长江网武汉城市留言板和长江日报特邀市人社局相关负责人在线与网民实时互动,新医保参保手续和缴费标准、异地就医住院费用如何直接结算等成为网民关注的热点。
明年缴费标准统一为每人每年200元
网民:缴费标准如何确定?
市人社局医保处:新制度规定缴费标准与城乡居民人均可支配收入挂钩,各类居民按统一标准缴纳居民医疗保险费用,最初城镇居民医保启动的时候,当时是按人员的类型进行缴费的,新政统一了缴费标准。按照上上年度全市城乡居民人均可支配收入的0.57%,这个结果四舍五入取整以后由人社部门每年向社会公布。上上年度的含义就是2017年9月份开始征收2018年居民医保费,标准就是按照2016年人均可支配收入的0.57%确定,四舍五入是每人每年200元,所有人统一标准。
此外,武汉市城乡基本医疗保险没有任何户籍限制。覆盖范围确定为本市统筹范围内,这一描述超出了以往所说的本市行政区域内的范围,包含我市医疗保险延伸到的其他区域,比如说目前职工医保延伸到的南昌、宜昌、合肥等长江中游城市群,在宜昌的葛洲坝集团的职工也是武汉市城镇医疗保险统筹的范围。
三种情况需参保人现金垫付医疗费用
网民:城乡医保制度整合以后,参保人待遇有哪些?
市医保中心:待遇分三个方面,一是普通门诊,二是门诊医疗部分重症和慢性疾病,三是住院医疗待遇。
参保居民持社会保障卡,大学生持身份证,在全市定点医疗机构范围内选择就医。有三种类型需要到经办机构备案或者是核准以后才能够进行住院就医:一是参保居民病情需要,由本市三级医疗机构转往非定点医疗机构进行治疗的,就是说需要转诊转院医疗的参保居民必须由本市三级医疗机构备案以后进行审核结算。二是参保居民紧急抢救,或者是因外出务工,或者长期在外地居住需要在外地就医,这几种内容经社保医疗机构核准以后也可以按照政策进行结算。三是大学生在实习期间,在寒暑假期间,或者是在休学等不在校或院所期间需要因病住院医疗的,经社保经办机构备案以后也可以按政策进行结算。
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