事关你我！仙桃解读各项医保政策实施细则>>
<div class="wx_rich_media_content" id="jsWxContainer"><section data-role="outer" label="edit by 135editor"><p style="text-align: justify; outline: 0px; max-width: 100%; line-height: normal; visibility: visible; font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; box-sizing: border-box !important;"><br data-filtered="filtered" style="outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"></p><section neue="neue" pingfang="pingfang" sc="sc" hiragino="hiragino" gb="gb" ui="ui" microsoft="microsoft" arial="arial" sans-serif="sans-serif" px="px" justify="justify" rgb="rgb" important="important" helvetica="helvetica" sans="sans" yahei="yahei" break-word="break-word" border-box="border-box" data-role="outer" label="Powered by 135editor.com" data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="outline: 0px; max-width: 100%; letter-spacing: 0.544px; font-size: medium; color: rgb(0, 0, 0); text-align: right; visibility: visible; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; box-sizing: border-box !important;"><section data-role="paragraph" data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"><section data-role="paragraph" data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"><section data-role="paragraph" data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"><section data-role="paragraph" data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"><section data-role="paragraph" data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"><section data-role="paragraph" data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"><section data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"><section data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="outline: 0px; max-width: 100%; letter-spacing: 0.544px; font-size: 16px; visibility: visible; box-sizing: border-box !important;"><section data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"><section data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"><section data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="margin-top: 10px; margin-bottom: 10px; outline: 0px; max-width: 100%; letter-spacing: 0.544px; align-items: center; display: flex; text-align: justify; visibility: visible; box-sizing: border-box !important;"><section data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="box-sizing: border-box; outline: 0px; max-width: 100%; display: inline-block; vertical-align: bottom; width: auto; flex: 1 0 1px; letter-spacing: 0px; visibility: visible;"><section data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="margin-top: 0.5em; margin-bottom: 0.5em; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"><section data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="outline: 0px; max-width: 100%; border-top: 1px dashed rgb(62, 62, 62); height: 0px; line-height: 0; visibility: visible; box-sizing: border-box !important;"><br data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" data-filtered="filtered" style="outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"></section></section></section><section data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="box-sizing: border-box; padding-right: 10px; padding-left: 10px; outline: 0px; max-width: 100%; display: inline-block; vertical-align: bottom; width: auto; flex: 0 1 auto; box-shadow: rgb(0, 0, 0) 0px 0px 0px; line-height: 0; visibility: visible;"><section data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"><section data-darkmode-bgcolor-15932285319316="rgb(232, 202, 21)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 222, 23)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="box-sizing: border-box; outline: 0px; max-width: 100%; border-color: rgb(62, 62, 62); background-color: rgb(255, 222, 23); display: inline-block; width: 9px; height: 9px; vertical-align: top; overflow: hidden; border-width: 1px; border-radius: 100px; border-style: solid; box-shadow: rgb(255, 255, 255) 1px 1px 0px inset; line-height: 0; letter-spacing: 0px; visibility: visible; color: rgb(67, 67, 67) !important;"><br data-darkmode-bgcolor-15932285319316="rgb(232, 202, 21)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 222, 23)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" data-filtered="filtered" style="outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"></section></section></section><section data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="box-sizing: border-box; outline: 0px; max-width: 100%; display: inline-block; vertical-align: bottom; width: auto; flex: 1 0 1px; visibility: visible;"><section data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="margin-top: 0.5em; margin-bottom: 0.5em; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important;"><section data-darkmode-bgcolor-15932285319316="rgb(25, 25, 25)" data-darkmode-original-bgcolor-15932285319316="rgb(255, 255, 255)" data-darkmode-color-15932285319316="rgb(163, 163, 163)" data-darkmode-original-color-15932285319316="rgb(0, 0, 0)" style="outline: 0px; max-width: 100%; border-top: 1px dashed rgb(62, 62, 62); height: 0px; line-height: 0; visibility: visible; box-sizing: border-box !important;"><br></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section><section><section data-role="outer" label="edit by 135editor"><section style="margin-bottom: unset;"><section><section data-id="98758" style="outline: 0px;visibility: visible;"><section style="margin: 10px auto;outline: 0px;text-align: center;line-height: 1.75em;visibility: visible;"><section style="outline: 0px;display: inline-block;visibility: visible;"><section style="outline: 0px;display: flex;justify-content: flex-start;visibility: visible;"><section data-width="45%" style="max-width: 45% !important;box-sizing:border-box;margin-bottom: -8px;outline: 0px;width: 45%;height: 8px;background: #366092;overflow: hidden;visibility: visible;"><br style="outline: 0px;visibility: visible;"></section><section style="box-sizing:border-box;margin-bottom: -8px;outline: 0px;width: 0px;height: 1px;border-top: 8px solid #366092;border-right: 8px solid transparent;overflow: hidden;visibility: visible;"><br style="outline: 0px;visibility: visible;"></section></section><section style="padding: 1em;outline: 0px;border-width: 8px;border-style: solid;border-color: #ebeeed #ebeeed #ebeeed #366092;visibility: visible;box-sizing: border-box;"><section data-autoskip="1" style="outline: 0px; text-align: justify; line-height: 1.75em; letter-spacing: 1.5px; visibility: visible;"><p hm_fix="379:464" style="outline: 0px;vertical-align: inherit;visibility: visible;"><span style="outline: 0px;visibility: visible;font-size: 18px;"> 9月28日下午，市政府新闻办召开仙桃市医保政策解读新闻发布会，介绍《仙桃市职工基本医疗保险门诊共济保障实施细则》《仙桃市健全重特大疾病医疗保险和救助制度实施细则》相关背景情况和主要内容，并回答记者提问。</span></p></section></section><section style="outline: 0px;display: flex;justify-content: flex-start;visibility: visible;"><section data-width="35%" style="max-width: 35% !important;box-sizing:border-box;margin-top: -8px;outline: 0px;width: 35%;height: 8px;background: #366092;overflow: hidden;visibility: visible;"><br style="outline: 0px;visibility: visible;"></section><section style="box-sizing:border-box;margin-top: -8px;outline: 0px;width: 0px;height: 1px;border-top: 8px solid #366092;border-right: 8px solid transparent;overflow: hidden;visibility: visible;"><br style="outline: 0px;visibility: visible;"></section></section></section></section></section><section style="outline: 0px;visibility: visible;"><section style="margin-bottom: 0em;outline: 0px;text-align: center;line-height: 1.75em;visibility: visible;"><span class="wxart_image" wx-style="display:inline-block;box-sizing: border-box;vertical-align: inherit;height: 370px;outline: 0px;display: initial;width: 100%;visibility: visible !important;"></span></section></section><section style="outline: 0px;letter-spacing: 0.544px;text-align: center;line-height: 1.75em;visibility: visible;font-family: -apple-system, BlinkMacSystemFont, Arial, sans-serif;"><span style="outline: 0px; color: rgb(136, 136, 136); visibility: visible;">新闻发布会现场</span></section><section data-id="100782" style="outline: 0px;letter-spacing: 0.544px;visibility: visible;font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif;"><section style="margin: 10px 5px 10px 10px;outline: 0px;text-align: center;visibility: visible;"><section style="outline: 0px;visibility: visible;"><section style="margin-top: -2px;padding-bottom: 4px;outline: 0px;border-width: 1px;border-style: solid;border-color: #ffffff;background-position: initial;background-size: initial;background-repeat: initial;background-attachment: initial;background-origin: initial;background-clip: initial;visibility: visible;box-sizing: border-box;"><section style="margin-top: -6px;margin-right: 4px;margin-left: -7px;padding: 1em 1em 1em 1.5em;outline: 0px;border-width: 1px;border-style: solid;border-color: #f2f2f2;overflow: hidden;visibility: visible;box-sizing: border-box;"><section data-autoskip="1" style="outline: 0px; text-align: justify; line-height: 1.75em; letter-spacing: 1.5px; color: rgb(255, 255, 255); visibility: visible;"><section style="outline: 0px;line-height: 1.75em;visibility: visible;"><span style="outline: 0px;color: #366092;visibility: visible;"><strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;background-color: #fefefe;visibility: visible;">●</span></strong><strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;font-size: 17px;visibility: visible;">发布人</span></strong></span></section><section style="outline: 0px;line-height: 1.75em;visibility: visible;"><strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;color: #000000;font-size: 17px;visibility: visible;">谢 娟</span></strong><span style="outline: 0px;color: #000000;font-size: 17px;visibility: visible;">市医疗保障局党组成员、副局长</span></section><section style="outline: 0px;line-height: 1.75em;visibility: visible;"><strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;color: #000000;font-size: 17px;visibility: visible;">向志军</span></strong><span style="outline: 0px;color: #000000;font-size: 17px;visibility: visible;">市医疗保障局党组成员、副局长</span></section><section style="outline: 0px;line-height: 1.75em;visibility: visible;"><strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;color: #000000;font-size: 17px;visibility: visible;">曾 亮</span></strong><span style="outline: 0px;color: #000000;font-size: 17px;visibility: visible;">市医疗保障服务中心副主任</span></section></section></section></section></section></section></section><section style="margin-bottom: 0em;outline: 0px;text-align: center;line-height: 1.75em;visibility: visible;"><span class="wxart_image" wx-style="display:inline-block;box-sizing: border-box;vertical-align: inherit;height: 416px;outline: 0px;display: initial;width: 100%;visibility: visible !important;"></span></section><p style="outline: 0px;line-height: normal;visibility: visible;"><span style="outline: 0px; color: rgb(136, 136, 136); visibility: visible;">市医疗保障局党组成员、副局长谢娟介绍《仙桃市职工基本医疗保险门诊共济保障实施细则》《仙桃市健全重特大疾病医疗保险和救助制度实施细则》相关背景情况和主要内容。</span></p><section data-support="96编辑器" data-style-id="32639"><section style="margin-top: 10px;margin-bottom: 10px;padding: 14px;border-width: 5px 1px 1px;border-style: solid;border-color: #3a81ed;box-sizing: border-box;"><section style="color: rgb(0, 0, 0); letter-spacing: 2px; line-height: 1.75em; transform: rotateZ(0deg);"><section style="text-align: justify;line-height: 2em;"><span style="font-size: 18px;"> 9月9日，市人民政府印发了关于医疗保障方面的2部实施细则,《仙桃市职工基本医疗保险门诊共济保障实施细则》（以下简称《门诊共济实施细则》）、《仙桃市健全重特大疾病医疗保险和救助制度实施细则》（以下简称《救助制度实施细则》）。下面，我就印发2部实施细则的相关背景和主要内容向大家作介绍。</span></section></section></section></section></section><section data-support="96编辑器" data-style-id="37979"><section style="padding-top: 25px; padding-bottom: 15px; box-sizing: border-box;"><section><section style="display: inline-block;"><section style="padding: 5px 10px;background-color: #205792;box-sizing: border-box;letter-spacing: 2px;color: #ffffff;font-size: 16px;"><p><strong>一、起草背景</strong></p></section><section style="box-sizing:border-box;height: 0px;width: 0px;border-right: 7px solid #3a81ed;border-top: 5px solid #3a81ed;border-left: 7px solid transparent !important;border-bottom: 5px solid transparent !important;"><br></section></section><section style="margin-top: -22px;margin-left: 13px;padding-right: 10px;padding-bottom: 10px;padding-left: 10px;border-left: 1px solid #5898f8;box-sizing: border-box;"><section style="color: rgb(66, 66, 66); letter-spacing: 2px; line-height: 1.75em; text-align: justify; transform: rotateZ(0deg);"><section style="line-height: 2em;"><span style="font-size: 18px;"> 2022年6月1日和8月5日，省人民政府办公厅分别印发《关于建立健全职工基本医疗保险门诊共济保障机制的实施意见》(鄂政办发〔2022〕25号)、《关于健全重特大疾病医疗保险和救助制度的实施意见》(鄂政办发〔2022〕35号)，就做好职工医保门诊共济和重特大疾病医疗保障工作明确要求，全省各统筹地区要结合本地实际进一步细化政策规定。根据市人民政府工作安排，市医保局起草了《门诊共济实施细则》《救助制度实施细则》，8月上旬通过局官方网站广泛征求社会公众意见，8月下旬通过发机要征求相关单位意见。在充分征求社会公众、相关单位意见建议后，修改完善，多次报请省医保局专家把关、核稿。9月5日经市政府2022年第31次常务会议讨论通过，9月9日市人民政府正式印发。</span></section></section></section></section><section><section style="display: inline-block;"><section style="padding: 5px 10px;background-color: #205792;box-sizing: border-box;letter-spacing: 2px;color: #ffffff;font-size: 16px;"><p><strong>二、主要内容</strong></p></section><section style="box-sizing:border-box;height: 0px;width: 0px;border-right: 7px solid #3a81ed;border-top: 5px solid #3a81ed;border-left: 7px solid transparent !important;border-bottom: 5px solid transparent !important;"><br></section></section><section style="margin-top: -22px;margin-left: 13px;padding-right: 10px;padding-bottom: 10px;padding-left: 10px;border-left: 1px solid #5898f8;box-sizing: border-box;"><section style="color: rgb(66, 66, 66); letter-spacing: 2px; line-height: 1.75em; text-align: justify; transform: rotateZ(0deg);"><section style="line-height: 2em;"><span style="font-size: 18px;"> (一)《门诊共济实施细则》</span></section><section style="line-height: 2em;"><span style="font-size: 18px;"> <strong>1.改进个人账户计入办法和支付范围。</strong>正常缴纳职工医保费的(含退休继续缴费人员和灵活就业人员)，以其参保缴费基数的一定比例计入个人账户，其中男性满60周岁、女性满55周岁的按2.5%计入，其他参保人员按2%计入;原按每月50元一次性缴纳医保费的退休职工，仍按每月15元标准计入个人账户;符合不再缴费但享受职工医保待遇条件的参保人员，个人账户计入标准以仙桃市2021年基本养老金月平均水平为基数，按2.5%的比例由统筹基金划入;以单建统筹方式参加职工医保的单位职工，不设立个人账户，同步调整单建统筹单位缴费费率至7.7%，保障该类群体门诊统筹待遇。进一步扩大个人账户支付范围，可供参保人员的配偶、父母、子女支付。</span></section><section style="line-height: 2em;"><span style="font-size: 18px;"> <strong>2.职工医保普通门诊统筹医疗待遇。</strong>普通门诊统筹设立起付标准和最高支付限额(即“最高发生额”)。一个自然年度内，男性满60周岁、女性满55周岁的起付标准为500元，其他参保人员为600元。退休职工普通门诊统筹最高发生额为2500元，在职职工最高发生额为2000元。在一个自然年度内，普通门诊统筹起付标准以上、最高发生额以下的部分，由普通门诊统筹基金按比例支付：本市一级医院为80%、二级医院为65%、三级医院为50%、异地联网定点医疗机构门诊就医支付比例为50%。男性满60周岁、女性满55周岁的对应上述支付比例提高10个百分点。</span></section><section style="line-height: 2em;"><span style="font-size: 18px;"> <strong>3.施行时间。</strong>《门诊共济实施细则》自2022年12月31日起施行。</span></section><section style="line-height: 2em;"><span style="font-size: 18px;"> (二)《救助制度实施细则》</span></section><section style="line-height: 2em;"><span style="font-size: 18px;"> <strong>1.救助对象覆盖范围。</strong>公平覆盖医疗费用负担较重的困难职工和城乡居民，将医疗救助对象分为四类：一类对象为城乡特困人员、孤儿;二类对象为城乡最低生活保障对象、返贫致贫人口;三类对象为城乡低保边缘家庭成员、纳入监测范围的农村易返贫致贫人口(包含脱贫不稳定、边缘易致贫、突发严重困难人口);四类对象为因病致贫重病患者和仙桃市人民政府规定的其他特殊困难人员。各类医疗救助对象根据相关规定实行动态管理。</span></section><section style="line-height: 2em;"><span style="font-size: 18px;"> <strong>2.大病保险待遇。</strong>大病保险对一类、二类医疗救助对象实施大病保险起付线降低50%、报销比例提高5%、不设置封顶线。</span></section><section style="line-height: 2em;"><span style="font-size: 18px;"> <strong>3.医疗救助待遇。</strong></span></section><section style="line-height: 2em;"><span style="font-size: 18px;"> (1)资助参保。一类救助对象，全额资助;二类救助对象，按个人缴费标准90%比例给予定额资助(不低于320元标准资助);三类救助对象，纳入监测范围的农村易返贫致贫人口过渡期内按个人缴费标准50%比例给予定额资助。</span></section><section style="line-height: 2em;"><span style="font-size: 18px;"> (2)门诊慢特病医疗救助。享受我市门诊特殊慢性病待遇的救助对象，当月基本医疗保险门诊慢性病限额用完后，再发生的政策范围内医疗费用，最高可按对应门诊慢性病限额的60%予以医疗救助。</span></section><section style="line-height: 2em;"><span style="font-size: 18px;"> (3)住院医疗救助：一类、二类救助对象，不设起付标准，分别按100%、75%比例救助;三类救助对象，年度内起付标准为2700元(过渡期内纳入监测范围的脱贫不稳定人口、边缘易致贫人口医疗救助年度内起付标准仍执行1500元)，按65%比例救助;四类救助对象，年度内起付标准为6500元，按55%比例救助。</span></section><section style="line-height: 2em;"><span style="font-size: 18px;"> (4)救助限额：一类救助对象不设年度救助限额，二类、三类、四类救助对象年度最高救助限额5万元。</span></section><section style="line-height: 2em;"><span style="font-size: 18px;"> (5)托底保障：对规范转诊且在省域内就医的医疗救助对象，经三重制度综合保障后，政策范围内个人自付医疗费用超过6500元以上的部分，市域内按70%给予倾斜救助;市域外省域内按60%给予倾斜救助，倾斜救助年度封顶线为8万元。农村低收入人口过渡期内仍按原政策执行。</span></section><section style="line-height: 2em;"><span style="font-size: 18px;"> <strong>4.施行时间。</strong>《救助制度实施细则》自2022年9月1日起施行。</span></section></section></section></section></section></section><section style="outline: 0px;color: rgb(34, 34, 34);letter-spacing: 0.544px;text-align: center;line-height: 1.75em;font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif;"><strong style="outline: 0px;">大家关心的问题还有哪些</strong></section><section style="outline: 0px;color: rgb(34, 34, 34);letter-spacing: 0.544px;text-align: center;line-height: 1.75em;font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif;"><strong style="outline: 0px;"><span style="outline: 0px;letter-spacing: 0.544px;font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, Arial, sans-serif;">看看现场解答</span></strong><br style="outline: 0px;"></section><section style="outline: 0px;color: rgb(34, 34, 34);letter-spacing: 0.544px;text-align: center;line-height: 1.75em;font-family: -apple-system, BlinkMacSystemFont, Arial, sans-serif;">☟</section><section data-support="96编辑器" data-style-id="33912"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="text-align: right;"><section style="color: #ffa835;letter-spacing: 2px;font-size: 18px;line-height: 1.75em;transform: rotateZ(0deg);-webkit-transform: rotateZ(0deg);-moz-transform: rotateZ(0deg);-ms-transform: rotateZ(0deg);-o-transform: rotateZ(0deg);"><p style="text-align:left;"> <span style="color: #5898f8;"><strong>仙桃电视台记者</strong></span></p></section></section><section><section style="padding: 1px 14px 14px;background-color: #effaff;box-sizing: border-box;"><section style="margin-top: -30px;"><section style="display: flex;justify-content: center;align-items: flex-start;"><section data-width="25%" style="max-width: 25% !important;box-sizing:border-box;width: 25%;"><span class="wxart_image" wx-style="display:inline-block;box-sizing: border-box;vertical-align: inherit;height: 180px;display: block;width: 100%;"></span></section><section data-width="75%" style="max-width: 75% !important;box-sizing:border-box;padding-top: 40px;padding-left: 10px;width: 75%;"><section style="color: #3c3c3c;letter-spacing: 2px;font-size: 15px;"><p><span style="font-size: 18px;">谢局长，您好!我是仙桃电视台记者，请问出台《门诊共济实施细则》的意义在哪里?建立职工医保普通门诊统筹需要个人再单独缴费吗?</span></p></section></section></section></section></section></section></section></section><section data-support="96编辑器" data-style-id="24347" data-color="rgb(134, 182, 209)"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-top: 1px dotted #86b6d1;border-left: 1px dotted #86b6d1;border-top-right-radius: 10px;border-right: none;border-bottom: none;border-bottom-left-radius: 10px;box-sizing: border-box;"><section style="border-right: 3px solid #86b6d1;border-bottom: 3px solid #86b6d1;border-bottom-left-radius: 10px;border-top-right-radius: 10px;box-sizing: border-box;"><section style="padding: 10px; letter-spacing: 2px; box-sizing: border-box;"><p style="text-align:center;margin-bottom: 0em;"><span class="wxart_image" wx-style="display:inline-block;box-sizing: border-box;vertical-align: inherit;width: 100%;"></span></p><p style="text-align:center;margin-bottom: 0em;"><span style="color: #888888;font-size: 16px;">市医疗保障局党组成员、副局长谢娟</span></p><p style="text-align:center;margin-bottom: 0em;"><br></p><p><span style="font-size: 18px;"> <strong>答：</strong>出台《门诊共济实施细则》的意义在于，解决个人账户门诊保障能力不足的问题，将参保职工普通门诊费用纳入医保报销，实现门诊就医有基本医保报销和个人账户支付双重保障。</span></p><p><span style="font-size: 18px;"> 个人不需要再单独缴费。建立职工医保普通门诊统筹，所需资金从职工基本医疗保险统筹基金中支出，用人单位及参保人员不再另行缴费。</span></p></section></section></section></section></section><section data-support="96编辑器" data-style-id="33912"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="text-align: right;"><section style="color: #ffa835;letter-spacing: 2px;font-size: 18px;line-height: 1.75em;transform: rotateZ(0deg);-webkit-transform: rotateZ(0deg);-moz-transform: rotateZ(0deg);-ms-transform: rotateZ(0deg);-o-transform: rotateZ(0deg);"><p style="text-align:left;"> <span style="color: #5898f8;"><strong>仙桃日报社记者</strong></span></p></section></section><section><section style="padding: 1px 14px 14px;background-color: #effaff;box-sizing: border-box;"><section style="margin-top: -30px;"><section style="display: flex;justify-content: center;align-items: flex-start;"><section data-width="25%" style="max-width: 25% !important;box-sizing:border-box;width: 25%;"><span class="wxart_image" wx-style="display:inline-block;box-sizing: border-box;vertical-align: inherit;height: 174px;display: block;width: 100%;"></span></section><section data-width="75%" style="max-width: 75% !important;box-sizing:border-box;padding-top: 40px;padding-left: 10px;width: 75%;"><section style="color: #3c3c3c;letter-spacing: 2px;font-size: 15px;"><p><span style="font-size: 18px;">向局长，您好!我是仙桃日报社记者。请问参保职工门诊就医发生的医疗费用该如何报销呢?</span></p></section></section></section></section></section></section></section></section></section><section data-support="96编辑器" data-style-id="24347" data-color="rgb(134, 182, 209)" style="margin-bottom: unset;"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-top: 1px dotted #86b6d1;border-left: 1px dotted #86b6d1;border-top-right-radius: 10px;border-right: none;border-bottom: none;border-bottom-left-radius: 10px;box-sizing: border-box;"><section style="border-right: 3px solid #86b6d1;border-bottom: 3px solid #86b6d1;border-bottom-left-radius: 10px;border-top-right-radius: 10px;box-sizing: border-box;"><section style="padding: 10px; letter-spacing: 2px; box-sizing: border-box;"><p style="text-align:center;margin-bottom: 0em;"><span class="wxart_image" wx-style="display:inline-block;box-sizing: border-box;vertical-align: inherit;width: 100%;"></span></p><p style="text-align:center;margin-bottom: 0em;"><span style="font-size: 16px;color: #888888;">市医疗保障局党组成员、副局长向志军</span></p><p style="text-align:center;margin-bottom: 0em;"><br></p><p><span style="font-size: 18px;"> <strong>答：</strong>参保职工在定点医疗机构门诊就医时，一定要出示本人的医保电子凭证或社会保障卡，发生的门诊医疗费用通过医保信息系统直接结算，不需要当事人单独跑医保部门进行手工报销。</span></p></section></section></section></section></section><section data-support="96编辑器" data-style-id="33912" style="margin-bottom: unset;"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="text-align: right;"><section style="color: #ffa835;letter-spacing: 2px;font-size: 18px;line-height: 1.75em;transform: rotateZ(0deg);-webkit-transform: rotateZ(0deg);-moz-transform: rotateZ(0deg);-ms-transform: rotateZ(0deg);-o-transform: rotateZ(0deg);"><p style="text-align:left;"> <span style="color: #5898f8;"><strong>仙桃广播电台记者</strong></span></p></section></section><section><section style="padding: 1px 14px 14px;background-color: #effaff;box-sizing: border-box;"><section style="margin-top: -30px;"><section style="display: flex;justify-content: center;align-items: flex-start;"><section data-width="25%" style="max-width: 25% !important;box-sizing:border-box;width: 25%;"></section><section data-width="75%" style="max-width: 75% !important;box-sizing:border-box;padding-top: 40px;padding-left: 10px;width: 75%;"><section style="color: #3c3c3c;letter-spacing: 2px;font-size: 15px;"><p><span style="font-size: 18px;">向局长，您好!我是仙桃广播电台记者，请问《实施细则》对医疗救助对象参加2023年度城乡居民医疗保险的参保资助标准分别是多少?</span><span style="color: #888888;font-size: 16px;text-align: center;"></span></p></section></section></section></section></section></section></section></section><section data-support="96编辑器" data-style-id="24347" data-color="rgb(134, 182, 209)" style="margin-bottom: unset;"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-top: 1px dotted #86b6d1;border-left: 1px dotted #86b6d1;border-top-right-radius: 10px;border-right: none;border-bottom: none;border-bottom-left-radius: 10px;box-sizing: border-box;"><section style="border-right: 3px solid #86b6d1;border-bottom: 3px solid #86b6d1;border-bottom-left-radius: 10px;border-top-right-radius: 10px;box-sizing: border-box;"><section style="padding: 10px; letter-spacing: 2px; box-sizing: border-box;"><p><span style="font-size: 18px;"> <strong>答：</strong>医疗救助对象参加2023年度城乡居民医疗保险的，分类实施参保资助。一类、二类、三类、救助对象标准分别为350元、320元、175元。属全额资助缴费的，由认定其身份的市直部门代缴；其他人员只需缴差额部分。医疗救助对象于2022年10月20日以后开始缴费。</span></p></section></section></section></section></section><section data-support="96编辑器" data-style-id="33912" style="margin-bottom: unset;"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="text-align: right;"><section style="color: #ffa835;letter-spacing: 2px;font-size: 18px;line-height: 1.75em;transform: rotateZ(0deg);-webkit-transform: rotateZ(0deg);-moz-transform: rotateZ(0deg);-ms-transform: rotateZ(0deg);-o-transform: rotateZ(0deg);"><p style="text-align:left;"> <span style="color: #5898f8;"><strong>中国仙桃网记者</strong></span></p></section></section><section><section style="padding: 1px 14px 14px;background-color: #effaff;box-sizing: border-box;"><section style="margin-top: -30px;"><section style="display: flex;justify-content: center;align-items: flex-start;"><section data-width="25%" style="max-width: 25% !important;box-sizing:border-box;width: 25%;"><span class="wxart_image" wx-style="display:inline-block;box-sizing: border-box;vertical-align: inherit;height: 174px;display: block;width: 100%;"></span></section><section data-width="75%" style="max-width: 75% !important;box-sizing:border-box;padding-top: 40px;padding-left: 10px;width: 75%;"><section style="color: #3c3c3c;letter-spacing: 2px;font-size: 15px;"><p><span style="font-size: 18px;">曾主任，您好!我是中国仙桃网记者。请问《实施细则》中所述的医疗救助对象看病就医有哪些需要特别注意的事项?</span></p></section></section></section></section></section></section></section></section><section data-support="96编辑器" data-style-id="24347" data-color="rgb(134, 182, 209)" style="margin-bottom: unset;"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-top: 1px dotted #86b6d1;border-left: 1px dotted #86b6d1;border-top-right-radius: 10px;border-right: none;border-bottom: none;border-bottom-left-radius: 10px;box-sizing: border-box;"><section style="border-right: 3px solid #86b6d1;border-bottom: 3px solid #86b6d1;border-bottom-left-radius: 10px;border-top-right-radius: 10px;box-sizing: border-box;"><section style="padding: 10px; letter-spacing: 2px; box-sizing: border-box;"><p style="text-align:center;margin-bottom: 0em;"><span class="wxart_image" wx-style="display:inline-block;box-sizing: border-box;vertical-align: inherit;width: 100%;"></span></p><p style="text-align:center;margin-bottom: 0em;"><span style="font-size: 16px;color: #888888;">市医疗保障服务中心副主任曾亮</span></p><p style="text-align:center;margin-bottom: 0em;"><br></p><p><span style="font-size: 18px;"> <strong>答：</strong>经基层首诊转诊的一类、二类医疗救助对象和纳入监测范围的农村易返贫致贫人口，在市域内定点医疗机构住院，持有效证件办理入院手续，实行“先诊疗后付费”，入院时只需缴纳基本医保住院起付标准费用，无需缴纳住院押金。</span></p><p><span style="font-size: 18px;"> 巩固拓展脱贫攻坚成果同乡村振兴有效衔接期内，农村低收入人口市域外定点医疗机构就医需及时办理转诊手续，未按要求办理转诊手续、不在定点医疗机构就医的，执行当地分级诊疗政策，政策范围外医疗费用超医疗总费用比例部分由患者自行承担。农村低收入人口在定点医疗机构住院，必须在入院3个工作日内到医疗机构医保窗口登记办理身份确认，主动告知农村低收入人口身份，未按规定时间在就诊医疗机构办理医保登记并告知农村低收入人口身份的，政策范围外医疗费用超医疗总费用比例部分由患者承担。如果按照规定办理转诊、办理身份登记了，则超过部分由医疗机构承担。这主要是为了控制政策范围外医疗费用占比，减轻农村低收入人口医疗费用负担。</span></p></section></section></section></section></section><section data-support="96编辑器" data-style-id="33912" style="margin-bottom: unset;"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="text-align: right;"><section style="color: #ffa835;letter-spacing: 2px;font-size: 18px;line-height: 1.75em;transform: rotateZ(0deg);-webkit-transform: rotateZ(0deg);-moz-transform: rotateZ(0deg);-ms-transform: rotateZ(0deg);-o-transform: rotateZ(0deg);"><p style="text-align:left;"> <span style="color: #5898f8;"><strong>仙桃周刊社记者</strong></span></p></section></section><section><section style="padding: 1px 14px 14px;background-color: #effaff;box-sizing: border-box;"><section style="margin-top: -30px;"><section style="display: flex;justify-content: center;align-items: flex-start;"><section data-width="25%" style="max-width: 25% !important;box-sizing:border-box;width: 25%;"><span class="wxart_image" wx-style="display:inline-block;box-sizing: border-box;vertical-align: inherit;height: 180px;display: block;width: 100%;"></span></section><section data-width="75%" style="max-width: 75% !important;box-sizing:border-box;padding-top: 40px;padding-left: 10px;width: 75%;"><section style="color: #3c3c3c;letter-spacing: 2px;font-size: 15px;"><p><span style="font-size: 18px;">曾主任，您好!我是仙桃周刊社记者。请问农村低保对象在市第一人民医院住院如何报销？</span></p></section></section></section></section></section></section></section></section><section style="margin-bottom: unset;"><section data-support="96编辑器" data-style-id="24347" data-color="rgb(134, 182, 209)"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-top: 1px dotted #86b6d1;border-left: 1px dotted #86b6d1;border-top-right-radius: 10px;border-right: none;border-bottom: none;border-bottom-left-radius: 10px;box-sizing: border-box;"><section style="border-right: 3px solid #86b6d1;border-bottom: 3px solid #86b6d1;border-bottom-left-radius: 10px;border-top-right-radius: 10px;box-sizing: border-box;"><section style="padding: 10px; letter-spacing: 2px; box-sizing: border-box;"><p><span style="font-size: 18px;"> <strong>答：</strong>经基层首诊转诊的农村低保对象，在市域内定点医疗机构住院，持有效证件办理入院手续，实行“先诊疗后付费”，入院时只需缴纳基本医保住院起付标准费用，无需缴纳住院押金。由于我市现行政策对低保对象免收基本医保住院起付标准，所以农村低保对象在市第一人民医院住院时，凭低保相关证件入院时不用缴纳费用，出院时凭社会保障卡或是医保电子凭证享受基本医保、大病保险、医疗救助“一站式”服务，报销的费用由医保经办机构和医院结算，个人只需承担报销剩余后的费用。<br></span></p></section></section></section></section></section></section></section></section><section data-role="outer" label="edit by 135editor" style="margin-bottom: 24px; box-sizing: border-box; font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, Arial, sans-serif;"><section data-role="paragraph" style="box-sizing: border-box;"><section data-role="outer" label="edit by 135editor" style="box-sizing: border-box;"><section data-role="title" data-tools="135编辑器" data-id="115366" style="box-sizing: border-box;"><section style="margin-top: 20px;margin-right: auto;margin-left: auto;box-sizing: border-box;"><section style="display: flex;justify-content: center;box-sizing: border-box;"><section style="box-sizing: border-box;"><section data-role="paragraph" style="box-sizing: border-box;"><section style="outline: 0px; max-width: 100%; clear: both; min-height: 1em; color: rgb(34, 34, 34); letter-spacing: 1px; visibility: visible; line-height: normal; font-family: -apple-system, BlinkMacSystemFont, Arial, sans-serif; box-sizing: border-box !important;"><br></section></section></section></section></section></section></section></section></section></section>来源：仙桃电视台</div><p></p> 看样子今年的钱收不起来了，交的起的人还是少数，现在钱不好挣，消费都是舍不得，就是进医院全部检查费又不能报，能看病的新药也不能报，专坑老百姓 走形式 没看懂，共济门诊？ 关键在医院！国家政策再好也抵不了医院的髙消费。可以说现在是专坑普通老百姓！ 新农合有哪些新的政策？ 反正就是坑老百姓的，开个p的会，开会也是商讨怎么坑老百姓 低保要交居民医保了？“医疗救助对象参加2023年度城乡居民医疗保险的，分类实施参保资助。一类、二类、三类、救助对象标准分别为350元、320元、175元。属全额资助缴费的，由认定其身份的市直部门代缴；其他人员只需缴差额部分。医疗救助对象于2022年10月20日以后开始缴费。”
页:
[1]