幸运飞艇11期

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物價醫保科病人常見問題集錦
資料來源:[ 物價醫保科  ]  
增改時間:[ 2017-3-27 8:49:51  ]  
 

一、我市少兒與大學生醫保的涵蓋范圍?


幸运飞艇11期  GENJU《SHENZHENSHISHEHUIYILIAOBAOXIANBANFA》DEGUIDING ,BENSHIHUJIWEIMAN18ZHOUSUIDEFEICONGYEJUMIN、BENSHIZHONGXIAOXUEXIAOHETUOYOUJIGOUZAICEQIEQIFUMUYIFANGZHENGZAICANJIABENSHISHEHUIBAOXIANBINGMAN1NIANYISHANGDEFEIBENSHIHUJISHAONIANERTONG、ZAIBENSHIGELEIQUANRIZHIPUTONGGAODENGXUEXIAO(HANMINBANXUEXIAO)HUOKEYANYUANSUOZHONGJIESHOUPUTONGGAODENGXUELIJIAOYUDEQUANRIZHIXUESHENGCANJIAJIBENYILIAOBAOXIANERDANG(BUHANSHENGYUYILIAOBAOXIAN)。


二、我市少兒與大學生如何辦理醫療保險參保手續?


  WOSHIZHONGXIAOXUEXIAO、TUOYOU JIGOUZAICEDESHAONIANERTONG,YIJIGELEIPUTONGGAODENGXUEXIAO、 KEYANYUANSUODEQUANRIZHIXUESHENG,TONGYIZAIXINRUXUERUYUANSHIYOUSUOZAIXUEXIAOBANLICANBAOSHOUXU。JUYOUBENSHIHUJIWEIRUXUERUYUANHUOZAISHIWAIDINGJUJIUDUQIEWEIMAN18ZHOUSUIDESHAONIANERTONG,DAOHUJISUOSHUDIDESHEBAOJIGOUHUOJINGZHENGFUPIZHUNCHENGLIDESHEQUJUWEIHUIJIJIEDAOBAN(YIXIAJIANCHENGSHEQU)SHENQINGBANLICANBAOSHOUXU。


三、我市少兒與大學生醫療保險首次參保的什么時候享受醫保待遇?


幸运飞艇11期  SHENHUXINSHENGERZIRUHUZHIRIQI1GEYUENEISHENBAOCANBAODE ,JIAOFEICONGCHUSHENGYUEFENKAISHIJISUANDAOCINIAN8YUEFEN,BINGZICHUSHENGZHIRIQIXIANGSHOUYILIAOBAOXIANDAIYU;CHUCIZHIWAIDE,CONGJIAOQINGFEIYONGDECIYUEQIXIANGSHOUYILIAOBAOXIANDAIYU。


四、我市參保的少兒與大學生如何繳費?


幸运飞艇11期  SHAOERYIBAOJIAOFEIANMEIXUENIANDU(DANGNIAN9YUEFENZHICINIAN8YUEFEN)YI CIXINGJIAOFEI ,TONGGUOYINXINGZHANGHUTUOSHOU ,DIYICICONGJIANHURENYINXINGZHANGHUKOUFEI,SHAOERYIBAOJINRONGKABANLIXIALAIHOUDIERNIANKAISHIMEINIAN9YUEDICONGZHEZHANGJINRONGSHEBAOKASHANGANNIANYICIXINGKOUFEI。


五、參保少兒及大學生如何綁定就診社康中心或醫院?


幸运飞艇11期  YOUYUSHEKANGBINGWEIQUANBUPEIBEIERKEYISHENG,YINCI ,14ZHOUSUIYIXIADECANBAORENKEYIBANGDINGYIJIASHEKANGZHONGXINHUOZHEBANGDINGYIJIAERJIHUOERJIYIXIADEYIYUANZUOWEIMENZHENJIUYIDEDINGDIANYILIAOJIGOU 。MAN 14ZHOUSUIJIYISHANGDECANBAOREN BUSHUYUERKESHOUZHENFANWEI ,XUBANGDING YI JIASHEKANGZHONGXINZUOWEIMENZHENJIUYIDEDINGDIANYILIAOJIGOU 。WEIANGUIDINGBANGDINGJIUZHENSHEKANGZHONGXINHUOYIYUANDE,BUXIANGSHOUMENZHENDAIYU 。WOYUANWEISANJIZHUANKEYIYUANBUSHUYUMENZHENJIUYIDEDINGDIANYILIAOJIGOU。

  CANBAORENKEYIZHIJIEDAOSUOYAOBANGDINGQIMENZHENJIUYIDEYIYUANHUOSHEKANGZHONGXINJINXINGBANGDING;HUOZHEDENGLUSHEBAOJUWANGZHANZHONGDE“SHEBAOZAIXIANFUWU”DE“SHAOER 、DAXUESHENGYIBAOGERENCAOZUOXITONG( KETINGBAO 、BANGDINGSHEKANG 、CHAXUNCANBAOXINXI )”,XUANZEYIYUANYUSHEKANGDEMINGCHENG ,BANLIBANGDING 。LINGWAI ,CANBAORENYIJINGBANLISHEBAOKABANGDINGYINXINGZHANGHUDE,YEKEDAOYINXINGZIDONGJUYUANJIHUOZHETONGGUOWANGSHANGYINXINGXUANZEBANGDINGMENZHENJIUYIDEDINGDIANYILIAOGOU。

  BANGDINGSHEKANGHOU 1GEYUENEIBUDEBIANDONG 。ZHIHOURUXU BIANGENGBANGDINGSHEKANGDE ,KEZAI DANGYUE20 RIQIANXUANZE XINDEDINGDIANYILIAOJIGOUBINGZHONGXINBANLIBANGDINGSHOUXU ,WANCHENGBANGDINGHOUCIYUEKEANGUIDINGXIANGSHOUDAIYU 。


六、參保少兒及大學生的門診待遇有哪些?


幸运飞艇11期  SHAOERJIDAXUESHENGCANJIAJIBENYILIAOBAOXIANERDANGZHIHOU ,QIZAIBANGDINGDESHEKANGZHONGXINHUOYIYUANFASHENGDEMENZHEN(HANJIZHEN)FEIYONGANYIXIAGUIDINGCHULI:

幸运飞艇11期(YI)SHUYUJIBENYILIAOBAOXIANYAOPINMULUZHONGJIALEIYAOPINHEYILEIYAOPINDE,FENBIEYOUSHEQUMENZHENTONGCHOUJIJINAN80%HE60%DEBILIZHIFU。

( ER ) SHUYUJIBENYILIAOBAOXIANMULUNEIZHENDANXIANGLIAOXIANGMUHUOYIYONGCAILIAODE ,YOUSHEQUMENZHENTONGCHOUJIJINZHIFU 90% ,DANZUIGAOZHIFUXIANEBUCHAOGUO120YUAN。 CANBAOREN YINBINGQINGXUYAOJINGJIESUANYIYUANPIZHUNZHUANNADAOQITADINGDIANYILIAOJI GOU FA SHENG DE MENZHEN YI LIAOFEIYONG YOUSHE QUMEN ZHEN TONG CHOU JI JIN AN SHANG SHU DI(YI)、DI(ER)XIANGGUIDINGZHIFUFEIYONGDE 90% BAOXIAO。

幸运飞艇11期  YOUSHEQUMENZHENTONGCHOUJIJINZAIYIGEYILIAOBAOXIANNIANDUNEI( DANGNIAN7YUEZHICINIAN6YUE)ZHIFUGEIMEIGEZHUYUANYILIAOBAOXIANCANBAORENDEMENZHENYILIAOFEIYONG,ZONGEZUIGAOBUDECHAOGUO1000YUAN。

  CANBAOSHAOERJIDAXUESHENGYINBINGQINGXUYAOFASHENGDEMENZHENSHUXUEFEI,YOUJIBENYILIAOBAOXIANDABINGTONGCHOUJIJINZHIFU 70% 。


七、參保少兒及大學生住院時可享受哪些待遇?


(YI)CANBAOSHAOERJIDAXUESHENGZHUYUANFASHENGDEJIBENYILIAOFEIYONGHEDIFANGBUCHONGYILIAOFEIYONGQIFUXIANYISHANGBUFEN,YOUYILIAOBAOXIANJIJINZHIFU90%。

幸运飞艇11期(ER) CANBAORENZHUYUANSHIYONGJIBENYILIAOBAOXIANZHENLIAOXIANGMUFANWEINEIDETESHUYIYONGCAILIAOJIDANJIAZAI1000YUANYISHANGDEYICIXINGYIYONGCAILIAO、ANZHUANGHUOZHIHUANRENGONGQIGUAN,YOUJIBENYILIAO BAOXIANDABINGTONGCHOUJIJINANXIALIEGUIDINGZHIFU,DANZUIGAOZHIFUJINEBUCHAOGUOSHISHEHUIBAOXIANXINGZHENGBUMENGONGBUDEPUJIXINGJIAGE。

1.SHUYUGUOCHANCAILIAODE,ANSHIJIJIAGEDE 90%ZHIFU;

2.SHUYUJINKOUCAILIAODE,ANSHIJIJIAGEDE 60%ZHIFU。

(SAN)CANBAORENZHUYUANCHUANGWEIFEIYOUJIBENYILIAOBAOXIANDABINGTONGCHOUJIJINANSHIJIZHUYUANCHUANGWEIFEI ZHIFU,DANBUDECHAOGUOXIALIEGUIDINGBIAOZHUN:ZUIGAOZHIFUJINEWEISHIJIAGEGUANLIBUMENQUEDINGDEFEIYINGLIXINGYILIAOJIGOUPUTONGBINGFANGAJIFANGJIANSHUANGRENFANGCHUANGWEIFEIZHENGFUZHIDAOJIAGEDEDIYIDANG ,JI60YUAN。


八、如何享受大病門診醫療保險待遇?


  CANBAOSHAOERJIDAXUESHENGYOUXIALIEQINGXINGZHIYIDE,XIANGSHOUMENZHENDABINGDAIYU:

1.慢性腎功能衰竭門診透析;
2.列入醫療保險支付范圍的器官移植后門診用抗排斥藥;
3.惡性腫瘤門診化療 、介入治療 、放療或核素治療;
4.血友病專科門診治療;
5.再生障礙性貧血專科門診治療;
6.地中海貧血專科門診治療;
7.顱內良性腫瘤專科門診治療;
8.精神分裂癥門診專科治療;
9.分裂情感性障礙門診專科治療;
10.持久的妄想性障礙(偏執性精神病)門診專科治療;
11.雙相(情感)障礙門診專科治療;
12.癲癇所致精神障礙門診專科治療;
13.精神發育遲滯伴發精神障礙門診專科治療;
14.艾滋病門診專科治療;
15.市政府批準的其他 情形。

幸运飞艇11期  CANBAORENSHENQINGXIANGSHOUMENZHENDABINGDAIYUDE,YINGXIANGSHISHEHUIBAOXIANJIGOUWEITUODEYILIAOJIGOUSHENQINGRENDING ,JINGSHISHEHUI BAOXIANJIGOUHEZHUNHOU ,PING DABINGZHENDUANZHENGMINGHEDABINGMENZHENBINGLIZAIDINGDIANYILIAOJIGOUJIUYI 。

  CANBAORENLIANXUCANBAOSHIJIANMAN 36GEYUEDE ,ZIQISHENQINGZHIRIQIXIANGSHOUDABINGMENZHENDAIYU;LIANXUCANBAOSHIJIANWEIMAN 36GEYUEDE ,ZISHISHEHUIBAOXIANJIGOUHEZHUNZHIRIQIXIANGSHOUDABINGMENZHENDAIYU 。XIANGSHOUDABINGMENZHENDAIYUDECANBAORENFASHENGDEJI BENYILIAOFEIYONG 、DI FANGBUCHONGYILIAOFEIYONG ,FENBIEYOUJI BENYILIAO BAOXIANDABINGTONGCHOUJIJIN 、DIFANGBUCHONGYILIAOBAOXIANJIJINANYIXIABILIZHIFU:

1.連續參保時間未滿12個月的,支付比例為60%;
2.連續參保時間滿12個月未滿36個月的 ,支付比例為75%;
3.連續參保時間滿36個月的 ,支付比例為 90%。


九、父母個人賬戶可用于支付子女的門診醫療費用嗎?


  KEYI。SHAOERCANJIAJIBENYILIAOBAOXIANERDANGZHIHOU,RUGUOQIFUMUYIFANGDEGERENZHANGHUJILEIECHAOGUOBENSHISHANGNIANDUZAIGANGZHIGONGPINGJUNGONGZI5%YISHANGDE ,CHAOGUOBUFENKEYIZHIFU QICANJIAJIBENYILIAOBAOXIANERDANGZINVDEMENZHENYILIAOFEIYONG 。(ZHI2017NIAN6YUE30RIZHIWEICHAOGUO4052YUAN。)BANLIYILIAOBAOXIANGERENZHANGHUJIATINGGUANLIANHOU ,CANBAOSHAOERZAI FEI BANGDING YILIAO JIGOUMENZHENJIUYISHI ,SHIYONG SHAO ERBEN REN DESHEHUI BAOZHANGKA ,FASHENGDEMENZHENYILIAOFEIYONG KEYICONG FUMUYI FANGDEYI BAOGEREN ZHANGHULIZHIFU ,JIANGBUHUIZHANYONGSHAOERBENRENDESHEQUMENZHENTONGCHOUJIJINZHIFUXIANE。


十、如何辦理醫療保障個人賬戶家庭關聯?


1.微信關聯

  GUANZHU“SHENZHENSHEBAO”WEIXINGONGZHONGHAO,XUANZECAIDANLAN“YEWUBANLI”→“GERENYEWUBANLI”,DENGLUFUMUZHANGHUHOU,XUANZE“CANBAOXINXIXIUGAI”→“YIBAOZHANGHUJIATINGBANGDING”。 。

2.社保服務個人網頁關聯

  FUMUYIFANGDENGLU“SHENZHENSHISHEHUIBAOXIANJIJINGUANLIJU”WANGYEZHONGDE“SHEHUIBAOXIANFUWUGERENWANGYE”SHURUXIANGGUANXINXI,ZIZHUBANLI。

  JUTICAOZUORUXIA:FUMUDENGLUGERENWANGYE→SHEBAOYEWUBANLI→YILIAOYEWUBANLI→GERENZHANGHUJIATINGGONGXIANG→XINZENGBANGDING→SHURUZINVSHEBAODIANNAOHAOJISHENFENZHENGHAODENG→TIJIAOBAOCUN,JIWANCHENGGUANLIAN。

3.銀行自助終端機關聯

  FUMUSHEBAOKAWEIJINRONGSHEBAOKADE,KEZAIYINXINGZIZHUZHONGDUANJISHANGYUHAIZIJINRONGSHEBAOKAGUANLIAN,SHIQIJIATINGZHANGHUGONGXIANG。


十一 、基本醫療保險的最高支付限額多少?地方補充醫療保險最高支付限額多少?


幸运飞艇11期  ZAITONGYIGESHEBAONIANDUNEI( DANGNIAN7YUEZHICINIAN6YUE ),YILIAOBAOXIANTONGCHOUJIJINZHIFUDEZUIGAOXIANEYULIANXUCANBAOSHIJIANGUAGOU,QIZHONG:

幸运飞艇11期(YI)MEIGEYILIAOBAOXIANNIANDUJIBENYILIAOBAOXIANTONGCHOUJIJINZHIFUXIANE,GENJUCANBAORENLIANXUCANJIAJIBENYILIAOBAOXIANDESHIJIANANXIALIEBIAOZHUNZHIXING:(2015NIANZAIGANGZHIGONGPINGJUNGONGZIWEI6753YUAN*12YUE)

1.續參保時間不滿 6個月的,為本市上年度在崗職工平均工資的 1倍 ;
2.連續參保時間滿6個月不滿 12 個月的 ,為本市上年度在崗職工平均工資的2倍;
3.連續參保時間滿12個月不滿 24個月的,為本市上年度在崗職工平均工資的3倍 ;
4.連續參保時間滿24個月不滿 36個月的,為本市上年度在崗職工平均工資的4倍;
5.連續參保時間滿36個月不滿 72個月的,為本市上年度在崗職工平均工資的5倍;
幸运飞艇11期 6.連續參保時 間滿72個月以上的 ,為本市上年度在崗職工平均工資的6倍。

(二)每個醫療保險年度地方補充醫療保險基金的支付限額 ,根據參保人連續參加地方補充醫療保險的時間按下列標準執行: 1.續參保時間不滿 6個月的 ,為 1萬元 ;
2.連續參保時 間滿6個月不滿 12個月的 ,為5萬元 ;
3.連續參保時 間滿12 個月不滿 24個月的 ,為 10萬元 ;
4.連續參保時 間滿24個月不滿36個月的 ,為 15萬元 ;
5.連續參保時 間滿36個月不滿 72個月的 ,為20萬元 ;
6.連續參保時 間滿72個月以上的 ,為 100萬元。

  CANBAORENZAIBENSHIDINGDIANYILIAOJIGOUZHUYUANFASHENGDEJIBENYILIAOFEIYONGHEDIFANGBUCHONGYILIAOFEIYONGCHAOCHUDIFANGBUCHONGYILIAOBAOXIANJIJINZHIFUXIANEDEBUFEN ,YOUDIFANGBUCHONGYILIAOBAOXIANJIJINZHIFU 50%。

  CANBAORENZAI YIGESHEBAONIANDUNEIYILIAOBAOXIANCANBAOZHONGDUANBUCHAOGUOSANGEYUEDE ,SHITONG LIANXUCANBAO;CANBAOZHONGDUANCHAOGUOSANGEYUEDE ,ZAICICANBAOSHIZHONGXINJISUANLIANXUCANBAOSHIJIAN 。


十二、參加深圳市重特大疾病補充醫療保險可以享受的待遇?


  ZAITONGYISHEHUIYILIAOBAOXIANNIANDUNEI,CANBAORENZHUYUANSHIFASHENGDEYILIAOFEIYONG,AN《SHENZHENSHISHEHUIBAOXIANBANFA》GUIDINGSHUYUSHEHUIYILIAOBAOXIANMULUFANWEINEI、QIEYINGYOUQIBENRENZHIFUDEBUFENLEIJICHAOGUO1WANYUANDE,CHAOCHUBUFENYOUCHENGBANJIGOUZHIFU70%。

ZAITONGYISHEHUIYILIAOBAOXIANNIANDUNEI,CANBAORENHUANZHONGTEDAJIBINGSHIYONG《SHENZHENSHIZHONGTEDAJIBINGBUCHONGYILIAOBAOXIANYAOPINMULU》NEIYAOPINDEFEIYONG,YOUCHENGBANJIGOUZHIFU70%,ZHIFUJINEZUIGAOBUCHAOGUO15WAN。


十三、參保少兒及大學生在什么情形下可轉診市外醫療機構?沒辦轉診手續在外地住院能報銷嗎?


  CANBAOSHAOERJIDAXUESHENGZAIBENSHIDINGDIANYILIAOJIGOUZHENZHIHOUYOUXIALIEQINGXINGZHI YI DE,KEZHUANWANGSHIWAIYILIAOJIGOUJIUZHEN:1.SUOHUANBINGZHONGSHUYUSHIRENLIZIYUANBAOZHANGBUMENGONGBUDEZHUANZHENJIBINGZHONGLEI;2.JINGBENSHISANJIYIYUANHUOSHIJIZHUANKEYIYUANJIANCHAHUIZHENRENGWEINENGQUEZHENDEYINANBINGZHENG;3.BENSHISANJIYIYUANHUOSHIJIZHUANKEYIYUANMUQIANWUSHEBEIHUOJISHUZHENZHIDEWEIZHONGREN。

  CANBAOREN WEIANGUIDINGBANLIZHUANZHENSHOUXUDE ,DAOSHIWAIDINGDIANYILIAOJIGOUJIUYI 、GUONEIQITAFEIWO SHIDINGDIANYILIAOJIGOUFASHENGZHUYUANFASHENGDEJIBENYILIAOFEIYONGHEDIFANGBUCHONGYILIAOFEIYONG,FENBIEANYIBAOBANFAGUIDINGZHIFUBIAOZHUNDE90% 、70%ZHIFU 。YILIAOFEIYONGXUZAIZAICHUYUANZHIRIQI 12GEYUENEISHENQINGBAOXIAO,YUQIBUYUSHOULI。

幸运飞艇11期  SHIWAIJIESHOUZHUANZHENDEYILIAOJIGOUYINGDANGSHIYUZHUANCHUYILIAOJIGOUTONGJIJIYISHANGDEFEIYINGLIXINGYILIAOJIGOU 。


十四、咨詢電話及網站


1.深圳市社保局咨詢電話 12333,
2.深圳市社保局網站 www .szsi .gov.cn,
3.深圳市兒童醫院網站 bfdyh.cn,
幸运飞艇11期 4.深圳市兒童醫院咨詢電話 83936101轉物價醫保科


深圳市兒童醫院物價醫保審計科 宣


 

 
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地址:深圳市福田區益田路7019號  電話:83936101  傳真:83009800  郵編:518038
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