医疗服务---云南省吉林快三高等学校大学生基本医疗保险工作宣传提纲
云南省吉林快三高等学校大学生基本医疗保险工作宣传提纲
一、建立大学生基本医疗保险工作的目的是什么?
jianlidaxueshengjibenyiliaobaoxian,shirenzhenguancheluoshi“guofa〔2007〕20hao”he“yunzhengfa〔2007〕130hao”wenjianjingshen,jiejuehaobaokuoxueshengzaineidechengzhenfeicongyejuminnaruyiliaobaozhangfanchoudeshehuiredianwenti,jianlihewanshanquanshengduocengcijibenyiliaobaozhangzhidu。
二、建立大学生基本医疗保险的指导思想是什么?
yidengxiaopinglilunhe“sangedaibiao”zhongyaosixiangweizhidao,anzhaogoujianshehuizhuyihexieshehuidezongtiyaoqiu,jianchiyirenweiben,luoshikexuefazhanguan,buduanshenhuachengzhenyiliaobaozhangtizhigaige,jianliyidabingtongchouweizhudedaxueshengjibenyiliaobaoxianzhidu,ranggengguangfandechengzhenjuminnenggouxiangyoujibenyiliaobaozhang,tixianshehuigongping,cujinshehuiwending。
三、哪些在校大学生可以参保及在何处参保?
(yi)shengshuzaikundegaodengxuexiao(hanminbangaoxiao、dulixueyuan)、suoshukeyanyuansuo(yixiajiancheng“gaodengxuexiao”)zhongjieshouputonggaodengxuelijiaoyudequanrizhibenzhuankesheng、feizaizhiyanjiusheng(yixiajiancheng“daxuesheng”),zaiyunnanshengyiliaobaoxianjijinguanlizhongxin(yixiajiancheng“shengyibaozhongxin”)canbao。
(er)qitagaodengxuexiaodaxuesheng,yougaodengxuexiaosuozaiditongchouanpaicanbao。
四、省属在昆大学生基本医疗保险工作的时间目标任务是什么?
2008nian5yuekaishixuanchuandongyuan、6yuekaishicanbaodengjigongzuo,2008nian9yue1riquanmianqidong,2008nian11yuewanchengquanbuzaikungaoxiaodaxueshengdecanbaorenwu。
wu、daxueshengcanbaodechouzishuipingzenyang?
(yi)shengshuzaikundegaodengxuexiaodaxueshengmeirenmeixuenianjibenyiliaobaoxianchouzishuipingwei80yuan。buzhuhejiaofeibiaozhunwei:
1、yuanxiangshougongfeiyiliaodedaxueshengjibenyiliaobaoxianfeimeixuenianrenjunshengcaizhengbuzhu80yuan,gerenbujiaofei。
2、weixiangshougongfeiyiliaodedaxueshengjibenyiliaobaoxianfeimeixuenianrenjunshengcaizhengbuzhu40yuan,suozaigaodengxuexiaobuzhu30yuan,gerenjiaofei10yuan。
yuanxiangshougongfeiyiliaodedaxueshengzhi: anyuanxiangshougongfeiyiliaodeguiding,guojiazhengshihezhunshezhideputonggaodengxuexiao(buhanjunshiyuanxiao)jihuaneizhaoshoudeputongbenzhuankezaixiaoxuesheng、yanjiusheng(buhanweituopeiyang、zifei、ganbuzhuanxiuxuesheng)。
liu、daxueshengjibenyiliaobaoxiangongzuozhonggebumendezhizeshishenme?
(yi) laodongbaozhangbumengenjuguojiayouguanzhengceguiding,fuzezhidingjutishishixizehexiangguanzhengcecuoshi,tongchouxiediao,ducu、zhidaoyiliaobaoxianjingbanjigoujilinkuaisanshishi。
(er)yibaozhongxinfuzezhengshoudaxueshengyiliaobaoxianfei、fuzejijinguanli、jiuyiguanliheyiliaodaiyushenhejiyudingdianyiliaojigoufeiyongjiesuandengyewugongzuo;chengdanbuchongyiliaobaoxiantongyixiangshangyebaoxiangongsitoubaogongzuo。
(san)caizhengbumenfuzejiangyingyoucaizhengfudandedaxueshengjibenyiliaobaoxianbuzhuzijinhemeinianxinzengteshukunnandaxueshengsuoxushehuibaozhangkafeilierucaizhengyusuan;fuzeyiliaobaoxianjijincaizhengzhuanhuguanli;jiaqiangjijinjianduheguanli。
(si)jiaoyubumenfuzeducugaodengxuexiao,anguidingyaoqiudaxueshengcanjiajibenyiliaobaoxian,gulidaxueshengziyuancanjiabuchongyiliaobaoxian。
(wu)gaodengxuexiaofuzejilinkuaisanbenxiaodaxueshengjinxingcanbaodengji、daishoudaxueshenggerenyiliaobaoxianfeijixiezhubanliyiliaobaoxiandaiyuzhifudengxiangguangongzuo;fuzejiangmeinian8yuechubiyeshengshixingtingbaoji9yuedixinshengcanbaojichushujuluruyiliaobaoxianxinxicaijixitong。
七、大学生基本医疗保险费是否计征税费?
daxueshengjibenyiliaobaoxianfeibujizhengshuifei。
八、如何加强大学生抵御重大疾病风险能力?
jianyibinggulidaxueshengtongguocanjiabuchongyiliaobaoxian,jitigaoyiliaofeiyongbaoxiaobili,youwujijinzhifudezuigaoxiane,keyijiaodadijiaqiangdiyuzhongdajibingfengxiannengli。
九、大学生如何参保?
(yi)daxueshengchishenfenzheng、xueshengzhengdengyouguanziliao,zaibenxiaotianxie《yunnanshengchengzhenjuminjibenyiliaobaoxian(daxuesheng)canbaoshenqingdengjibiao》,banlicanbaodengjihejiaofeishouxu。
(er)gaodengxuexiaoduiyishangziliaohe《dengjibiao》neirongjinxingshenhe;bingjiangcaijidecanbaoxinxiluruyiliaobaoxianxinxicaijixitong。
(san)yibaozhongxinyijucanbaoxinxishengchengjiaofeiqingce,tongzhigaodengxuexiaoanjiaofeiqingcedaishougerenyingjiaonadejibenyiliaobaoxianfei。
(si)yiliaobaoxianfeijingyibaozhongxinshenhewuwuhou,youkaihuyinxinghuarucaizhengzhuanhu,bingyouyinxingxianggaodengxuexiaochuju《yunnanshengshehuibaoxianfeijiaokuanshouju》。
(wu)shengshehuibaozhangkazhizuofaxingzhongxingenjucanbaoxinxi,zhizuo《zhonghuarenmingongheguoshehuibaozhangka》(yixiajiancheng“shehuibaozhangka”),jiaoyousuozaigaodengxuexiaofafang。
十、大学生参加基本医疗保险后享受怎样的医疗待遇?
daxueshengjibenyiliaobaoxianjijinanzhao“yishoudingzhi、shouzhipingheng、lveyoujieyu”deyuanzeshiyong,shengshuzaikundegaodengxuexiaozhixingyixiadaiyubiaozhun:
(yi)daxueshengjibenyiliaobaoxianjijinzhuyaoyongyuzhifuzhuyuan、putongmenzhenheteshubingmenzhenyiliaofeiyong;buchongyiliaobaoxianzhuyaoduizhuyuanhemenzhenteshubingyiliaofeiyongjinxingbuzhu。
(er)daxueshengjibenyiliaobaoxiandeyaopinmulu、zhenliaoxiangmujifuwusheshibiaozhunanzhaoyunnanshengchengzhenjuminjibenyiliaobaoxianyouguanguidingzhixing。
(san)canbaohoubanlilexiuxue、tuixueshouxudedaxuesheng,zaicanbaoqixianneifashengdeyiliaofeiyong,renganyouguanguidingbaoxiao。
十一、在昆大学生享受的待遇水平如何?
(yi)zhuyuanyiliaodaiyu
1、qifubiaozhun
xuenianneidiyicizhuyuan: yijiyiliaojigou100yuan,erjiyiliaojigou200yuan,sanjiyiliaojigou300yuan;diercizhuyuanqifufeijianban;disanci(han)yishangzhuyuandebuzaijiaonaqifufei。
2、zhuyuanqijianfashengdeteshujiancha、teshuzhiliaoheyileiyaopingerenxianzifu10%;ruoshiyongleyaopinmuluyiwaideqiangjiuyaopinshi,yousuozaidingdianyiliaojigoushenpibeianhoufangkeshiyong,yaopinfeiyougerenxianzifu40%。
3、baoxiaobilihezuigaozhifuxiane
(1)jibenyiliaobaoxian
xueniannei,fuhejibenyiliaobaoxianbaoxiaofanweineidezhuyuanyiliaofeiyongbaoxiaobiliwei60%;tongchoujijinzuigaozhifuxianewei1.6wanyuan。
(2)buchongyiliaobaoxian
xueniannei,zaicanjiajibenyiliaobaoxiandetongshi,youcanjialebuchongyiliaobaoxiandedaxuesheng,fuhejibenyiliaobaoxianbaoxiaofanweineidezhuyuanyiliaofeiyongbaoxiaobilitigaodao90%;buchongyiliaobaoxianzuigaozhifuxianeshangbufengding,bingchengdanyiwaishanghaishengu、jibingshengu10000yuandepeifuzeren,chengdanyiwaishangcanandengjizuigao10000yuandepeifuheyiwaishanghaimenzhenfeiyong100yuanyishang5000yuanyinei90%depeifuzeren。
(er)menzhenyiliaodaiyu
1、putongmenzhen
menzhenyiliaofeitongchoubiaozhunzandingweimeirenmeixuenian30yuan,youshengyibaozhongxinandaxueshengcanbaorenshuhuaruxiaoyiyuan(yiwushi)baoganshiyong。baoganfeiyongjieyuzai10%yineideguixiaoyiyuan(yiwushi),jieyuchaoguo10%defeiyongyoushengyibaozhongxinshouhui;ruoxuenianneifashengchaozhibufenyoushengyibaozhongxinfudan30%,gaodengxuexiaofudan70%。
2、teshubingmenzhen
(1)exingzhongliu(menzhenfang、hualiao)、manxingshengongnengshuaijie(menzhentouxi)、qiguanyizhi(shuhoukangpaiyi)、xitongxinghongbanlangchuang、zaishengzhangaixingpinxueteshubingmenzhenfashengdeyiliaofeiyong,qifubiaozhunwei300yuan,qifubiaozhunbucanyuzhuyuanqifubiaozhunleiji,qifuxianyishangfeiyongbaoxiaobilihezuigaozhifuxianeyuzhuyuandaiyuyizhi。
(2)huanteshubingdedaxuesheng,youbenrenxiangjiuduyuanxiaotichushumianshenqing,jingshengyibaozhongxinanguidingchengxushenhehoufaji《teshubingjiuzhenka》,chiyou《teshubingjiuzhenka》dedaxueshenghuanzhe,fangkexiangshouxiangyingdeteshubingyiliaodaiyu。
(san)qitagaodengxuexiaodaiyushuipingyougetongchoudianxiangguanguidingquedinghuodiaozheng。
十二、大学生有哪些医疗费用,基本医疗保险基金和补充医疗保险资金不予支付:
(yi)jibenyiliaoyaopinmulu、zhenliaoxiangmuhefuwusheshibiaozhunyiwaidefeiyong(jijiuchuwai)。
(er)jiankangtijian、jihuamianyi、yufangbaojian、jiankangjiaoyudenggonggongweishengfuwudefeiyong。
(san)weibanlizhuanzhenzhuanyuanshenpibeianshouxu,zixingwaichujiuyideyiliaofeiyong。
(si)zhengxing、meirong、xujiu、xidu、dajiadouou、zishazican、zifendengweifafanzuixingweisuozhideyiliaofeiyong,yijiyinyiliaoshigusuozengjiadeyiliaofeiyong。
(wu)anyouguanguidingbuyuzhifudeqitafeiyong。
十三、发生重大疫情、灾情时大学生医疗费怎么办?
yinzhongdayiqing、zaiqinghechuanranxingjibingfashengdejizhen、qiangjiufeiyong,bulierudaxueshengyiliaobaoxianjijindezhifufanwei。
十四、在昆大学生如何实现就医管理和费用结算?
(yi)gaodengxuexiaoanzhaojiujinjiuyideyuanzexuanzeyizhierjiadingdianyiliaojigou(buhanxiaoyiyuan),zuoweibenxiaodaxueshengxiaowaizhuyuandedingdianyiliaojigou。
(er)gaodengxuexiaoxiaoyiyuan(yiwushi)fuzedaxueshengputongmenzhen,wuxiaoyiyuan(yiwushi)degaodengxuexiaoyouyibaozhongxinzhidinglinjinshequweishengfuwuzhongxinqianshufuwuxieyi,weidaxueshengtigongputongmenjizhenyiliaofuwu。
(san)daxueshengpingshehuibaozhangkahexueshengzhengdaozhidingdedingdianyiliaojigoujiuyi,suofashengdezhuyuanheteshubingmenzhenyiliaofeiyong,anguidingyingyougerenfudandefeiyongyougerenzhifu,yingyoutongchoujijinhuobuchongyiliaobaoxianzhifudefeiyong,youshengyibaozhongxinyudingdianyiliaojigouzhijiejiesuan。
(si)daxueshengzaijiaqi、shixi、xiuxueqijianyinjiweizhongzhengxuyidizhuyuanzhiliaode,yuanzeshangzaidangdiyibaodingdianyiliaojigoujiuyi,bingzaiyizhouneitongguojiuduyuanxiaoxiangshengyibaozhongxinbeian,suofashengdeyiliaofeiyongxianyougerenquanedianfu,yiliaozhongjiehouyoujiuduyuanxiaotongyidaoshengyibaozhongxinanguidingbaoxiao;menzhenfeiyongyoujiuduyuanxiaoyiliaojigouanguidingbaoxiao。
(wu)fashengwuzerenrendeyiwaishanghaishi,qifeiyongkepingdingdianyiliaojigouzhenduanzhengminghejiuduyuanxiaochujudexiangguanzhengminganguidingbaoxiao。
(liu)yinbingqingxuyaojinxingzhuanzhenzhuanyuande,junyouxiaoyiyuan(yiwushi)huoweituodeshequweishengfuwuzhongxinchujuzhuanzhenzhuanyuanzhengming,dingdianyiliaojigoufangkeshouzhizhuyuan(jizhenqiangjiuchuwai)。
zhuanshengwaijiuyide,xutigongzhishaoersuosanjidingdianyiliaojigouzhurenyishihuizhenyijian,youzhuanchuyiyuangaizhanghousongyibaozhongxinshendingbeian,gerenzifubilizaiyuanjichushangtigaoergebaifendian,feiyongyoujiuduyuanxiaohuoxueshengbenrenquanedianfu。
十五、如何管理大学生基本医疗保险医疗费用支出?
genjudaxueshengdeyiliaotedian,caiqujijiyouxiaodejianguancuoshi,buduangaijinhewanshanyiliaobaoxianfeiyongjiesuanbanfa,jianlikexuehelianquandefeiyongjiesuanliucheng,jianshaochengxu,fangbianhuanzhe。daeyiliaofeiyongzhichuyaozaixuexiaogongshi,dusaiguanliloudong。
十六、如何监督大学生基本医疗保险基金?
daxueshengjibenyiliaobaoxianjijindejianduguanligenju《yunnanshengshehuibaoxianjijinjiandutiaoli》、《yunnanshengshehuibaoxianjijinjiandutiaolishishixize》dengxiangguanguidingzhixing。
十七、大学生基本医疗保险费的结算年度如何计算?
daxueshengjibenyiliaobaoxiandejiesuannianduweimeixueniande9yue1rizhiciniande8yue31ri,yougaodengxuexiaobanlilebiyetingbaoshouxudedaxueshengzai9yuetingzhixiangshouyiliaobaoxiandaiyu。daxueshengzaiduqijianyinglianxucanbao。
十八、社会保障卡制作费由谁承担?
yougaodengxuexiaoan《jiaoyubu、caizhengbujilinkuaisanrenzhenzuohaogaodengxuexiaojiatingjingjikunnanxueshengrendinggongzuodezhidaoyijian》(jiaocai〔2007〕8hao)rendingweiteshukunnandedaxuesheng,qishehuibaozhangkagongbenfeizhuyaoyoutongjicaizhengjiyubuzhu;qitadaxueshengdeshehuibaozhangkafeiyougerenchengdan。
十九、吉林快三大学生基本医疗保险与城镇职工基本医疗保险的衔接。
zaixiaodaxueshengcanjiachengzhenjuminjibenyiliaobaoxian,biyehouwendingjiuyede,yingdangsuitongyongrendanweicanjiachengzhenzhigongjibenyiliaobaoxian;shuyulinghuojiuyede,anlinghuojiuyerenyuanshenfencanjiachengzhenzhigongjibenyiliaobaoxian。