明起《昆明市城乡居民基本医疗保险实施办法》实施，近400万昆明城乡居民同城同保在新医保启动期内，昆明市医保中心公布了值班电话 对新医保有疑问打电话问问

Clear up[Kunming urban and rural residents insurance of primary medical treatment measures for the implementation]The implementation of the,Nearly 400 WanKunMing city urban and rural residents and the start in the new medical insurance period,Kunming medical insurance center announced the duty phone have doubt call ask for new medical insurance

　　明天就是2013年元旦了，《昆明市城乡居民基本医疗保险实施办法》(以下简称《办法》)将实施，该项新政策将惠及昆明近400万人，而居民基本医保住院最高可报销6万元。昨日，昆明市医保中心就如何享受居民基本医保、有哪些待遇进行了详细解读。

Tomorrow is New Year's day in 2013,[Kunming urban and rural residents insurance of primary medical treatment measures for the implementation](Hereinafter referred to as the[Way to])Will be implemented,The new policy will benefit nearly 4 million people in kunming,And residents basic medical insurance in hospital can apply for a maximum of 60000 yuan.yesterday,Kunming medical insurance center on how to enjoy residents basic medical insurance/What are the treatment interpretation in detail.

　　按照管理，上一年度缴费才能在下一年度享受医保待遇。但由于2013年是该项新政实施的第一年，该年度医保缴费从2012年10月才展开，目前已有358万参保。为了方便市民，让这项惠民政策应保尽保，医保中心将缴费时间延续到2013年，具体截止时间将在近期公布。

According to the management,Previous year pay can enjoy treatment of medical insurance next year.But since 2013, is the New Deal in the first year,The annual medical insurance payment from October 2012 to begin,At present more than 3.58 million ginseng.In order to facilitate citizens,Let the huimin policy should be all,Medical insurance center will capture expends time to 2013,The deadline will be announced in the near future.

　　而作为基本医保的有效补充，大病补充医保此次也随着新政进行了调整。记者昨日从医保中心获悉，调整后的大病补充医保具体内容也将在近期公布，其利民、惠民力度将大于4个月前公布的征求意见稿。

And as the effective supplement of the basic medical insurance,A serious illness supplementary medical insurance have also along with the new adjustments.Yesterday, reporters learned from the medical insurance center,After the adjustment the serious illness supplementary medical insurance details will be announced in the near future,The da/Huimin strength for advice to be released more than four months ago.

　　【亮点】

[window]

　　新医保居民住院最高报销6万

New residents medical insurance in the highest for 60000

　　缴费

Pay cost

　　城乡居民基本医疗保险基金实行个人缴纳和政府补助相结合的办法筹集，筹资标准统一为每人每年306元。其中，个人缴费为50元(此前缴费为70元)，中央财政补助为156元，省、市、县财政共补助100元。

Urban and rural residents, fund of insurance of primary medical treatment executes a individual pay and the combination of government subsidies to raise,Financing unified standard for per person per year 306 yuan.Among them,Individual pay cost for $50(After payment is RMB 70),The central fiscal subsidies for 156 yuan,The province/The city/County fiscal subsidy of RMB 100.

　　待遇

treatment

　　城乡居民住院医疗的，一级及其以下医疗机构起付标准为100元，报销比例为85%。二级医疗机构起付标准为300元，报销比例为75%。三级医院起付标准为600元，报销比例为60%。一个自然年度内，最高支付限额为6万元。

Urban and rural residents medical treatment in hospital,Level and the medical institutions fu biao is 100 yuan,Reimbursement ratio is 85%.Secondary medical institutions fu biao is 300 yuan,Reimbursement ratio is 75%.Fu biao of the third class hospitals for 600 yuan,Reimbursement ratio is 60%.A natural year,Highest pay limitation to be 60000 yuan.

　　【解读】

[reading]

　　解读一 持证就医

Reading a card holder

　　1.领取社会保障卡的原城镇居民参保人，凭社会保障卡、身份证就医。

1. Get the social security card of the urban residents ginseng,With the social security card/Id go to a doctor.

　　2.未领取社会保障卡的原新农合参保人，凭身份证原件(待社会保障卡发放后，卡、证并用)就医。

2. Did not receive the original social security card new farmers ginseng protect people,In the original id card(After waiting for social security card issued,card/The l/c and)Go to a doctor.

　　3.领取了“昆明市城乡居民基本医疗保险就医证”的无户籍(未落户)参保人，凭参保地发放的“昆明市城乡居民基本医疗保险就医证”就医。

3. To get the"Kunming urban and rural residents for medical treatment of insurance of primary medical treatment"Of the household register(Not in)Ginseng protect people,Issued by ginseng protect land"Kunming urban and rural residents for medical treatment of insurance of primary medical treatment"Go to a doctor.

　　4.若参保人持相关凭证到医院就医出现“医院端无参保数据”无法就医的情况，由定点医院与医保经办机构核实参保人的参保缴费信息，经核实已参保缴费，再根据参保人提供的就医凭证信息录入参保人就医住院医疗费数据。

Protects a person 4. If the relevant certificate to the hospital for medical treatment"Hospital is a ginseng protect data"Can't go to a doctor,By the hospital and orgnaization of agency of medical insurance protects a person to verify the ginseng of payment information,After verification has ginseng protect capture to expend,Protects a person to offer the medical certificate protects a person to input for medical treatment in hospital medical data.

　　解读二 “普通门诊”定点就医

Interpretation of the "Ordinary outpatient service"Fixed-point medical treatment

　　门诊统筹医疗费最高支付限额有400元，但需要参保人在普通门诊定点医疗机构范围内选择一家医疗机构，作为个人普通门诊医疗待遇的就医地点，原则上一年内不得变更。

Outpatient service medical treatment as a whole highest pay limitation has 400 yuan,But need to join in the medical establishment that decide a dot of average outpatient service within the scope of choosing a medical institution,As personal ordinary outpatient service medical treatment of medical treatment,In principle, one year may not be changed.

　　市民可就近选择一家社区卫生服务中心或乡镇卫生院作为自己的普通门诊就医定点机构，目前昆明确定了142家基层医疗卫生机构，《2013年度昆明市居民医保“普通门诊”定点医疗机构名单(首批)》公布于昆明医保之窗(www.kmybzc.com)。

Citizens can choose a nearby community health service center or rural hospitals as their common fixed point of outpatient service go to a doctor,The kunming identified 142 grassroots medical institutions,[2013 kunming residents medical insurance"Ordinary outpatient service"The medical establishment that decide a dot(One of the first)]Posted on the window of the medical insurance in kunming(www.kmybzc.com).

　　那么参保人到哪里进行选点呢？持社会保障卡或身份证可到医保经办机构、劳动保障服务所(站)或居住地附近的普通门诊签约定点医疗机构(社区卫生服务中心、乡镇卫生院)办理普通门诊就医选点手续。

Protects a person so where to click on?The social security card or id card to orgnaization of agency of medical insurance/Labor and social security services(standing)Or near the residence of the signing of average outpatient service medical establishment that decide a dot(Community health service center/Rural hospitals)Go through the formalities of common source of outpatient service go to a doctor.

　　解读三 “特殊疾病”待遇

Reading three "Special disease"treatment

　　目前，昆明城镇医保中有2000多参保人享受“特殊疾病”待遇了，2013年新政实施后，新农合参保人如有此需要，则需申请办理该待遇享受。

At present,,Kunming urban medical insurance in ginseng of more than 2000 people enjoy"Special disease"Treatment of the,After the implementation of the New Deal in 2013,New farming ginseng protect people as there is the need to close,The need to apply for to enjoy this treatment.

　　昆明市医保中心介绍，原则上城乡居民医保“特殊疾病”门诊医疗机构为具有特殊疾病诊治能力的二级以上医院，即59家县区级人民医院及其以上医院。《2013年度昆明市居民医保“特殊疾病”门诊定点医疗机构名单(首批)》公布于昆明医保之窗(www.kmybzc.com)。

Kunming medical insurance center is introduced,In principle, the medical insurance of urban and rural residents"Special disease"Outpatient medical institutions to have special disease diagnosis and treatment capacity above the level of the hospital,Namely, 59 home hospital at or above the county and district people's hospital.[2013 kunming residents medical insurance"Special disease"Outpatient service medical establishment that decide a dot(One of the first)]Posted on the window of the medical insurance in kunming(www.kmybzc.com).

　　在选点上，享受特殊疾病门诊医疗待遇的参保居民在“特殊疾病门诊定点医疗机构”范围内选择一家医疗机构就医，原则上一年内不得变更。参保人持社会保障卡或身份证到所属医保经办机构办理“特殊疾病”门诊就医选点手续。

On the choosing,Enjoy special disease outpatient service medical treatment in the ginseng of residents"Special disease outpatient medical establishment that decide a dot"Within the scope of choosing a medical institutions for medical treatment,In principle, one year may not be changed.Ginseng protect people who live under the social security card or id card to the subordinate medical insurance agency orgnaization deals with"Special disease"Click on formalities of outpatient service go to a doctor.

　　解读四 新生儿待遇咋追溯

Reading four babies treatment zha traceability

　　城乡居民(含新生儿)参保缴费时间为每年7月1日至12月25日，保险待遇期为次年1月1日至12月31日止。若新生儿出生落户在昆明，按规定在出生后一年内(含一年)参保并缴费的，医保待遇可追溯到出生之日。若昆明户籍新生儿的母亲(或父亲)参加居民医保的，且在待遇期内，新生儿出生当年可视同随母亲(或父亲)参保，享受其母亲(或父亲)保险待遇。新生儿应在出生当年参加居民医保并缴费。

Urban and rural residents(Including the newborn)Ginseng protect capture expends time to 1 July to December 25 every year,Insurance treatment period for the following year January 1 to December 31.If birth locating in kunming,According to regulations in within one year after the birth(Of a year)Ginseng and capture to expend,Medical insurance treatment can be traced back to the date of birth.If kunming household newborn's mother(Or a father)Residents to participate in medical insurance,And during the treatment period,Mother's birth year can be regarded as(Or a father)ginseng,Enjoy the mother(Or a father)Insurance pay.Baby should be born in that year to residents medical insurance and pay cost.

　　昆明户籍新生儿，出生一年内参保的，待遇追溯期内全额垫付的住院医疗费，按“住院医疗待遇”或“外地住院医疗待遇”标准零星报销。

Kunming census register,Ginseng was born one year,On behalf of the owner of the pay back period of a full medical treatment in hospital,According to the"The hospital medical treatment"or"Other medical treatment in hospital"Standard sporadic reimbursement.

　　罗南疆

ROM the nanjiang

　　有问题可以打电话问

Can make a phone call to ask if you have any questions

　　昆明市医保中心将2012年12月31日至2013年1月5日定为城乡居民基本医疗保险启动期。在此期间，全市各医保经办机构实行24小时值班制度，值班电话及主要领导手机的通信畅通，做到24小时有人接听。值班人员将协调处理本县区城乡居民基本医保启动期内的参保缴费、待遇支付、系统管理等各项工作和突发问题，解答居民的咨询。

Kunming medical insurance center will be December 31, 2012 to January 5, 2013 as the urban and rural residents insurance of primary medical treatment to start.In the meantime,In the medical insurance agencies shall practise a system of 24 hours on duty,On the phone and leading mobile communications,Do it 24 hours someone answer.Personnel on duty will coordinate with the county urban and rural residents basic medical insurance start-up period of ginseng protect capture to expend/Pay pay/System management of the work and had a problem,Answer the inhabitants of the consultation.

　　昆明市医疗保险中心

Kunming medical insurance center

　　总值班电话：63961809

Always on duty calls:63961809

　　参保缴费业务值班：

Ginseng protect pay business on duty:

　　梁鼎

LiangDing

　　63960676 13700601884

63960676, 13700601884

　　待遇支付业务值班：

Pay pay business on duty:

　　江平

Jiang ping

　　63960379 13208803516

63960379, 13208803516

　　系统管理业务值班：

System management business on duty:

　　王雪皑

WangXue 皑

　　63969630 13888799211

63969630, 13888799211

　　李卫明 13987100002

LiWeiMing 13987100002

　　董学宁 13608840981

DongXueNing 13608840981

　　张 翔 13987134456

Zhang xiang 13987134456

　　赵 洁 13529387401

Zhao jie 13529387401

　　普忠伟 13987681828

PuZhongWei 13987681828

　　五华区医保分中心

WuHuaOu health care centers

　　值班电话：66277572

On the telephone:66277572

　　王珊玲 13888072208

WangShanLing 13888072208

　　盘龙区医保分中心

PanLongOu health care centers

　　值班电话：63195219

On the telephone:63195219

　　张铃 13769198989

ZhangLing 13769198989

　　官渡区医保分中心

Xiong deyou health care centers

　　值班电话：67170455

On the telephone:67170455

　　陈勤皓 13888971001

ChenQinHao 13888971001

　　西山区医保分中心

The mountain west conference health care centers

　　值班电话：68046995

On the telephone:68046995

　　李菊花 13888175527

LiJuHua 13888175527

　　东川区医保分中心

DongChuanOu health care centers

　　值班电话：62138540、62122656

On the telephone:62138540/62122656

　　李竹央 13888610096

LiZhuYang 13888610096

　　呈贡区医保分中心

ChengGong district health centers

　　值班电话： 67484693

On the telephone: 67484693

　　晋宁县医保分中心

Jinning county health care centers

　　值班电话：67809975、67807283

On the telephone:67809975/67807283

　　陈云忠 13085382388

ChenYunZhong 13085382388

　　富民县医保分中心

FuMinXian health care centers

　　值班电话：68814628、68817926

On the telephone:68814628/68817926

　　赵志梅 13888059278

ZhaoZhiMei 13888059278

　　宜良县医保分中心

Should be good county health care centers

　　值班电话： 67543061、67542123

On the telephone: 67543061/67542123

　　杨晓波 13708418649

YangXiaoBo 13708418649

　　石林县医保分中心

City health centers

　　值班电话：

On the telephone:

　　67799877、67799876

67799877/67799876

　　李琼仙 13888099079

You fairy 13888099079

　　嵩明县医保分中心

SongMingXian health care centers

　　值班电话： 67920330、67920082

On the telephone: 67920330/67920082

　　王文忠 13529168597

13529168597 king.l.why positive psychology is necessary

　　禄劝县医保分中心

LuQuanXian health care centers

　　值班电话：68903516、68904102

On the telephone:68903516/68904102

　　李光武 13987683939

LiGuangWu 13987683939

　　寻甸县医保分中心

XunDianXian health care centers

　　值班电话：62652231

On the telephone:62652231

　　李唐良 15911659004

LiTangLiang 15911659004

　　安宁市医保分中心

AnNingShi health care centers

　　值班电话：

On the telephone:

　　68686019、68698619

68686019/68698619

　　武慧萍 13187840968

WuHuiPing 13187840968

　　高新区医保分中心

High-tech health centers

　　值班电话：68155528

On the telephone:68155528

　　郭进辉 13698762019

GuoJinHui 13698762019

　　经开区医保分中心

The open district health centers

　　值班电话：68163217

On the telephone:68163217

　　陆萍 13085367870

LiuPing 13085367870

　　滇池度假区医保分中心

Medical insurance branch in dianchi lake resort

　　值班电话：64664831

On the telephone:64664831

　　霍勇 13987680337

Blood 13987680337

　　阳宗海风景名胜区医保分中心

Yangzonghai scenic area health care centers

　　值班电话：67517257

On the telephone:67517257

　　马猛 15974828680

The horse over 15974828680