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云南非定点医院急诊费医保可报销--亲稳网络舆情监控室
2013-01-09
8日,云南省人力资源和社会保障厅负责人表示,根据2013年1月1日起实施的《云南省基本医疗保险急诊抢救管理办法》(以下简称《办法》)规定,医保参保人若发生危急重症,来不及到定点医疗机构就诊,到非定点医疗机构发生的72小时内不间断的门诊急诊抢救产生的医疗费、打120的急诊抢救医疗费,均可通过医保报销。
The 8 th,Yunnan province human resources and social security hall director said,According to January 1, 2013[Measures for the administration of insurance of primary medical treatment of emergency rescue in yunnan province](Hereinafter referred to as the[Way to])Provisions of the,In case of emergency and severe cases in medical insurance ginseng protect people,Too late to the medical establishment that decide a dot,To the medical establishment that decide a dot occurred within 72 hours of uninterrupted outpatient emergency medical rescue/Call 120 emergency rescue of medical treatment,All can through medical insurance reimbursement.
《办法》对基本医疗保险统筹基金支付的急诊抢救类型有四类:一是参保人员由于发生危急重症,身体处于危险状态时,在定点医疗机构产生的72小时内不间断的门诊急诊抢救医疗费;二是参保人员由于发生危急重症,身体处于危险状态时,来不及到定点医疗机构就诊,按照就近就地原则到非定点医疗机构发生的72小时内不间断的门诊急诊抢救医疗费;三是参保人员在救护车上急诊抢救时的医疗费;四是参保人员住院期间因紧急抢救需使用现行《云南省基本医疗保险工伤保险和生育保险药品目录》(以下简称《目录》)外药品的医疗费。
[Way to]To plan as a whole fund of insurance of primary medical treatment to pay of four types of emergency rescue:One is ginseng protect personnel due to emergency and severe cases in,When the body is in a state of danger,In the medical establishment that decide a dot to produce within 72 hours of uninterrupted outpatient emergency rescue treatment;Second, ginseng protect personnel due to emergency and severe cases in,When the body is in a state of danger,Too late to the medical establishment that decide a dot,In accordance with the principle of transforming to nod medical establishment surely happen within 72 hours of uninterrupted outpatient emergency rescue treatment;Three is ginseng protect personnel to emergency rescue in the ambulance on the way of treatment;Four is ginseng protect personnel in hospital for emergency rescue to use current[Yunnan catalog of medicines and chemical reagents of insurance of primary medical treatment of inductrial injury insurance and maternity insurance](Hereinafter referred to as the[directory])The drug treatment.
急诊抢救基本医疗保险统筹基金支付标准:参保人员发生的门诊急诊抢救医疗费用,属于本办法规定支付范围内的,按照各统筹地基本医疗保险规定的住院统筹基金支付标准结算;急诊抢救时使用现行《目录》外属于急诊抢救的药品,个人先自付30%,余下部分按统筹地规定的报销比例结算;使用现行《目录》外其他药品,按全自费结算。
Emergency rescue plan as a whole fund of insurance of primary medical treatment to pay standards:Ginseng protect personnel to the outpatient emergency rescue medical expenses,Belongs to this pay within the scope of the measures,According to the plan as a whole to the provisions of the insurance of primary medical treatment in hospital as a whole fund pays standard settlement;Use the emergency rescue[directory]Outside of emergency rescue,Individual first pays 30%,The remaining part of the proportion according to the provisions of the plan as a whole to submit an expense account settlement;Use the current[directory]The other drugs,According to the settlement at his own expense.
《办法》要求各统筹地医保部门将120急救中心纳入基本医疗保险定点医疗机构范围,视同基层医疗机构。120急救中心救护车出车产生的急诊抢救医疗费用按本办法规定纳入统筹基金报销范围,实行直接结算。未实现联网的,可参照前款报销办法结算。 记者 李丹丹
[Way to]Request each plan as a whole to medical insurance department will 120 emergency center included in the scope of the medical establishment that decide a dot of insurance of primary medical treatment,Are regarded as basic medical institutions.120 emergency center an ambulance driving the emergency rescue medical expenses included in the plan as a whole fund in accordance with the present measures,A direct settlement.Did not realize the networking,Can refer to in the preceding paragraph to submit an expense account settlement.The reporter li dandan
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