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北京拟规定非京籍婴儿出生时患病可有条件报销--亲稳网络舆情监控室
2013-01-25

  前天记者从北京两会上获悉,本市今年有望实施惠民措施,扩大生育医疗费用支付范围,以减轻群众医疗负担。不仅如此,本市社保卡还将首次增加除医保以外的新功能,即增加启动生育、工伤保险“持卡结算”。

The day before yesterday reporter from Beijing about two,This city is expected to implement this year we measures,Expand the birth medical treatment fee to pay limits,In order to reduce the medical burden.Not only that,The city social security card will also increase the medical insurance for the first time, in addition to outside the new function,By adding start fertility/Inductrial injury insurance"Their settlement".

  减负 Alleviate the burden on

  企业缴费下降无碍个人报销 Enterprise pay cost down clear personal expense

  据了解,2012年12月21日人社部结束了就《生育保险办法(征求意见稿)》公开征求意见。引人瞩目的是,征求意见稿企业缴纳生育险的缴费比例一般不超过0.5%,比现行规定的1%左右大幅度降低。

It is understood,On December 21, 2012 people club department over it[Birth insurance measures(draft)]Public to solicit their opinions.The spotlight is,Draft enterprise pay bears the risk of pay cost ratio generally not more than 0.5%,The current regulation than about 1% of the greatly reduced.

  为此本市初步决定,待《生育保险办法》出台后,北京市将适当调整生育保险缴费比例,以进一步减轻企业负担。

Therefore this city preliminary decision,to[Birth insurance measures]Issued after,Beijing will adjust birth insurance pay cost ratio,To further reduce the burden on enterprises.

  据了解,目前本市生育保险费的缴费比例是0.8%,由企业负责缴费,个人不缴费。现在,本市生育保险年缴费总额要超过10亿元。如果将生育保险费的缴费比例降低到0.5%,那么每年将为相关企业节约数亿元的资金。而企业省下的则有望用于企业的投资再发展,或者可能被用于企业职工的福利等。对于个人来说,报销额不会受影响,原来能报多少将来还能报多少。

It is understood,At present this city birth insurance premium of pay cost ratio is 0.8%,In charge of by the enterprise pay cost,Individual not pay cost.now,The city of birth insurance pay cost in the total to more than 1 billion yuan.If the birth insurance premium of pay cost reduced to 0.5% proportion,So every year for related enterprise will save hundreds of millions of dollars of money.And enterprise save are expected to used in enterprise investment and development,Or may be used for the welfare of the staff and workers of the enterprise, etc.For the person,Reimbursement amount will not be affected,The original can offer much in the future also can offer much.

  报销 reimbursement

  生育险报销拟扩大范围 Birth insurance reimbursement expand range

  随着非京籍职工等新群体被纳入到本市生育保险范畴,随之带来了一个新问题。此前本市规定,对于北京市民的新生儿,可参加城镇居民医保,报销新生儿出生时即患病所发生的医疗费用。而对于本市非京籍职工来说,虽然这些父母参加了生育保险,母亲分娩时的生育费用也能够报销了,可是由于其孩子的户籍可能还是非京籍,因此这些新生儿在出生时因患病所发生的医疗费用,仍然无法报销。

With the new worker not an group is attached to this city birth insurance category,Then brought a new problem.After this municipality,,The citizens of Beijing for newborns,Can participate in medical insurance for urban residents,The baby is born to submit an expense account is the medical treatment cost that place of illness.And to this city not the record for the worker,Although these parents attended the birth insurance,Mother during labor and birth cost can also went to pieces,But due to its children's census register may still not by Beijing,So the babies born because of illness in the medical treatment cost that place of,Still cannot submit an expense account.

  对此,本市正在研究扩大生育医疗费用支付范围。换言之,对于那些非京籍生育保险参保职工所生新生儿在出生时患病所发生的这一次医疗费用,即可允许生育保险按一定比例对其予以报销。

this,This city is studying expand birth medical treatment fee to pay limits.In other words,For those not Beijing by birth insurance ginseng protect a worker to babies born at birth sick what happened this time medical costs,Can allow birth insurance according to a certain proportion to it to submit an expense account.

  此外,本市今年还拟将孕产期内因怀孕、分娩发生的妊娠合并症,也纳入到生育保险基金的支付范围。另外,产前检查费的基金支付标准,也有望提高。

In addition,The city this year is going to be pregnant period internal cause pregnancy/Delivery of pregnancy complications occurred,Also into the birth insurance fund to pay limits.In addition,Prenatal examination fund payment standard,Is expected to improve.

  -生育险 - birth insurance

  结算 settlement

  生育也有望持卡实时结算 Birth is expected to real-time settlement activity

  2013年,本市还要提高社保经办管理服务效能,研究启动生育、工伤保险“持卡结算”这一重要功能。

In 2013,,The city will improve the management of orgnaization of social service efficiency,Research start birth/Inductrial injury insurance"Their settlement"The important function.

  本市自2009年试点推出社保卡后,其始终只具有医疗保险的功能,因此,也有市民称其为“医保卡”。今年本市拟在社保卡增加生育、工伤保险“持卡结算”的功能,这也有望是本市社保卡第一次增加其他社会保险险种的功能。

This city since 2009 pilot launched after the social security card,Its always only has the function of medical insurance,so,Have people called it"Medical insurance card".This year the city to be on social security card increase fertility/Inductrial injury insurance"Their settlement"function,This will also is the social security card first increase other social insurance risk function.

  在这一功能推出后,生育、工伤保险的相关参保者,届时也将和医保参保者一样无需个人垫付相关费用,享受到持卡即时结算的便捷服务了。

In this function after launch,birth/Inductrial injury insurance related beneficiaries,At the appointed time will also and health as well as participants without personal disbursements related expenses,Enjoy their immediate settlement and convenient service.

  据相关负责人介绍,本市工伤保险涉及工伤职工看病报销,以及伤残津贴、生活护理费和因工死亡职工供养亲属抚恤金等。今年本市拟先将工伤职工看病报销这一功能加入社保卡中,而伤残津贴、生活护理费等工伤保险其他内容暂不考虑纳入社保卡功能中。

According to relevant controller introduces,Inductrial injury insurance of inductrial injury worker in the city to see a doctor to submit an expense account,And disability allowance/The life nurses cost and because be versed in dead worker make offerings to relative pension, etc.This year the city intends to inductrial injury worker a doctor to submit an expense account this function to join in the social security card,And disability allowance/The life nurses cost and other contents of inductrial injury insurance will not enter into the social security card in the function.

  此外,由于本市工伤职工基本都是医保参保者,而工伤医疗机构也基本都是医疗保险定点机构,所以将工伤职工看病报销功能加入社保卡中,预计不需要涉及太多的信息采集工作。

In addition,The city because of inductrial injury worker is basic medical insurance beneficiaries,And treatment of inductrial injury medical institutions and basic medical insurance is orgnaization,So will see a doctor of inductrial injury worker to submit an expense account function in social security card,Don't need too much expected in information collection work.

  本报记者赵鹏

Our reporter ZhaoPeng


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