The basic medical insurance implementing regulations of urban residents of Yantai are issued formally

The basic medical insurance implementing regulations of urban residents of Yantai are issued formally
The basic medical insurance implementing regulations of urban residents of Yantai are issued formally
On the 9th, the reporter learns, " basic medical insurance implementing regulations of urban residents of Yantai " are issued formally from medical insurance undertaking of market of Yantai, the intersection of specification and range to implement this, effect an insurance, register, pay the fees, issue licence, information alter, seek medical advice, close, carry on detailed concrete exposition. " basic medical insurance trial methods of urban residents in Yantai " issued before comparing early, this specification has been carried on thinningly and supplemented, clearer to the concrete requirement which urban residents effect an insurance. Specification one: Effect an insurance range expand according to the stipulations of implementing regulation, effect an insurance the intersection of target and definition and effect an insurance to be further more intact, more clear in student, stage in the middle and primary schools students, preschool child and other residents under the age of 18, effect an insurance according to household register in principle, but the intersection of school and guard station in the urban stage students of middle and primary schools, and the school guard station is not in the urban vocational high school, the students of the special secondary school class in special secondary school, special school, technical school, duty school and every institution of higher learning, technical school class,etc. can effect an insurance according to the roll. The ones that include in the original trial method effect an insurance outside the target, the specification includes in the new effecting an insurance crowd of a part, include being already urban residents (the urban residents after changing to occupy including the village) participating in new rural cooperative medical service ,Can pay the fees that year newly and agriculturally for year after expiring jointly, participated in the city to occupy the medical insurance; Joining the new agricultural village that shuts changes to occupy urban residents, can effect an insurance directly. And get to the retired personnel not enjoying the urban worker's basic medical insurance treatment to the urban unemployed worker that the insurance treatment of the unemployment expires, can participate in the basic medical insurance of urban residents. Specification two: Information management define implementing regulation to be very clear further, urban residents basic the intersection of medical insurance and all kinds of effect an insurance the intersection of resident and day on a basis of annual September 30, confirm that the annual basic medical insurance premium raises standard and treatment to pay the standard to originally pay the fees. Determination in it is teenage, grow up that that is to say or old residents, and low insurance, disabled target,etc., fix with September 30 of every year, basis confirms on day which kind of targets of effecting an insurance oneself is, originally paying the fees from October 1 to September 30 of next year raises funds according to this target promptly in year the standard pays the fees. Confirm, to for concentrate on, pay the fees issue September 30, effect an insurance resident pay the fees each can enjoy the treatment month annual a August 1 at the same time, it is a year for medical treatment from the 1st of every January to December 31. Coincidence urban low insurance target, severe disabled person and " 'sanwu' people " Multiple condition, enjoy the government to subsidize only according to a kind of condition among them. Because of " 'sanwu' people " The government subsidizes 95%, and low insurance target and severe physically disabled person's government subsidize 90%, effect an insurance personnel can select the superior and fetch. When target coincides with severe disabled person low insurance, because the low insurance target has time restriction, propose joining and taking care of one degree of deformity in order to enjoy the treatment forever. And neonate, since handling the moon of the household register, can effect an insurance, pay the fees immediately, pay the fees, need, pay, should pay the fees annual the intersection of surplus and month expense only for the first time, can enjoy the treatment from a month, so neonatal parents should leave the registered permanent residence for children in time, it will be convenient to effect an insurance as soon as possible. Specification three: Settlement of seeking medical advice, in the the intersection of standardization and one the intersection of medical treatment and year, teenage the intersection of resident and the intersection of unexpected injury and clinic medical fee pay volume and grow up and old the intersection of resident and ordinary the intersection of clinic and medical fee pay volume, charge resident to in hospital and conduct the intersection of number and the intersection of clinic and medical fee, pay within the limit of 30,000 yuan at most. , the improvement of supportability at the same time, as the fund is operated, submit an expense account proportion and amount will be all raised appropriately. The specification is also especially indicated, effect an insurance when residents go through all kinds of hospitalization costs and settle the procedure, must offer the original document of the hospitalization cost, there is no primitive document of charging, the insured fund refuses to pay. Meanwhile, acute disease happen when residents go out to visit one's relatives, travel to effect an insurance to need to treat and cure promptly, can seek medical advice nearby, but the hospitalization cost not acute disease happening in the nonlocal medical organization, the insured fund refuses to pay. Specification four: Restrain and encourage the mechanism to be compatible in order to let residents effect an insurance positively and normally, also include restraining partly from and encouraging the mechanism in the implementing regulation that was just issued. By the look of tied mechanism, are qualified to effect an insurance and has not effected an insurance and paid the fees and stopped paying the fees residents in time at first, if at one time paying arrears when in year to effect an insurance, should be afforded the expenses by individual in the past, it pays service life and does not charge to and pay the fees for service life continuously, the hospitalization cost refuses to pay while paying arrears at the same time. From encourage mechanism come, say, effect an insurance at first resident pay the fees for five years more than continuously, the expenses are paid the proportion and raised by 5%. Secondly, residents have not happened in hospital or conducted medical fee of the number clinic in one year, clinic expenses can submit an expense account 72, fall ill, can enjoy treatment this continuously continuously. The intersection of reporter and Guo FanKai, reporter of rock, Cui


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