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云南省高等yabo手机版大学生基本医疗保险实施细则(试行)

发布时间: 2017年02月10日 作者:  点击: []

一、保障范围

yabo手机版shengshuzaikundegaodengyaboshoujiban、suoshukeyanyuansuo(yixiajiancheng“gaodengyaboshoujiban”)zhongjieshouputonggaodengjiaoyudequanrizhibenzhuankesheng、feizaizhiyanjiusheng(yixiajiancheng“daxuesheng”),zaiyunnanshengyiliaobaoxianjijinguanlizhongxin(yixiajiancheng“shengyibaozhongxin”)canbao。

二、筹资水平

yabo手机版(yi)shengshuzaikundegaodengyaboshoujibandaxueshengmeirenmeinianjibenyiliaobaoxianchouzishuipingwei80yuan。buzhuhejiaofeibiaozhunwei:

1.yuanxiangshougongfeiyiliaodedaxueshengjibenyiliaobaoxianfeimeixuenianrenjunshengcaizhengbuzhu80yuan,gerenbujiaofei。

2.weixiangshougongfeiyiliaodedaxueshengjibenyiliaobaoxianfeimeixuenianrenjunshengcaizhengbuzhu40yuan,suozaigaodengyaboshoujibanbuzhu30yuan,gerenjiaofei10yuan。

yuanxiangshougongfeiyiliaodedaxueshengzhi: anyuanxiangshougongfeiyiliaodeguiding,guojiazhengshixiaozhunshezhideputonggaodengyaboshoujiban(buhanjunshiyuanxiao)jihuaneizhaoshoudeputongbenzhuankezaixiaoxuesheng、yanjiusheng(buhanweituopeiyang、zifei、ganbuzhuanxiuxuesheng)。

yabo手机版(er)gulidaxueshengziyuancanjiabuchongyiliaobaoxian,buchongyiliaobaoxianfeiyoudaxueshenggerenmeixueniananbudiyu50yuanjiaona。

三、参保登记

(yi)daxueshengchishenfenzheng、xueshengzhengdengyouguanziliao,zaibenxiaotianxie《yunnanshengchengzhenjuminjibenyiliaobaoxian(daxuesheng)canbaoshenqingdengjibiao》,banlicanbaodengjihejiaofeishouxu。

(er)gaodengyaboshoujibanduiyishangziliaohe《dengjibiao》neirongjinxingshenhe;bingjiangcaijidecanbaoxinxiluruyiliaobaoxianxinxicaijixitong。

(san)yibaozhongxinyijucanbaoxinxishengchengjiaofeiqingce,tongzhigaodengyaboshoujibananjiaofeiqingcedaishougerenyingjiaodejibenyiliaobaoxianfei。

(si)yiliaobaoxianfeijingyibaozhongxinshenhewuwuhou,youkaihuyinxinghuarucaizhengzhuanhu,bingyouyinxingxianggaodengyaboshoujibanchuju《yunnanshengshehuibaoxianfeijiaokuanshouju》。

yabo手机版(wu)shengshehuibaozhangkazhizuofaxingzhongxingenjucanbaoxinxi,zhizuo《zhonghuarenmingongheguoshehuibaozhangka》(yixiajiancheng“shehuibaozhangka”),jiaoyousuozaigaodengyaboshoujibanfafang。

四、待遇水平

shengshuzaikundegaodengyaboshoujibanzhixingyixiadaiyubiaozhun:

yabo手机版(yi)daxueshengjibenyiliaobaoxianjijinzhuyaoyongyuzhifuzhuyuan、putongmenzhenheteshubingmenzhenyiliaofeiyong;buchongyiliaobaoxianzhuyaoduizhuyuanhemenzhenteshubingyiliaofeiyongjinxingbuzhu。

(er)daxueshengjibenyiliaobaoxiandeyaopinmulu,zhenliaoxiangmujiyaboshoujibansheshibiaozhunanzhaoyunnanshengchengzhenjuminjibenyiliaobaoxianyouguanguidingzhixing。

(san)canbaohoubanlilexiuxue、tuixueshouxudedaxuesheng,zaicanbaoshixianneifashengdeyiliaofeiyong,renganyouguanguidingbaoxiao。

(si)zhuyuanyiliaodaiyu

1.qifubiaozhun

xuenianneidiyicizhuyuan: yijiyiliaojigou100yuan,erjiyiliaojigou200yuan,sanjiyiliaojigou300yuan;diercizhuyuanqifufeijianban;disanci(han)yishangzhuyuandebuzaijiaonaqifufei。

2.zhuyuanqijianfashengdeteshujiancha、teshuzhiliaoheyileiyaopingerenxianzifu10%;ruoshiyongleyaopinmuluyiwaideqiangjiuyaopinshi,yousuozaidingdianyiliaojigoushenpibeianhoufangkeshiyong,yaopinfeiyougerenxianzifu40%。

yabo手机版3.baoxiaobilihezuigaozhifuxiane

(1)jibenyiliaobaoxian

yabo手机版xueniannei,fuhejibenyiliaobaoxianbaoxiaofanweineidezhuyuanyiliaofeiyongbaoxiaobiliwei60%;tongchoujijinzuigaozhifuxianewei1.6wanyuan。

(2)buchongyiliaobaoxian

xueniannei,zaicanjiajibenyiliaobaoxiandetongshi,youcanjialebuchongyiliaobaoxiandedaxuesheng,fuhejibenyiliaobaoxianbaoxiaofanweineidezhuyuanyiliaofeiyongbaoxiaobilitigaodao90%;buchongyiliaobaoxianzhifuxianeshangbufengding,bingchengdanyiwaishanghaishigu、jibingshengu10000yuandepeifuzeren,chengdanyiwaishangcanandengjizuigao10000yuandepeifuheyiwaishanghaimenzhenfeiyong100yuanyishang5000yuanyinei90%depeifuzeren。

(wu)menzhenyiliaodaiyu

1.putongmenzhen

yabo手机版menzhenyiliaofeitongchoubiaozhunzandingweimeirenmeixuenian30yuan,youshengyibaozhongxinandaxueshengcanbaorenshuhuaruxiaoyiyuan(yiwushi)baoganshiyong。baoganfeiyongjieyuzai10%yineideguixiaoyiyuan(yiwushi),jieyuchaoguo10%defeiyongyouyibaozhongxinshouhui;ruoxuenianneifashengchaozhibufenyoushengyibaozhongxinfudan30%,gaodengyaboshoujibanfudan70%。

2.teshubingmenzhen

yabo手机版(1)exingzhongliu(menzhenfang、hualiao)、manxingshengongnengshuaijie(menzhentouxi)、qiguanyizhi(shuhoukangpaiyi)、xitongxinghongbanlangchuang、zaishengzhangaixingpinxueteshubingmenzhenfashengdeyiliaofeiyong,qifuxianyishangfeiyongbaoxiaobilihezuigaozhifuxianeyuzhuyuandaiyuyizhi。

(2)huanteshubingdedaxuesheng,youbenrenxiangjiuduyuanxiaotichushumianshenqing,jingshengyibaozhongxinanguidingchengxushenhehoufaji《teshubingjiuzhenka》,chiyou《teshubingjiuzhenka》dedaxueshenghuanzhe,fangkexiangshouxiangyingdeteshubingyiliaodaiyu。

yabo手机版(liu)youxialieqingkuangzhiyide,suofashengdeyiliaofeiyong,jibenyiliaobaoxianjijinhebuchongyiliaobaoxianzijinbuyuzhifu:

1.jibenyiliaoyaopinmulu、zhenliaoxiangmuheyaboshoujibansheshibiaozhunyiwaidefeiyong(jijiuchuwai)。

yabo手机版2.jiankangtijian、jihuamianyi、yufangbaojian、jiankangjiaoyudenggonggongweishengyaboshoujibandefeiyong。

3.weibanlizhuanzhenzhuanyuanshenpibeianshouxu,zixingwaichujiuyideyiliaofeiyong。

4.zhengxing、meirong、xujiu、xidu、dajiadouou、zishazican、zifendengweifafanzuixingweisuozhideyiliaofeiyong。

5.anyouguanguidingbuyuzhifudeqitafeiyong。

五、就医管理和费用结算

yabo手机版(yi)gaodengyaboshoujibananzhaojiujinjiuyideyuanzexuanzeyizhierjiadingdianyiliaojigou(buhanxiaoyiyuan),zuoweibenxiaodaxueshengxiaowaizhuyuandedingdianyiliaojigou。

yabo手机版(er)gaodengyaboshoujibanxiaoyiyuan(yiwushi)fuzedaxueshengputongmenzhen,wuxiaoyiyuandegaodengyaboshoujibanyouyibaozhongxinzhidinglinjinshequweishengyaboshoujibanzhongxinqianshuxieyi,weidaxueshengtigongputongmenzhenjizhenyiliaoyaboshoujiban。

yabo手机版(san)daxueshengpingshehuibaozhangkahexueshengzhengdaozhidingdedingdianyiliaojigoujiuyi,suofashengdezhuyuanheteshubingmenzhenyiliaofeiyong,anguidingyingyougerenfudandefeiyongyougerenzhifu,yingyoutongchoujijinhuobuchongyiliaobaoxianzhifudefeiyong,youyibaozhongxinyudingdianyiliaojigouzhijiejiesuan。

(si)daxueshengzaijiaqi、shixi、xiuxueqijianyinjiweizhongzhengxuyidizhuyuanzhiliaode,yuanzeshangzaidangdiyibaodingdianyiliaojigoujiuyi,bingzaiyizhouneitongguojiuduyuanxiaoxiangyibaozhongxinbeian,suofashengdeyiliaofeiyongxianyougerenquanedianfu,yiliaozhongjiehouyoujiuduyuanxiaotongyidaoyibaozhongxinanguidingbaoxiao;menzhenfeiyongyoujiuduyuanxiaoyiliaojigouanguidingbaoxiao。

yabo手机版(wu)fashengwuzerenrendeyiwaishanghaishi,qifeiyongkepingdingdianyiliaojigouzhenduanzhengminghejiuduyuanxiaochujudexiangguanzhengminganguidingbaoxiao。

yabo手机版(liu)yinbingqingxuyaojinxingzhuanzhenzhuanyuande,junyouxiaoyiyuan(yiwushi)huoweituodeshequweishengyaboshoujibanzhongxinchujuzhuanzhenzhuanyuanzhengming,dingdianyiliaojigoufangkeshouzhizhuyuan(jizhenqiangjiuchuwai)。

zhuanshengwaijiuyide,xutigongzhishaoersuosanjidingdianyiliaojigouzhurenyishihuiyiyijian,youzhuanchuyiyuangaizhanghousongyibaozhongxinshendingbeian,gerenzifubilizaiyuanjichushangtigaoergebaifendian,feiyongyoujiuduyuanxiaohuoxueshengbenrenquanedianfu。

(qi)xueniannei,daxueshengzhuyuanrenshuyuanzeshangbuchaoguocanbaozongrenshude2%,duichaoguodexiaoyiyuanjiangshiqingkuangjianshaoxianiandumenzhenyiliaobaogantongchoufeiyong。

六、其它

yabo手机版jibenyiliaobaoxiandejiesuannianduweimeixueniande9yue1rizhiciniande8yue31ri,yougaodengyaboshoujibanbanlilebiyeshouxudedaxueshengzai9yuetingzhixiangshouyiliaobaoxiandaiyu。daxueshengzaiduqijianyinglianxucanbao。

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