权威解读！《长寿区健全重特大疾病医疗保险和救助制度实施办法》
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<span style="box-sizing: content-box; list-style-type: none; font-size: 15px; color: #3F3F3F; outline: none !important; visibility: visible;" > 近日，区人民政府办公室印发</span><span style="color: #1F497D; visibility: visible;"><strong style="visibility: visible;"><span style="box-sizing: content-box; list-style-type: none; font-size: 15px; outline: none !important; visibility: visible;">《重庆市长寿区健全重特大疾病医疗保险和救助制度实施办法》</span></strong></span><span style="box-sizing: content-box; list-style-type: none; font-size: 15px; color: #3F3F3F; outline: none !important; visibility: visible;">（以下简称《实施办法》），聚焦减轻困难群众重特大疾病医疗费用负担，</span><span style="box-sizing: content-box; list-style-type: none; font-size: 15px; color: #3F3F3F; outline: none !important; visibility: visible;">进一步夯实困难群众医疗救助托底保障。</span>
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出台的背景
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<span style="font-size: 15px; visibility: visible;">为贯彻落实党中央、国务院决策部署和市委、市政府工作要求，按照“应保尽保、保障基本”，“尽力而为、量力而行”的原则，区政府办公室制定印发了《实施办法》。融合了我区现行医疗救助政策和乡村振兴医保帮扶政策，聚焦减轻困难群众重特大疾病医疗费用负担，建立健全防范和化解因病致贫返贫长效机制，进一步夯实医疗救助托底保障功能，强化基本医保、大病保险、医疗救助三重制度综合保障，促进三重制度综合保障与慈善救助、商业健康保险等协同发展、有效衔接，构建政府主导、多方参与的多层次医疗保障体系。</span>
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医疗救助的保障对象是哪些？
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<span style="font-size: 15px; visibility: visible;">医疗救助公平覆盖医疗费用负担较重的困难职工和城乡居民，根据救助对象类别实施分类救助。对低保对象、特困人员（含城乡孤儿、事实无人抚养困境儿童）、低保边缘家庭成员和纳入监测范围的农村易返贫致贫人口，按规定给予救助。对不符合低保、特困人员救助供养或低保边缘家庭条件，但因高额医疗费用支出导致家庭基本生活出现严重困难的大病患者，简称因病致贫重病患者，根据实际给予一定救助。<br style="visibility: visible;"/></span>
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<span style="font-size: 15px; visibility: visible;">对于重点优抚对象（含烈士遗属，不含1―6级残疾军人）、城乡重度（1―2级）残疾人员等其他救助对象，按照既往政策规定继续实施救助。</span>
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<span style="font-size: 14px; visibility: visible;">医疗救助对象由哪些部门认定？如何做到精准识别医疗救助对象？</span>
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<span style="font-size: 15px; visibility: visible;">特困人员（含城乡孤儿、事实无人抚养困境儿童）、低保对象、低保边缘家庭成员由民政部门认定；农村易返贫致贫人口由乡村振兴部门认定。因病致贫家庭重病患者由民政部门会同医保部门等相关部门合理确定认定条件，目前相关文件正在制定中。我区规定的其他特殊困难人员，按上述救助对象类别给予相应救助。救助对象身份自被认定后，相关信息由认定部门及时上传报送，医保、民政、乡村振兴部门通过信息共享等方式，为新增人员及时办理参保登记并添加享受待遇标识，确保及时纳入医疗救助保障。</span>
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如何做好医疗救助对象的综合保障？
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<span style="font-size:15px;">发挥基本医保主体保障功能，参保人员享受同等的基本医保待遇；大病保险对参加居民医保的特困人员、低保对象、返贫致贫人员，起付线降低50%、报销比例提高5个百分点、取消封顶线；医疗救助对困难群众实施托底保障。具体为：<br/></span>
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<span style="color:#1f497d;"><strong><span style="font-size: 15px;">一是分类资助参保。</span></strong></span><span style="font-size:15px;">救助对象参加城乡居民基本医保一档的，特困人员给予全额资助，低保对象按照90%给予定额资助，返贫致贫人口、纳入监测范围的农村易返贫致贫人口和低保边缘家庭成员按照70%给予定额资助；救助对象自愿参加城乡居民基本医保二档的，统一按照参加城乡居民基本医保一档个人缴费标准的100%给予资助。<br/></span>
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<span style="color:#1f497d;"><strong><span style="font-size: 15px;">二是实施医疗费用救助。</span></strong></span><span style="font-size:15px;">救助对象患特殊疾病在定点医药机构发生的住院费用或门诊治疗的费用，以及救助对象患特殊疾病以外的其他疾病，在二级及以上医疗机构一次性住院发生医保政策范围内费用超过3万元的费用，纳入医疗救助保障。<br/></span>
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<span style="color:#1f497d;"><strong><span style="font-size: 15px;">三是协同救助。</span></strong></span><span style="font-size:15px;">开展职工医疗互助，鼓励职工参加医疗互助，鼓励商业保险机构加强产品创新，在产品定价、赔付条件、保障范围等方面对困难群众适当倾斜。探索建立医疗保障、社会救助与慈善帮扶相互衔接机制，将慈善资源作为医疗救助的重要补充，推进实施综合保障。<br/></span>
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<span style="color:#1f497d;"><strong><span style="font-size: 15px;">四是健全高额医疗费用支出预警监测机制和救助帮扶机制。</span></strong></span><span style="font-size:15px;">综合考虑经济状况和医疗费用支出情况，动态做好监测人员与分类救助政策的衔接。</span>
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医疗救助重特大疾病病种有哪些？
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<span style="font-size:15px;">医疗救助重特大疾病病种有肺癌、食道癌、胃癌、结肠癌、直肠癌、乳腺癌、宫颈癌、严重多器官衰竭（心、肝、肺、脑、肾）、再生障碍性贫血、终末期肾病（尿毒症）、耐多药肺结核、艾滋病机会性感染、重性精神病、血友病、肝肾移植前透析和手术后抗排异治疗、慢性粒细胞白血病、急性心肌梗塞、脑梗死、重症甲型H1N1、1型糖尿病、甲亢、唇腭裂、地中海贫血、白血病、精神分裂症、躁狂症、焦虑症等26个病种。</span>
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较之前的政策有什么优化？
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<span style="color:#1f497d;"><strong><span style="font-size: 15px;">一是统一了重特大疾病医疗救助支付比例。</span></strong></span><span style="font-size:15px;">对特困人员(包括城乡孤儿、事实无人抚养儿童)按90%的比例救助，低保对象和返贫致贫人口按80%的比例救助，纳入监测范围的农村易返贫致贫人口、低保边缘家庭成员及因病致贫重病患者对象按70%的比例救助。<br/></span>
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<span style="color:#1f497d;"><strong><span style="font-size: 15px;">二是明确了封顶线。</span></strong></span><span style="font-size:15px;">年度救助限额分别不低于10万元、6万元。<br/></span>
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<span style="color:#1f497d;"><strong><span style="font-size: 15px;">三是新增了倾斜救助。</span></strong></span><span style="font-size:15px;">对规范转诊且在全市范围内就医的救助对象，经三重制度综合保障后政策范围内个人负担仍然较重的，给予倾斜救助，由救助对象认定部门按照相关政策执行。</span>
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<strong>0</strong><strong data-original-title="" title="" data-num="7">7</strong>
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参保群众如何更方便快捷获得医疗救助？
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<span style="font-size:15px;">一是简化申请、审核、救助资金给付流程，身份明确的救助对象，在市内定点医疗机构就医实行基本医保、大病保险、医疗救助“一站式”即时结算，未获得“一站式”即时结算的，到区医保经办窗口“一门受理”窗口申请即可获得救助。</span>
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<span style="font-size:15px;">二是经基层首诊转诊的低保对象、特困人员在区内定点医疗机构住院，实行“先诊疗后付费”，无需缴纳住院押金。</span>
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</section> 巴适得很嘛 {:4_197:}{:4_197:}{:4_197:} 希望越来越好 {:4_197:}{:4_197:}{:4_197:}{:4_197:}{:4_197:} {:4_197:}{:4_197:} 困难的人很多 好。。。晓得啦。。。。。{:4_381:}{:4_373:}{:4_375:}{:4_381:}{:4_381:}{:4_381:}{:4_381:} {:4_197:}{:4_197:}{:4_197:}{:4_197:} 知道了。。。。