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云南省高等学校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

红蓝电竞shengshuzaikundegaodengxuexiao、suoshukeyanyuansuo(yixiajiancheng“gaodengxuexiao”)zhongjieshouputonggaodengjiaoyudequanrizhibenzhuankesheng、feizaizhiyanjiusheng(yixiajiancheng“daxuesheng”),zaiyunnanshengyiliaobaoxianjijinguanlizhongxin(yixiajiancheng“shengyibaozhongxin”)canbao。

二、筹资水平

(yi)shengshuzaikundegaodengxuexiaodaxueshengmeirenmeinianjibenyiliaobaoxianchouzishuipingwei80yuan。buzhuhejiaofeibiaozhunwei:

1.yuanxiangshougongfeiyiliaodedaxueshengjibenyiliaobaoxianfeimeixuenianrenjunshengcaizhengbuzhu80yuan,gerenbujiaofei。

2.weixiangshougongfeiyiliaodedaxueshengjibenyiliaobaoxianfeimeixuenianrenjunshengcaizhengbuzhu40yuan,suozaigaodengxuexiaobuzhu30yuan,gerenjiaofei10yuan。

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

红蓝电竞(er)gulidaxueshengziyuancanjiabuchongyiliaobaoxian,buchongyiliaobaoxianfeiyoudaxueshenggerenmeixueniananbudiyu50yuanjiaona。

三、参保登记

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

(er)gaodengxuexiaoduiyishangziliaohe《dengjibiao》neirongjinxingshenhe;bingjiangcaijidecanbaoxinxiluruyiliaobaoxianxinxicaijixitong。

(san)yibaozhongxinyijucanbaoxinxishengchengjiaofeiqingce,tongzhigaodengxuexiaoanjiaofeiqingcedaishougerenyingjiaodejibenyiliaobaoxianfei。

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

红蓝电竞(wu)shengshehuibaozhangkazhizuofaxingzhongxingenjucanbaoxinxi,zhizuo《zhonghuarenmingongheguoshehuibaozhangka》(yixiajiancheng“shehuibaozhangka”),jiaoyousuozaigaodengxuexiaofafang。

四、待遇水平

shengshuzaikundegaodengxuexiaozhixingyixiadaiyubiaozhun:

(yi)daxueshengjibenyiliaobaoxianjijinzhuyaoyongyuzhifuzhuyuan、putongmenzhenheteshubingmenzhenyiliaofeiyong;buchongyiliaobaoxianzhuyaoduizhuyuanhemenzhenteshubingyiliaofeiyongjinxingbuzhu。

(er)daxueshengjibenyiliaobaoxiandeyaopinmulu,zhenliaoxiangmujifuwusheshibiaozhunanzhaoyunnanshengchengzhenjuminjibenyiliaobaoxianyouguanguidingzhixing。

(san)canbaohoubanlilexiuxue、tuixueshouxudedaxuesheng,zaicanbaoshixianneifashengdeyiliaofeiyong,renganyouguanguidingbaoxiao。

(si)zhuyuanyiliaodaiyu

1.qifubiaozhun

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

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

红蓝电竞3.baoxiaobilihezuigaozhifuxiane

(1)jibenyiliaobaoxian

xueniannei,fuhejibenyiliaobaoxianbaoxiaofanweineidezhuyuanyiliaofeiyongbaoxiaobiliwei60%;tongchoujijinzuigaozhifuxianewei1.6wanyuan。

(2)buchongyiliaobaoxian

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

(wu)menzhenyiliaodaiyu

1.putongmenzhen

menzhenyiliaofeitongchoubiaozhunzandingweimeirenmeixuenian30yuan,youshengyibaozhongxinandaxueshengcanbaorenshuhuaruxiaoyiyuan(yiwushi)baoganshiyong。baoganfeiyongjieyuzai10%yineideguixiaoyiyuan(yiwushi),jieyuchaoguo10%defeiyongyouyibaozhongxinshouhui;ruoxuenianneifashengchaozhibufenyoushengyibaozhongxinfudan30%,gaodengxuexiaofudan70%。

2.teshubingmenzhen

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

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

(liu)youxialieqingkuangzhiyide,suofashengdeyiliaofeiyong,jibenyiliaobaoxianjijinhebuchongyiliaobaoxianzijinbuyuzhifu:

1.jibenyiliaoyaopinmulu、zhenliaoxiangmuhefuwusheshibiaozhunyiwaidefeiyong(jijiuchuwai)。

红蓝电竞2.jiankangtijian、jihuamianyi、yufangbaojian、jiankangjiaoyudenggonggongweishengfuwudefeiyong。

3.weibanlizhuanzhenzhuanyuanshenpibeianshouxu,zixingwaichujiuyideyiliaofeiyong。

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

5.anyouguanguidingbuyuzhifudeqitafeiyong。

五、就医管理和费用结算

(yi)gaodengxuexiaoanzhaojiujinjiuyideyuanzexuanzeyizhierjiadingdianyiliaojigou(buhanxiaoyiyuan),zuoweibenxiaodaxueshengxiaowaizhuyuandedingdianyiliaojigou。

红蓝电竞(er)gaodengxuexiaoxiaoyiyuan(yiwushi)fuzedaxueshengputongmenzhen,wuxiaoyiyuandegaodengxuexiaoyouyibaozhongxinzhidinglinjinshequweishengfuwuzhongxinqianshuxieyi,weidaxueshengtigongputongmenzhenjizhenyiliaofuwu。

红蓝电竞(san)daxueshengpingshehuibaozhangkahexueshengzhengdaozhidingdedingdianyiliaojigoujiuyi,suofashengdezhuyuanheteshubingmenzhenyiliaofeiyong,anguidingyingyougerenfudandefeiyongyougerenzhifu,yingyoutongchoujijinhuobuchongyiliaobaoxianzhifudefeiyong,youyibaozhongxinyudingdianyiliaojigouzhijiejiesuan。

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

红蓝电竞(wu)fashengwuzerenrendeyiwaishanghaishi,qifeiyongkepingdingdianyiliaojigouzhenduanzhengminghejiuduyuanxiaochujudexiangguanzhengminganguidingbaoxiao。

红蓝电竞(liu)yinbingqingxuyaojinxingzhuanzhenzhuanyuande,junyouxiaoyiyuan(yiwushi)huoweituodeshequweishengfuwuzhongxinchujuzhuanzhenzhuanyuanzhengming,dingdianyiliaojigoufangkeshouzhizhuyuan(jizhenqiangjiuchuwai)。

红蓝电竞zhuanshengwaijiuyide,xutigongzhishaoersuosanjidingdianyiliaojigouzhurenyishihuiyiyijian,youzhuanchuyiyuangaizhanghousongyibaozhongxinshendingbeian,gerenzifubilizaiyuanjichushangtigaoergebaifendian,feiyongyoujiuduyuanxiaohuoxueshengbenrenquanedianfu。

(qi)xueniannei,daxueshengzhuyuanrenshuyuanzeshangbuchaoguocanbaozongrenshude2%,duichaoguodexiaoyiyuanjiangshiqingkuangjianshaoxianiandumenzhenyiliaobaogantongchoufeiyong。

六、其它

红蓝电竞jibenyiliaobaoxiandejiesuannianduweimeixueniande9yue1rizhiciniande8yue31ri,yougaodengxuexiaobanlilebiyeshouxudedaxueshengzai9yuetingzhixiangshouyiliaobaoxiandaiyu。daxueshengzaiduqijianyinglianxucanbao。

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