西安门诊慢性病报销政策

9个月前 (05-08) 0 点赞 0 收藏 0 评论 442 已阅读

今天谈谈很多西安朋友关心的门诊慢性病报销政策,二零二一年(也就是去年),西安市医疗保障局对门诊慢性病政策进行了调整。这次政策调整惠及全市城镇职工和城乡居民医疗保险的参保人员。统一了城乡居民和城镇居民参保人员的慢性病病种的范围和限额。

慢性病

西安门诊慢性病报销

目前西安市职工及居民医保的门诊慢性病病种涵盖高血压、糖尿病、心脑血管疾病、慢性支气管炎、类风湿性关节炎、慢性肝炎、慢性肾病、恶性肿瘤、精神疾病、小儿脑瘫、部分血液系统疾病、部分自身免疫性疾病等四十多个病种;

慢性病办理后需要多久复审一次?需要两年一复审的慢性病病种包括:甲状腺功能减退、甲状腺功能亢进、癫痫、紫癜性肾炎、硬皮病、系统性红斑狼疮、慢性活动性肝炎、多耐药肺结核等;而其余大多数慢性病种只要审核通过后即可每年享受慢性病报销政策,不需要再次复审;

慢性病的具体报销政策如何?参保职工医保起付线标准为700元,报70%;参保居民医保起付线标准是350元,报65%;一个报销年度只收一个起付线。一个年度的慢性病病种补助限额从五千元、八千元到两万元不等。

一年无论在哪儿买药只需要承担一个起付线。起付标准以上的部分按比例报销,报销金额不超过病种限额。

以一个职工医保高血压并发颅脑腔梗慢性病为例,一年自己购买高血压药物、预防脑血栓等药物满700元后(这些钱可从医保卡支出),再买相关药物就可以享受直接报销70%,一年最高报销金额上限5000元。

怎样办理慢性病报销资格呢?
在西安市二级及以上定点医疗机构因慢性病住院的参保患者,出院后可以在该院直接申请门诊慢性病资格认定,医保中心20天内完成认定,通过后次月起可以享受慢性病报销政策。

相较2021年之前政策,现在改为在定点的医疗机构、药店直接结算,享受门诊慢性病补助的人员可以持医保电子凭证或者是自己的医保卡或者是社保卡。城乡居民也可以持身份证到全市定点的医疗机构就诊,在定点医疗机构就可以实现直接结算,个人只需支付个人承担的部分。那么参保的患者也可以持处方到全市的慢性病定点药店,直接购买慢性病相关药物,同样可以享受直接报销的政策。慢性病直接报销。参保人不需要再垫付医疗费用,减轻了个人的经济负担,也不需要再收集、整理一年的相关报销票据,避免个人因票据丢失而无法报销及报销周期长的问题。慢性病门诊

还没有申请过慢性病报销资格的西安患者朋友,可以给我留言沟通咨询慢性病报销的相关问题。

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钦业扫码支付盒子扫码枪条码扫描器超市健康码药店医院电子医保卡手机收钱机器一维二维码扫码器收银扫描平台 券后价¥39.9 天猫 优惠券¥6 立即领券
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