@资阳人，明年起四川省省本级医保参保职工门诊看病可报销
<div class="wx_rich_media_content" id="jsWxContainer"><p style='outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; visibility: visible;'>10月28日</p><p style='outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; visibility: visible;'>记者从四川省医疗保障局了解到</p><p style='outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; visibility: visible;'><br></p><p style='outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; visibility: visible;'><strong><span style='color: rgb(123, 12, 0);'>从明年1月1日起</span></strong></p><p style='outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; visibility: visible;'><strong><span style='color: rgb(123, 12, 0);'>四川省省本级职工基本医疗</span></strong><strong style='letter-spacing: 0.544px;'><span style='color: rgb(123, 12, 0);'>保险</span></strong></p><p style='outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; visibility: visible;'><strong style='letter-spacing: 0.544px;'><span style='color: rgb(123, 12, 0);'>门诊共济制度正式实施</span></strong></p><p style='outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; visibility: visible;'><strong><span style='color: rgb(123, 12, 0);'><br></span></strong></p><p style='outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; visibility: visible;'><strong><span style='color: rgb(123, 12, 0);'>省本级医保参保人员</span></strong></p><p style='outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; visibility: visible;'><strong><span style='color: rgb(123, 12, 0);'>在门诊看病可在年度限额内</span></strong></p><p style='outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; visibility: visible;'><strong><span style='color: rgb(123, 12, 0);'>进行医药费用报销</span></strong></p><p style='outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; visibility: visible;'><br></p><section style='margin-bottom: 10px; outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(12, 12, 12); font-size: 16px; letter-spacing: 0.544px; justify-content: flex-start; display: flex; flex-flow: row nowrap; visibility: visible; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;'><section style='box-sizing: border-box; padding: 5px; outline: 0px; max-width: 100%; display: inline-block; width: 100%; vertical-align: top; align-self: flex-start; flex: 0 0 auto; border-style: solid; border-width: 1px; border-color: rgb(79, 129, 189); box-shadow: rgb(79, 129, 189) 4px 4px 0px; line-height: 2; visibility: visible;'><p><span style='color: rgb(51, 51, 51);font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;font-size: 17px;letter-spacing: 0.544px;caret-color: red;'>近日，四川省医疗保障局公布《四川省省本级职工基本医疗保险门诊共济保障机制实施细则》（以下简称《实施细则》）</span><strong><span style='font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;font-size: 17px;letter-spacing: 0.544px;caret-color: red;color: rgb(123, 12, 0);'>，明确从2023年1月1日起，将省本级医保参保人员门诊费用纳入职工医保统筹基金支付范围</span></strong><span style='color: rgb(51, 51, 51);font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;font-size: 17px;letter-spacing: 0.544px;caret-color: red;'>，改革职工医保个人账户，建立健全门诊共济保障机制，提高医保基金使用效率，从而逐步减轻参保人员医疗费用负担，实现医保制度更加公平更可持续。</span></p><p><span style='letter-spacing: 0.544px;'><br></span></p><p style='margin-bottom: 24px;color: rgb(51, 51, 51);font-size: 17px;font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;'>“建立四川省省本级职工基本医疗保险门诊共济保障机制，是落实国务院和省政府相关要求的具体举措。”四川省医疗保障局待遇保障处相关负责人介绍，2021年国务院办公厅和四川省人民政府办公厅相继就建立健全职工基本医疗保险门诊共济保障机制出台文件。按照要求，四川省将建立职工基本医疗保险门诊共济保障机制，将门诊费用纳入职工医保统筹基金支付范围，通过完善个人账户、强化门诊共济保障，逐步减轻职工参保人员（含退休人员及灵活就业人员）医疗费用负担。</p><p style='margin-bottom: 24px;color: rgb(51, 51, 51);font-size: 17px;font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;'>按照《实施细则》，四川将改进省本级医保参保人员个人账户计入办法，单位缴纳的基本医疗保险费全部计入统筹基金。<strong><span style='color: rgb(123, 12, 0);'>在职职工个人账户由个人缴纳的基本医疗保险费计入，计入标准为本人参保缴费基数的2%。退休人员个人账户由统筹基金按定额划入，个人账户划入基数分别为2022年省本级企业、机关事业单位基本养老金平均水平，划入比例为2.8%。</span></strong>参加单建统筹的参保人员，不建立个人账户。</p><p style='margin-bottom: 24px;color: rgb(51, 51, 51);font-size: 17px;font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;'>调整统筹基金和个人账户结构后，增加的统筹基金主要用于增强门诊共济保障，提高参保人员门诊费用统筹保障水平。符合职工医保待遇享受条件的参保人员，在定点医疗机构、符合条件的定点零售药店发生的政策范围内普通门诊费用、购药费用纳入门诊统筹保障，探索将符合条件的“互联网+” 医疗服务纳入保障范围。</p><p style='margin-bottom: 24px;color: rgb(51, 51, 51);font-size: 17px;font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;'>“以后省本级医保参保人员在门诊看病也可以医保报销。”上述负责人介绍，门诊统筹保障待遇政策包括了起付线、支付比例和年度支付限额。</p></section></section><p><br></p><section data-role="title" data-tools="135编辑器" data-id="110377"><section style='text-align: center;margin: 10px auto;'><section style='display: flex;justify-content: center;align-items: center;'><section style='box-sizing: border-box;width: 27px;flex-shrink: 0;height: 0px;overflow: hidden;'><br></section><section style='background-position: initial;background-size: initial;background-repeat: initial;background-attachment: initial;background-origin: initial;background-clip: initial;padding: 10px 12px;'><section style='text-align: justify;'><span style='letter-spacing: 0.544px;'><strong><p style='vertical-align: inherit;'>关于起付线和支付比例</p></strong></span></section></section></section></section></section><p>《实施细则》规定，按自然年度设1次起付线，<strong><span style='color: rgb(123, 12, 0);'>在职职工起付线200元，退休人员起付线150元</span></strong>。参保人员在三级定点医疗机构和定点零售药店发生的医药费，统筹基金支付比例为50%，二级及以下定点医疗机构支付比例为 60%，退休人员在上述相应支付比例基础上提高10%。</p><section data-role="title" data-tools="135编辑器" data-id="110377"><section style='text-align: center;margin: 10px auto;'><section style='display: flex;justify-content: center;align-items: center;'><section style='box-sizing: border-box;width: 27px;flex-shrink: 0;height: 0px;overflow: hidden;'><br></section><section style='background-position: initial;background-size: initial;background-repeat: initial;background-attachment: initial;background-origin: initial;background-clip: initial;padding: 10px 12px;'><section style='text-align: justify;'><span style='letter-spacing: 0.544px;'><strong><p style='vertical-align: inherit;'>关于年度支付限额</p></strong></span></section></section></section></section></section><p>《实施细则》规定，<strong><span style='color: rgb(123, 12, 0);'>参加统账结合的在职职工医药费，统筹基金年度支付限额2000元，退休人员2500元；参加单建统筹的在职职工医药费，统筹基金年度支付限额为880元，退休人员为1100元</span></strong>。参保人员办理基本医保关系在职转退休，从享受医保退休待遇起，为其调整普通门诊统筹保障待遇。</p><p><strong>新闻多一点>></strong></p><section data-role="title" data-tools="135编辑器" data-id="110377"><section style='text-align: center;margin: 10px auto;'><section style='display: flex;justify-content: center;align-items: center;'><section style='box-sizing: border-box;width: 27px;flex-shrink: 0;height: 0px;overflow: hidden;'><br></section><section style='background-position: initial;background-size: initial;background-repeat: initial;background-attachment: initial;background-origin: initial;background-clip: initial;padding: 10px 12px;'><section style='text-align: justify;'><span style='letter-spacing: 0.544px;'><strong><p style='text-align: center;vertical-align: inherit;'><span style='letter-spacing: 0.544px;caret-color: red;'>明年1月1日起</span></p><section style='text-align: center;box-sizing: border-box;'>成都市职工医保普通门诊可报销</section></strong></span></section></section></section></section></section><section style='text-align: justify;'>近日，成都印发《成都市建立健全职工基本医疗保险门诊共济保障机制实施细则》（成办规〔2022〕4号）（简称《实施细则》），<strong><span style='color: rgb(123, 12, 0);'>明确从2023年1月1日起，将成都市职工医保参保人员普通门诊费用纳入职工医保统筹基金支付范围</span></strong>，改革职工医保个人账户，建立健全门诊共济保障机制，提高医保基金使用效率，逐步减轻参保人员医疗费用负担，实现医保制度更加公平更可持续。<br></section><section style='text-align: center;'><span style='text-align: justify;'><br></span></section><p>《实施细则》明确，改进个人账户计入办法，单位缴纳的基本医疗保险费全部计入统筹基金。在职职工个人账户由个人缴纳的基本医疗保险费计入，计入标准为本人参保缴费基数的2%。退休人员个人账户由统筹基金按定额划入，个人账户划入基数为2022年成都市基本养老金平均水平，划入比例为2.8%。参加单建统筹的参保人员，不建立个人账户。</p><p>《实施细则》提出，建立普通门诊费用统筹保障制度，普通门诊费用统筹保障制度覆盖成都市职工医保全体参保人员。符合职工医保待遇享受条件的参保人员，在定点医疗机构、符合条件的定点零售药店发生的政策范围内普通门诊费用、购药费用纳入普通门诊费用统筹保障。<strong><span style='color: rgb(123, 12, 0);'>起付线按自然年度设1次且在一个自然年度内累计计算，在职职工起付线200元，退休人员起付线150元</span></strong>。</p><p>参保人员在三级定点医疗机构和符合条件的定点零售药店发生的医药费，统筹基金支付比例为50%，二级及以下定点医疗机构支付比例为60%，退休人员在上述相应支付比例基础上提高10个百分点。<strong><span style='color: rgb(123, 12, 0);'>参加统账结合的在职职工医药费，统筹基金年度支付限额2000元，退休人员2500元；参加单建统筹的在职职工医药费，统筹基金年度支付限额为880元，退休人员为1100元</span></strong>。</p><p style='outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; visibility: visible;'>具体请戳图片看详情</p><p style='outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; visibility: visible;'>▼</p><p style='outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; visibility: visible;'></p>转载自「四川在线」</div><p></p> 这是好消息
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