关注！明年眉山市职工医保普通门诊可以报销了！
<div class="wx_rich_media_content" id="jsWxContainer"><p style="text-align: center;"></p><p style="text-align: center;"><br></p><section xmlns="http://www.w3.org/1999/xhtml"><section data-author="Wxeditor"><section data-from="local" author="wxeditor"><p style="text-indent: 0em;line-height: 2em;"><span style="font-family: "Helvetica Neue", Helvetica, "Hiragino Sans GB", "Microsoft YaHei", Arial, sans-serif; font-size: 15px; letter-spacing: 2px; text-indent: 0em;">近日，眉山市人民政府办公室印发了《</span><span style="font-family: "Helvetica Neue", Helvetica, "Hiragino Sans GB", "Microsoft YaHei", Arial, sans-serif; font-size: 15px; letter-spacing: 2px; text-indent: 0em; outline: 0px; caret-color: red; visibility: visible;">眉山市职工基本医疗保险门诊共济保障实施细则》（眉府办规〔2022〕5号，以下简称《实施细则》），明确从</span><strong style="font-family: "Helvetica Neue", Helvetica, "Hiragino Sans GB", "Microsoft YaHei", Arial, sans-serif; font-size: 15px; letter-spacing: 2px; text-indent: 0em; outline: 0px; caret-color: red; visibility: visible;"><span style="outline: 0px;color: rgb(192, 26, 32);visibility: visible;">2023年1月1日</span></strong><span style="font-family: "Helvetica Neue", Helvetica, "Hiragino Sans GB", "Microsoft YaHei", Arial, sans-serif; font-size: 15px; letter-spacing: 2px; text-indent: 0em; outline: 0px; caret-color: red; visibility: visible;">起，将眉山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，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。</span></p><p style="text-align: left; outline: 0px; color: rgb(0, 0, 0); font-family: PingFangSC-light; font-size: 16px; letter-spacing: 2px; visibility: visible; text-indent: 0em; line-height: 2em;"><span style="outline: 0px;caret-color: red;visibility: visible;font-family: Helvetica Neue, Helvetica, Hiragino Sans GB, Microsoft YaHei, Arial, sans-serif;font-size: 15px;"></span></p><p style="outline: 0px; color: rgb(0, 0, 0); font-family: PingFangSC-light; font-size: 16px; letter-spacing: 2px; text-align: center; visibility: visible; text-indent: 0em; line-height: 2em;"></p><section style="outline: 0px; color: rgb(0, 0, 0); font-family: PingFangSC-light; font-size: 16px; letter-spacing: 2px; visibility: visible;"><section style="outline: 0px;visibility: visible;"><section style="outline: 0px;visibility: visible;"><section style="outline: 0px;visibility: visible;"><section style="outline: 0px;visibility: visible;"><section style="outline: 0px;visibility: visible;"><section style="outline: 0px;visibility: visible;"><section style="outline: 0px;visibility: visible;"><section style="outline: 0px;visibility: visible;text-indent: 0em;line-height: 2em;"><section style="margin-top: 10px; margin-bottom: -10px; outline: 0px; justify-content: flex-start; display: flex; flex-flow: row nowrap; visibility: visible;"><section style="outline: 0px;display: inline-block;vertical-align: top;width: 338.5px;align-self: flex-start;flex: 0 0 auto;visibility: visible;"><section style="outline: 0px;transform-style: flat;transform: perspective(0px);visibility: visible;"><section style="margin-top: 10px;outline: 0px;text-align: right;justify-content: flex-end;display: flex;flex-flow: row nowrap;transform: translate3d(31px, 0px, 0px) rotateX(180deg) rotateY(180deg);visibility: visible;"><section style="margin-right: 3px;outline: 0px;display: inline-block;vertical-align: top;width: auto;align-self: flex-start;flex: 0 0 0%;height: auto;visibility: visible;"><section style="outline: 0px;transform: rotateZ(8.51deg);visibility: visible;"><section style="outline: 0px;text-align: center;visibility: visible;"><section style="outline: 0px;display: inline-block;width: 4px;height: 17px;vertical-align: top;overflow: hidden;border-style: solid;border-width: 1px;border-color: rgb(207, 65, 61);visibility: visible;"><section style="outline: 0px;text-align: justify;visibility: visible;"><p style="outline: 0px;visibility: visible;"><br style="outline: 0px;visibility: visible;"></p></section></section></section></section></section><section style="outline: 0px;display: inline-block;vertical-align: top;width: auto;align-self: flex-start;flex: 0 0 0%;height: auto;visibility: visible;"><section style="outline: 0px;transform: rotateZ(8.51deg);visibility: visible;"><section style="outline: 0px;text-align: center;visibility: visible;"><section style="outline: 0px;display: inline-block;width: 4px;height: 17px;vertical-align: top;overflow: hidden;border-style: solid;border-width: 1px;border-color: rgb(207, 65, 61);visibility: visible;"><section style="outline: 0px;text-align: justify;visibility: visible;"><p style="outline: 0px;visibility: visible;"><br style="outline: 0px;visibility: visible;"></p></section></section></section></section></section></section></section></section><section style="outline: 0px;display: inline-block;vertical-align: top;width: 338.5px;visibility: visible;"><section style="outline: 0px;height: auto;transform-style: flat;transform: perspective(0px);visibility: visible;"><section style="margin-top: 10px;outline: 0px;justify-content: flex-start;display: flex;flex-flow: row nowrap;transform: translate3d(-27px, 0px, 0px) rotateX(180deg) rotateY(180deg);visibility: visible;"><section style="margin-right: 3px;outline: 0px;display: inline-block;vertical-align: top;width: auto;align-self: flex-start;flex: 0 0 0%;height: auto;visibility: visible;"><section style="outline: 0px;transform: rotateZ(8.51deg);visibility: visible;"><section style="outline: 0px;text-align: center;visibility: visible;"><section style="outline: 0px;display: inline-block;width: 4px;height: 17px;vertical-align: top;overflow: hidden;border-style: solid;border-width: 1px;border-color: rgb(207, 65, 61);visibility: visible;"><section style="outline: 0px;text-align: justify;visibility: visible;"><p style="outline: 0px;visibility: visible;"><br style="outline: 0px;visibility: visible;"></p></section></section></section></section></section><section style="outline: 0px;display: inline-block;vertical-align: top;width: auto;align-self: flex-start;flex: 0 0 0%;height: auto;visibility: visible;"><section style="outline: 0px;transform: rotateZ(8.51deg);visibility: visible;"><section style="outline: 0px;text-align: center;visibility: visible;"><section style="outline: 0px;display: inline-block;width: 4px;height: 17px;vertical-align: top;overflow: hidden;border-style: solid;border-width: 1px;border-color: rgb(207, 65, 61);visibility: visible;"><section style="outline: 0px;text-align: justify;visibility: visible;"><p style="outline: 0px;visibility: visible;"><br style="outline: 0px;visibility: visible;"></p></section></section></section></section></section></section></section></section></section><section style="outline: 0px; justify-content: flex-start; display: flex; flex-flow: row nowrap; visibility: visible;"><section style="outline: 0px;display: inline-block;width: 677px;vertical-align: top;align-self: flex-start;flex: 0 0 auto;border-style: solid;border-width: 1px;border-color: rgb(207, 65, 61);visibility: visible;"><section style="margin-bottom: 5px;outline: 0px;justify-content: flex-start;display: flex;flex-flow: row nowrap;visibility: visible;"><section style="padding: 20px 10px 10px;outline: 0px;display: inline-block;width: 675px;vertical-align: top;align-self: flex-start;flex: 0 0 auto;border-bottom: 1px solid rgb(207, 65, 61);border-bottom-right-radius: 0px;visibility: visible;"><section style="outline: 0px;text-align: justify;visibility: visible;"><p style="outline: 0px;text-indent: 2em;visibility: visible;"><span style="font-family: Helvetica Neue, Helvetica, Hiragino Sans GB, Microsoft YaHei, Arial, sans-serif;font-size: 15px;">《实施细则》明确，<strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;color: rgb(192, 26, 32);visibility: visible;">改进个人账户计入办法。</span></strong>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<strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;color: rgb(192, 26, 32);visibility: visible;">2%</span></strong>。退休人员个人账户由统筹基金按定额划入，个人账户划入额度按照2022年眉山市基本养老金平均水平的<strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;color: rgb(192, 26, 32);visibility: visible;">2.8%</span></strong>确定。参加单建统筹的参保人员，不建立个人账户。</span></p><p style="text-align: left; outline: 0px; text-indent: 2em; visibility: visible;"></p><p style="outline: 0px;text-indent: 2em;visibility: visible;"><span style="font-family: Helvetica Neue, Helvetica, Hiragino Sans GB, Microsoft YaHei, Arial, sans-serif;font-size: 15px;"><strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;color: rgb(192, 26, 32);visibility: visible;">建立普通门诊费用统筹保障制度。</span></strong>普通门诊费用统筹保障制度覆盖眉山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<strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;color: rgb(192, 26, 32);visibility: visible;">政策范围内</span></strong>普通门诊费用、购药费用纳入普通门诊费用统筹保障。起付线按自然年度设1次且在一个自然年度内累计计算，<strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;color: rgb(192, 26, 32);visibility: visible;">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<strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;color: rgb(192, 26, 32);visibility: visible;">50%</span></strong>，二级及以下定点医疗机构支付比例为<strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;color: rgb(192, 26, 32);visibility: visible;">60%</span></strong>，退休人员在上述相应支付比例基础上<strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;color: rgb(192, 26, 32);visibility: visible;">提高10个百分点</span></strong>。参加统账结合的在职职工医药费，统筹基金年度支付限额<strong style="outline: 0px;"><span style="outline: 0px;color: rgb(192, 26, 32);">2000元</span></strong>，退休人员<strong style="outline: 0px;"><span style="outline: 0px;color: rgb(192, 26, 32);">2500元</span></strong>；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<strong style="outline: 0px;"><span style="outline: 0px;color: rgb(192, 26, 32);">800元</span></strong>，退休人员为<strong style="outline: 0px;"><span style="outline: 0px;color: rgb(192, 26, 32);">1000元</span></strong>。</span></p><p style="text-align: left; outline: 0px; text-indent: 2em;"></p><p style="outline: 0px;line-height: 1.75em;text-indent: 2em;"><span style="outline: 0px;font-family: Helvetica Neue, Helvetica, Hiragino Sans GB, Microsoft YaHei, Arial, sans-serif;font-size: 15px;">实施细则还规定了要建立高血压糖尿病（“两病”）门诊用药保障，明确将职工参保人纳入两病管理范围，同时完善门诊特殊疾病保障功能，明确门诊共济保障方式、加强管理与监督。</span></p></section></section></section></section></section></section></section></section></section></section></section></section></section></section><section data-role="outer" label="edit by 135editor" style="outline: 0px; letter-spacing: 0.544px; color: rgb(0, 0, 0); font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;"><p style="margin-bottom: 0em;outline: 0px;text-align: center;letter-spacing: 0.544px;vertical-align: inherit;text-size-adjust: inherit;caret-color: rgb(51, 51, 51);font-family: -apple-system, BlinkMacSystemFont, Arial, sans-serif;"><br></p></section></section></section></section><font size="1">来源：眉山智慧医保</font></div><p></p> 看不懂，谁给解释一下 核酸收费就算了。医保每年涨，社保每年涨。就职工医保单位缴的这点钱都都要被统筹了 我就想知道牙科门诊的报不报 风吹窗帘飘 发表于 2022-11-10 14:34我就想知道牙科门诊的报不报
目前眉山还不能报 感情的左撇子 发表于 2022-11-10 10:27
看不懂，谁给解释一下
看不懂就用就行了，强调一下医疗机构必须是二级及以上，基层医疗机构职工医保门诊不报。 看不懂。。职工医保，不是一直可以在医院刷卡报销吗 点赞点赞点赞点赞点赞
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