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武漢城市圈職工重大疾病醫療互助辦法

來源:     發布日期:2016-11-24

  weijinyibucujinwuhanchengshiquanduocengcishehuiyiliaobaozhangtixidewanshanhefazhan,chongfenfayangguangdazhigongtuanjieyouai、huzhuhujideguangrongchuantong,bangzhuhuanzhongdajibinghuoyinbingshengudezhigongjijiatingjianqingjingjifudan,huanjiejiatingshenghuokunnan,zhidingbenbanfa。

  huzhuduixiang

  diyitiao benbanfahuzhuduixiangweiwuhanchengshiquannei(hanzhongyangheshengshu)geqishiyedanwei、jiguantuantizhongdezaizhizhigong(yixiajianchengcanjiaren)。

  huzhufanwei

  diertiao canjiarenzai《lvyuequerenshu》querendeyouxiaoqineishouciquezhen(zhiyiqiancongweibeiyiliaojigouzhengshiquezhenguo)huanyouyixiayuanfaxingjibing(bixujingzhuyuanzhiliao),kexiangwuhanshizhigongyiliaohuzhubangongshi(yixiajianchenghuzhuban)shenqinghuzhudaiyu:⑴exingzhongliu;⑵yilaixuetou、futoudemanxingshengongnengshuaijie;⑶guanzhuangdongmodaqiaojizhijiazhirushu;⑷zaishengzhangaixingpinxue;⑸baixuebing;⑹zhongxingganyan;⑺liangxingnaozhongliu;(8)naodongmoliu;(9)xinzangbanmozhihuanshu;(10)yiwaishanghaizhiguanjiegongnengwanquansangshi;(11)yanzhongshaoshangⅲdumianjidaquanshen20%yishang;(12)jixingzhongzhengyixianyan;(13)shen、gan、xin、fei、gusuijilianheyizhishu;(14)zhudongmoshoushu;(15)jixingjisuihuizhiyanyinqidejietan;(16)aerzihaimoshizheng(jutidingyijianfuze)。

  huzhuqixian

  disantiao benyiliaohuzhuqixianmeisannianweiyizhouqi,yujiaonahuzhufeibingjiaoqifuheyaoqiudecanjiaziliaodecirilingshiqidaosannianhuzhuqimanriershisishizhi。shoucicanjiashizhixing90tianguanchaqi(rucanjiarenyicanjiashangyiqizhigongzhongdajibingyiliaohuzhu,bingzaiqihuzhuqimanriqianhuohuzhuqimanzhiriqi30tianneibanlilejixucanjiabenqihuzhushouxude,quxiao90tianguanchaqi)。

  canjiabanfa

  disitiao benbanfacaiqutuantihuiyuanzhi。canjiarenyousuozaidanweigonghui(yixiajianchengcanjiadanwei)tongyizuzhijiaonahuzhufei,ranhouyousuoshudiqu(xitong)gonghui(yixiajianchengdailidanwei)daohuzhubantongyibanlicanjiashouxu。zhigongcanjiarenshubushaoyubendanweizhigongzongshude80%,canjiadanweizhigongrenshushaoyuhuodengyu30rende,xu100%canjia。

  diwutiao shoucicanjiahuzhudedanweibixutigongnengzhengquefanyingdanweishangyuezaice(zaizhi)renyuanjibenqingkuangdebaobiaojixiangguanziliaodefuyinjian。

  huzhujiaofeibiaozhun

  diliutiao canjiarenyicanjiashangyiqizhigongzhongdajibingyiliaohuzhu,bingzaiqihuzhuqimanriqianhuohuzhuqimanzhiriqi30tianneishenqingjixucanjiahuzhude,benqijiaonadehuzhufeiweimeirenmeifen80yuan;shoucicanjiahuzhudezhigong,jiaonadehuzhufeiweimeirenmeifen100yuan。

  huzhufeiyingyicixingjiaona,meirencanjiafenezuiduowei3fen。

  canjiadanweixugenjushijiqingkuang,weicanjiazhigongxuandingxiangtongfenecanjia。

  canjiarenzaimeigehuzhuqixianneizhinengcanjiayici,budezhongfucanjia。

  zhongfucanjiadefeneshizuowuxiao。

  huzhuzeren

  diqitiao canjiarenzaihuzhuyouxiaoqinei(shoucicanjiadezhigongyu《lvyuequerenshu》querendecanjiahuzhuzhiriqi90tianhouzhisannianhuzhuqimanrizhi,huojixucanjiadezhigongyu《lvyuequerenshu》querendecanjiahuzhuzhiriqizhisannianhuzhuqimanrizhi),jinghuzhubanzhidingdeyiliaojigoushouciquezhenhuanbenbanfadiertiaoguidingdeqizhongyizhongzhongdajibing,bingjingzhuyuanzhiliao,kexianghuzhubanshenqinglingquyiliaohuzhujin,meifene10000yuan。lingquhuzhujinhou,huzhuzerenjigaozhongzhi。

  dibatiao shoucicanjiadezhigongshixingweiwenjinzhidu。zaiweiwenyouxiaoqinei(《lvyuequerenshu》querendecanjiahuzhuzhiriqi30tianhou90tiannei),jinghuzhubanzhidingdeyiliaojigoushouciquezhenhuanbenbanfadiertiaoguidingdeqizhongyizhongzhongdajibing,bingjingzhuyuanzhiliao,kexianghuzhubanshenqinglingquweiwenjin,lingquweiwenjinhou,huzhuzerenjigaozhongzhi。

  weiwenjingeifubiaozhun(meifene):yu《lvyuequerenshu》querendecanjiahuzhuzhiriqidi31tianzhi60tianwei1000yuan;di61tianzhi90tianwei2000yuan。

  dijiutiao canjiarenhuanyoubenbanfadiertiaosuozhiyizhongyishangzhongdajibingde,yiliaohuzhujinhuoweiwenjindegeifuzhiyiqizhongyizhongjibingweixian。

  dishitiao shelishengufuxubuzhujinzhidu。canjiarenzaihuzhubanzhidingdeyiliaojigouzhuyuanzhiliaoshi,yinhuanbingzhijieyinzhishengu,kexianghuzhubanshenqinglingqushengufuxubuzhujin,lingqushengufuxubuzhujinhou,huzhuzerenjigaozhongzhi。

  (yi)shoucicanjiahuzhudezhigongshengufuxubuzhujingeifubiaozhun(meifene):

  1.yu《lvyuequerenshu》querendecanjiahuzhuzhiriqidi31tianzhi60tianyinbingshengugeifu1000yuan;di61tianzhi90tiangeifu2000yuan;

  2.yu《lvyuequerenshu》querendecanjiahuzhuzhiriqidi91tianzhisannianhuzhuqimanrizhiyinbingshengugeifu3000yuan。

  (er)jixucanjiahuzhudezhigongshengufuxubuzhujingeifubiaozhun(meifene):

  1. canjiarenzaishangyihuzhuzhouqineiyinhuanbanfaguidingdezhongdajibingqieyixiangshouyiliaohuzhujin,benqineiyouyinshangyihuzhuzhouqixiangtongdaleijibingjibingfazhengyinzhishengu,geifu1000yuan;

  2.canjiarenyinhuanbenbanfaguidinghuzhufanweiyiwaijibingzhijieyinzhishengu,geifu3000yuan;

  3.canjiarenzaicanjiabenqihuzhuhuodongqianyihuanbenbanfaguidingdezhongdajibingqieweixiangshouyiliaohuzhujin,benqineiyouyinxiangtongdaleijibingjibingfazhengyinzhishengu,geifu5000yuan。

  dishiyitiao huzhuqimanshihuzhuzerenjigaozhongzhi。

  canjiarenzaiyigehuzhuzhouqineibudetuichu。

  dishiertiao canjiarenzaishangyihuzhuqimanrizhiqianbanlilejixucanjiabenqihuzhushouxude,benqihuzhudeqishiriweishangqihuzhuqimanridecirilingshi,quxiao90tiandeguanchaqi;zaishangyihuzhuqimanzhiriqi30tianneibanlilejixucanjiabenqihuzhushouxude,benqihuzhudeqishiriweijiaonahuzhufeibingjiaoqifuheyaoqiudecanjiaziliaodecirilingshi,quxiao90tiandeguanchaqi;chaoguo30tianhoujixucanjiahuzhudeshizuoshoucicanjia,rengxuzhixing90tianguanchaqi。

  dishisantiao canjiadanweizaicanjiahuzhuhoudeyigehuzhuqixiannei,bunengzaiweiweicanjiazhigongbubancanjiashouxu(xinjindanweidezhigongchuwai,danyingtigongfanyingxinjinzhigongjibenqingkuangdebaobiaojixiangguanziliaodefuyinjian,bingxuzaijindanweihouergeyueneibanlicanjiashouxu,xinzengrenyuanyingyubendanweiyuancanjiarenyuanjiaonaxiangtongfenedehuzhufei)。    

  chuwaizeren

  dishisitiao fashengyixiaqingxingde,buchengdanhuzhugeifuzeren:

  1、canjiarenzaihuzhuqineizhonghuancanjiaqiancenghuanbenbanfadiertiaoguidingdexiangtongdaleijibingde(yinbingsiwangchuwai);

  2、shoucicanjiadezhigongzai《lvyuequerenshu》querendecanjiahuzhuzhiriqi30tiannei,beiquezhenhuanbenbanfadiertiaoguidingdezhongdajibinghuoyinhuanbingzhijieyinzhicanjiarenshengude;

  3、canjiarenzaishoucicanjiahuojixucanjiabenqihuzhushi,yibanliletuixiushouxude;

  4、canjiarenyouyinmanbingshi、weizaohuocuangaibinglibingshiyijiqitagezhongqipian、zuobixingweide;

  5、canjiarenbeiyiyuancuowuzhenduanweihuanyoubenbanfahuzhufanweineidezhongdajibingde;

  6.yinziranzaihai、junshixingdong、dongluan、hefushe、guyifanzui、zishanghuodajiadououzaochengdeyiwaishanghaizhicanjisiwangde;

  7、congshigaofengxianyundongdaozhiyiwaishanghaizhicanjisiwangde;

  8、weifanbenbanfayouguanguidingdeqitaqingkuang。

  dishiwutiao canjiarenruyoudishisitiaodi4kuansuozhixingwei,jixingzhongzhiduiqidehuzhuzeren。

  dishiliutiao fanbushuyubenbanfahuzhufanweineidebingzhong,buchengdanhuzhujinhuoweiwenjingeifuzeren;feiyinbingyuanyinzhijieyinzhishengude,buchengdanshengufuxubuzhujingeifuzeren。 

  shenqingyugeifu

  dishiqitiao shenqinghuzhudaiyushiyingtigongyixiacailiao:

  1、jingcanjiadanwei、dailidanweishenhegaizhangde《wuhanchengshiquanzhigongzhongdajibingyiliaohuzhugeifushenqingshu》(yixiajiancheng《geifushenqingshu》);

  2、canjiarenshenfenzhengfuyinjian;rucanjiarenyijingshengu,huanxutigongyougonganbumenchujudehujizhuxiaozhengmingfuyinjian、zhidingshouyirenhuofadingshouyirendezhengmingcailiaojishenfenzhengfuyinjian;

  3、huzhubanzhidingdeyiliaojigouchujudechuyuanxiaojiehuosiwangzhengming、shoushubaogao,yongbingliqiepian、xueyejianyandengkexuefangfajianyanquezhensuohuanjibingdejianchabaogaodanhebingli,yijihuzhubanrenweibixutigongdeqitaxiangguancailiao。

  dishibatiao yiliaohuzhujinhuoweiwenjinjishengufuxubuzhujindeshenqing,bixuzaicanjiarenbeishouciquezhenhuanyoubenbanfadiertiaoguidingdezhongdajibing(huoyinhuanbingzhijieyinzhicanjiarenshengu)zhiriqi90tianneixianghuzhubantichu。chaoguoguidingqixianrengweitichushenqingde,shizuozidongfangqixiangshouyiliaohuzhujinhuoweiwenjinjishengufuxubuzhujindequanli。

  dishijiutiao huzhubanshoudaocanjiarenshouxuqibeidecailiaohou,20tianneijiangshenpijieluntongzhicanjiadanweihecanjiaren;30tianneijingdiaochaheshiwuwuhou,anbenbanfadeguidingqidongyiliaohuzhuzeren。

  diershitiao zhigongzhongdajibingyiliaohuzhujinyouhuzhubanguanli, qizijindeyunzuo、jiesuanheguanli,tongshijieshouwuhanchengshiquanzhigongyiliaohuzhugongzuoxiediaoweiyuanhui、shengzonggonghuiyewuzhuguanbumen、shengzonggonghuijingfeishenchaweiyuanhuidejiandu。

  diershiyitiao yiliaohuzhujinshixingdulihesuan,jianlizhuanyongzhanghu,zijinzhuankuanzhuanyong。

  fu ze

  diershiertiao benbanfasuozhidezhongdajibingbixufuheyixiadingyi: 

  1.exingzhongliu

  zuzhixibaojuyouyichangwuxubukekongzhideshengchangbingqiexiangzhouweizhengchangzuzhijinrunhexiangyuanchuqiguankuosan、zhuanyitexingdequanshengebuweiyuanfade、zuzhixuefenleiguishuyuexingzhongliudejibing。

  2.yilaixuetou、futoudemanxingshengongnengshuaijie

  zhimanxingshengongnengyanzhongshuaijie,xuyaoyilaiqieyijingjieshoulexueye(fumo)touxiweichishengming。

  3.guanzhuangdongmodaqiaojizhijiazhirushu

  zhiweizhiliaoguanzhuangdongmojibingerkaixiongshishilexueguanraodaoshuhuozhijiazhirushu。

  4.zaishengzhangaixingpinxue

  shiyizhonghuodexinggusuizaoxuegongnengshuaijiezheng,zhuyaobiaoxianweigusuizaoxuegongnengdixia,quanxuexibaojianshaohepinxue、chuxueganranzonghezheng,mianyiyizhijizhiliaoyouxiao。

  5.baixuebing

  zhizaoxuezuzhizhongdebaixibaojiqiyouzhixibaochengzhongliuxingzengzhi,baixibaodelianghezhifashengbianhua,xizaoxuexitongdeexingzhongliu。

  6.zhongxingganyan

  zhiganyanbingduganranzhishidabufenganzanghuaisibingshiqugongneng,qizhenduanbixujubeixialiequanbutezheng:shenduhuangdan;gangongnengjijutuihua;ganxingnaobing;ganxibaoyanzhongsunhuai。

  7.liangxingnaozhongliu

  zhiquezhendeyuanfayuluqiangneideliangxingzhongliu,qieyijingjieshoulekailushoushuqiechuhuoyijingshishileduinaozhongliujinxingdefangshezhiliao。bubaokuonaonangzhong、naoxueguanxingjibing。

  8.naodongmoliu

  zhinaodongmoliushoushuhuojieruzhiliaohou。

  9.xinzangbanmozhihuanshu

  zhiyinzhiliaoxinzangbanmojibingjinxingdexinzangbanmozhihuanshu。

  10.yiwaishanghaizhiguanjiegongnengwanquansangshi

  zhiyiwaishanghaisuozhizhitisunshangzhi3gejiyishangdaxiaoguanjiegongnengyongjiuxingsangshi。

  11.yanzhongshaoshangⅲdumianjidaquanshen20%yishang

  yintufayiwaishigubeigaowen、gaore、huaxuepindengshao、zhuo、tang、dianshang,jingqiangjiuzhiliaohou,pifuⅲdushaoshangdaquanshenpifuzongmianji20%yishang。zishangzicanchuwai。

  12.jixingzhongzhengyixianyan

  zhijixingyixianyanzhongbinglileixingweichuxuehuaisixing,qiejuyouyixiatezheng:quanfujutongjifumocijizheng;fushuichuxian;dixueyayuxiuke;dixuegai;nhayangxing;qiguangongnengshuaijie。jixingshuizhongxing(jianzhixing)yixianyanchuwai。

  13.shen、gan、xin、fei、gusuijilianheyizhishu

  zhiyinjibingyijingjieshouleshen、gan、xin、fei、gusui、xin-feilianhe、yi-shenlianhe、gan-shenlianheyizhishoushu。

  14.zhudongmoshoushu

  zhiweilejiaozhengzhudongmoxiazhai、fengehuoqiechuzhudongmoliuerjieshouxiong、fuzhudongmoshoushu,danxionghuofuzhudongmodefenzhichuwai。

  15.jixingjisuihuizhiyanyinqidejietan

  zhiyouyujisuihuizhiyanbingduganransuodaozhideyundonggongnengzhangaihuohuxigongnengjianruodetanhuanxingjibing。

  16.aerzihaimoshizheng

  shiyizumanxingbukenixingnaobianxingjibing,zhuyaolinchuangbiaoxianweizhinengshuaituihuosangshijixingweiyichang。

  diershisantiao canjiadanweizaicanjiayiliaohuzhuhou,ruofashengjibenxinxi(danweimingcheng、dizhi、youbian、lianxirenhelianxidianhuadeng)biangengshi,yingzaibiangenghou15tianneishumiantongzhihuzhuban。

  diershisitiao benbanfayuanzeshangsannianbaochibubian,sannianqimanhouhuzhubankegenjushijiqingkuangheyouguanzhengce,xiangyingdiaozhengbenbanfa。

  diershiwutiao benyiliaohuzhubuyiyingliweimude。

  benyiliaohuzhuyiwuhanshizonggonghuiweizhuti,yituochengshiquangejigonghuigongtongchengban;tongguozuzhizhigonghuzhuhuji,tuidongchengshiquanzhigongyiliaohuzhushiyedefazhan。

  diershiliutiao benbanfashiyongyicanjiashangyiqizhigongzhongdajibingyiliaohuzhubingzaiqimanhoujixucanjiabenqihuzhu,huoshoucicanjiahuzhudezhigong。shangyiqiyiliaohuzhuqiweimandecanjiazhigong,zaiyuandinghuzhuqixianneirengshiyongyuanbanfa。

  diershiqitiao benbanfayouwuhanshizhigongyiliaohuzhubangongshifuzejieshi。

  diershibatiao benbanfazi2016nian10yue1riqishixing。

 
 
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