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《英亚体育加强和改进基本医疗保险参保工作有关问题的通知》政策问答
发布时间: 2021-07-06


yi、weishenmeyaoxiafa《yingyatiyujiaqianghegaijinjibenyiliaobaoxiancanbaogongzuoyouguanwentidetongzhi》?

da: canbaogongzuoshijibenyibaodejichuxinggongzuo,weibaozhangcanbaorenyuanyifaxiangshoujibenyibaoquanyifahuilezhongyaozuoyong。weishenrushishiquanmincanbaojihua,jinyibutigaojibenyiliaobaoxiancanbaozhiliang,baozhangqunzhongquanyi,youhuacanbaojiaofeifuwu,genju《guojiayibaoju caizhengbu guojiashuiwuzongjuyingyatiyujiaqianghegaijinjibenyiliaobaoxiancanbaogongzuodezhidaoyijian》(yibaofa〔2020〕33hao),zhidinglebentongzhi。

er、zenyangquanmiantuijinjibenyibaocanbaokuomian?

da: zaiwendingyuanyoucanbaomiandejichushang,jiehechangzhurenkou、hujirenkou、jiuyerenkoudengzhibiao,wanshanyurenshe、shuiwu、gongan、minzheng、canlian、jiaoyu、sifa、weishengjiankang、shichangjianguandengbumendeshujugongxiangjiaohuanjizhi,jiaqiangrenyuanxinxibiduihegongxiang,jingzhunsuodingweicanbaorenyuan,xingchengquanmincanbaojihuaku。jianchihewanshanfugaiquanmin、yifacanjiadejibenyiliaobaoxianzhidu,jiaqiangcanbaofuwu,wanshanxinjiuyexingtaicongyerenyuancanbaojiaofeifangshi,chixuzuohaocanbaokuomianxuanchuanzhidaogongzuo。

san、ruhezuohaocanbaodaiyuxianjie?

da: zhongdianbaokuoliangleiqingxing:

(yi)guifanzhigongyibaodaiyuxianjie。yilianxucanjiajibenyiliaobaoxian2nianjiyishang(buhanbujiao)qiezhongduanjiaofei3geyueneizhongxincanjiayingyatiyuzhigongyibaodecanbaorenyuan,zicanbaojiaofeizhiyueqixiangshoudaiyu;chaoguo3geyuede,shezhi6geyuedaiyuxiangshoudengdaiqi,dengdaiqiqijianfashengdeyiliaofeiyongzhigongyibaobuyubaoxiao。

(er)guifanjuminyibaodaiyuxianjie。zi2022nianqi,weizaiyingyatiyujuminyibaojizhongshenbaocanbaojiaofeiqi(meinian9yuezhi12yue)banlixiayinianduyingyatiyujuminyibaocanbaodengjijiaofeishouxudecanbaorenyuan,kezaixiayiniandusuishibanlidangniandujuminyibaoxiangguanshouxu,binganyixiaguidingxiangshoudaiyu:

1.yilianxucanjiajibenyiliaobaoxian2nianjiyishang(buhanbujiao)qiezhongduanjiaofei3geyueneizhongxincanjiadangnianduyingyatiyujuminyibaodecanbaorenyuan,zicanbaojiaofeiciriqixiangshoudaiyu;chaoguo3geyuede,shezhi6geyuedaiyuxiangshoudengdaiqi,dengdaiqiqijianfashengdeyiliaofeiyongjuminyibaobuyubaoxiao。

2.weilianxucanjiajibenyiliaobaoxian2nianjiyishang(buhanbujiao)canjiayingyatiyujuminyibaodecanbaorenyuan,shezhi6geyuedaiyuxiangshoudengdaiqi,dengdaiqiqijianfashengdejuminyiliaofeiyongyibaobuyubaoxiao。

si、ruhejiedingzhongfucanbao?

da: zhongfucanbaoshizhitongyicanbaorenzhongfucanjiatongyijibenyiliaobaoxianzhidu(zhiduneizhongfucanbao)huozhongfucanjiabutongjibenyiliaobaoxianzhidu(kuazhiduzhongfucanbao),jutibiaoxianweitongyishijianduanneitongyicanbaorenyouliangtiaojiyishangcanbaojiaofeizhuangtaizhengchangdecanbaoxinxijilu。yuanzeshangbuyunxuzhongfucanbaohezhongfuxiangshoudaiyu(hanbuchabaoxiao)。

wu、canbaorenyuanruhecanbaoyouxiaoguibizhongfucanbaoqingkuang?

da: weiyouxiaoguibiyingyatiyuzhongfucanbaoqingkuang,chuzhengfuanguidingzizhucanbaodeshenghuokunnandetekunrenyuan,dibaoduixiang、dishourujiatingdengkunnanqunzhongwai,yinganzhaoyixiayuanzecanjiayingyatiyujibenyiliaobaoxian:

(yi)zaiyingyatiyuyicanjiazhigongyibaode,yuanzeshangbuyunxucanjiajuminyibao。canbaorenkezaizantingzhigongyibaocanbaoguanxihou,canjiasuozainianduhuoxiayiniandujuminyibao,zantingzhigongyibaocanbaoguanxidangyuekeanguidingxiangshouzhigongyibaodaiyu。

(er)zaijizhongjiaofeiqiyicanjiaxiayiniandujuminyibao,zaicishenqingcanjiazhigongyibaode(buhanbujiao),canbaorenzaibanlizhigongyibaocanbaojiaofeishi,tongbuzantingjuminyibaocanbaoguanxi,bingyu12yue31riqianjishibanlijuminyibaotuifeishouxu。

(san)yicanjiadangniandujuminyibaozaicishenqingcanjiazhigongyibaode,canbaorenzaibanlizhigongyibaocanbaojiaofeishi,tongbuzantingjuminyibaocanbaoguanxi。zhigongyibaocunzaidaiyudengdaiqide,kejixuxiangshoujuminyibaodaiyu,quebaodaiyuyouxiaoxianjie。

(si)zaitongyiniandunei,canbaorenyuancanjiazhigongyibaohejuminyibaode,qifubiaozhunjizhifuxianedengangezizhengcefenbiejisuan,yibaodaiyujiugaoxiangshou。

guojiayibaoxinxipingtaijichuxinxiguanlizixitongjianchenghou,gejijingbanjigouyaoliyongguojiatongyiyibaoxinxipingtaijichuxinxiguanlizixitongshishiheduigongneng,jishichaxuncanbaorenjiaofeizhuangtai,lianheshuiwu、renshebumenwanshancanbaojiaofeifuwu,jianshaozhongfucanbaojiaofei。

liu、canbaorenyuannazhongqingkuangxiakeyishenqingtuifei?

da: (yi)zhixingzhengcedetuifei

1.yongrendanweijiqizhigongyinweinengjishibanlituigongshouxuzaochengduojiaonazhigongyibaofeide,kegenjurenshebumentigongdexiangguancailiaobanlituifeishouxu。

2.linghuojiuyerenyuanzaiyujiaodangnianduzhigongyibaofeiqijian,keyishenqingweigerenbanlishenqingtuifeijiesuanyuefenjiyihouyujiaofeiyuefendetuifeishouxu。

3.canbaorenzaijuminyibaojiaofeihou,zaidaiyuxiangshouqiweikaishiqianhuoyindangnianchixuxiangshouzhigongyibaodaiyuerweixiangshoujuminyibaode,keyishenqingweigerenbanlituifeishouxu。daiyuxiangshoukaishihou,yuanzeshanggerenjiaofeibuzaituihui。

4.yitongguoyiliaojiuzhudengqudaoyouzhengfuanguidingzizhucanbaodejiuzhuduixiang,kezaijizhongjiaofeiqineianqudaoxiangzhuguanbumentichuzizhucanbaotuifeihou,biangengweigenggaojiaofeidangcizizhujiaofei。

5.anxiangguanbumenguidingyaoqiubanliqiyezhigongjibenyanglaobaoxianhuojiguanshiyedanweijibenyanglaobaoxiantuifeide,yiliaobaoxianyingtongbubanlituifeishouxu。

(er)diaozhengzhengcedetuifei

1.yinzhengcediaozheng、shenjijihedengyuanyin,yaoqiutuihuiyijiaonazhigongyibaofeide,keyijuxiangguanbumenchujudewenjian、wenshudengcailiaobanlituifeishouxu;

yinshejituixiu(hanbingtui、tegang)shijiantiqian,zaochengshishiduoshou,yaoqiutuihuiyizhengzhigongyibaodetuifei。

(san)jingbanyuanyindetuifei

1.yinyiliaobaoxianshitongjiaofeinianxianshenhegenggai,zaochengtuixiuhouyicixingbujiaoyiliaojiaofeinianxianduoshou,yaoqiutuihuiyizhengzhigongyibaodetuifei。

????2.jingbanjigoujiaofeihedingshi,yinshiyongfaguiyuanyin,weijishizhengqueshenbaojiaonaxianzhong、feilv、jishu,zaochengduojiao、wujiao、cuojiaozhigongyibaofeide,yaoqiutuihuiyizhengzhigongyibaodetuifei????

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