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hidden"> <div id="chvkimc" class="left_meta clearfix entry-meta"> <time datetime="{$article.time_date}" class="entry-date"> <strong>15</strong> <small>2018-04</small> </time> </div> </div> <h1>天津職工醫保推出新政個(gè)人參保人員繳費更加便捷</h1> <div id="upthfog" class="article-publish"> 作者：<a href="http://onliving.cn/">輕松保</a> <em>|</em> 發(fā)布時(shí)間：<small>2018-04-15</small> <em>|</em> 閱讀次數：<small>27619</small> </div> <div id="vejlzov" class="clearfix"></div> </div> <article class="article-info p-t-30 p-b-30"> <p> 今年12月1日起，本市將正式執行《關(guān)于職工基本醫療保險參保繳費及待遇有關(guān)問(wèn)題的通知》。本期醫保服務(wù)臺針對該政策中涉及個(gè)人參保人員的部分進(jìn)行詳細指南。 </p> <br /> <p> 關(guān)于參保繳費方面。已參加職工基本養老保險的無(wú)雇工個(gè)體工商戶(hù)、非全日制從業(yè)及其他靈活就業(yè)人員，可以個(gè)人身份參加職工基本醫保，繳費比例為8%。 </p> <p> 關(guān)于醫保待遇等待期。個(gè)人參保人員醫療保險等待期為六個(gè)月，即個(gè)人參保人員自連續繳費滿(mǎn)六個(gè)月起，本人就醫發(fā)生的醫療費用醫保才予以報銷(xiāo)。兩類(lèi)個(gè)人參保人員可自繳費之月起享受待遇，一是與用人單位終止、解除勞動(dòng)合同的人員和領(lǐng)取失業(yè)保險金期滿(mǎn)后兩個(gè)月內參保的人員;二是按規定向前補繳養老保險費，且一并向前連續補繳五年及以上的醫療保險費的人員。 </p> <p> 關(guān)于中斷繳費及補繳費。共分三種情況：一是連續繳費滿(mǎn)六個(gè)月后中斷繳費不超過(guò)六個(gè)月，并且當年中斷繳納的醫療保險費在次年3月份(含)以前辦理補繳的，中斷繳費期間發(fā)生的醫療費用按規定報銷(xiāo);二是連續繳費未滿(mǎn)六個(gè)月中斷繳費，且在中斷繳費后六個(gè)月內恢復繳費并及時(shí)足額補繳的，視為連續繳費，自連續繳費滿(mǎn)六個(gè)月起，發(fā)生的醫療費用按規定報銷(xiāo);三是連續中斷繳費超過(guò)六個(gè)月，自恢復繳費之月起連續繳費滿(mǎn)六個(gè)月后，發(fā)生的醫療費用按規定報銷(xiāo)。 </p> <p> 關(guān)于退休人員補繳費及待遇。個(gè)人參保人員不足規定醫療保險繳費年限的(男滿(mǎn)25年、女滿(mǎn)20年，且在本市實(shí)際繳費年限滿(mǎn)5年)，可在辦理退休手續時(shí)，按照當年繳費標準及所差年限，一次性補足應繳納的醫療保險費。對于已經(jīng)辦理退休手續的人員，不足上述繳費年限的，按照辦理補繳時(shí)個(gè)人參保規定的當年繳費基數辦理，一次性補足所差年限，自補足之月起發(fā)生的醫療費用按規定報銷(xiāo)。 </p> <p> 關(guān)于補繳費利息。個(gè)人補繳醫療保險費的，按規定加收利息。補繳2011年6月份(含)以前的基本醫療保險費，補繳利息計算開(kāi)始時(shí)間按照2005年3月執行。 </p> <p> 參保人員門(mén)診特殊病登記指南 </p> <p> 辦理登記流程 </p> <p> -患門(mén)特病的參保人員，應及時(shí)到社保經(jīng)辦機構選定的門(mén)特病聯(lián)網(wǎng)登記診斷定點(diǎn)醫院申請辦理門(mén)特病登記; </p> <p> -參?；颊叩结t院醫?？粕觐I(lǐng)《天津市基本醫療保險門(mén)診特殊病種登記審批表》(以下簡(jiǎn)稱(chēng)《審批表》)，據實(shí)填寫(xiě)個(gè)人基礎信息，在一級、二級和三級綜合醫院以及三級專(zhuān)科醫院(不含糖尿病)中選擇1—4家(同一級別醫院只能選擇1家)作為門(mén)特病治療醫院;癲癇、紫癜、再障病人只能選擇一家醫院;參?；颊呖稍龠x一家定點(diǎn)零售藥店購藥; </p> <p> -參?；颊叱帧秾徟怼返较嚓P(guān)診療科室，由指定門(mén)特病診斷主任醫師做出明確診斷，據實(shí)填寫(xiě)《審批表》相關(guān)內容并簽署姓名; </p> <p> -參?；颊叩结t院醫?？妻k理登記事宜。若因網(wǎng)絡(luò )故障等特殊原因，醫院無(wú)法辦理門(mén)特登記時(shí)，參保人員攜帶所需材料到參保所在地社保分中心申辦門(mén)特登記。 </p> <p> 辦理登記時(shí)需攜帶的材料 </p> <p> -社會(huì )保障卡、居民身份證; </p> <p> - 《天津市基本醫療保險門(mén)診特殊病種登記審批表》; </p> <p> -最近一次檢查結果和相關(guān)就診記錄; </p> <p> -定點(diǎn)門(mén)特聯(lián)網(wǎng)醫院開(kāi)具的診斷證明，并加蓋醫院醫?？乒潞歪t院診斷證明章。 </p> <p> 辦理時(shí)間工作日 </p> <p> 辦理登記時(shí)限 </p> <p> -定點(diǎn)醫院聯(lián)網(wǎng)登記：自醫院上傳信息72小時(shí)內審批確認(糖尿病鑒定登記即時(shí)審核); -社保分中心登記：受理當日辦結。 </p> <p> 特別提示 </p> <p> -若參?；颊咝枰兏委熱t院，患者本人或代理人持《門(mén)診特殊病種登記審批表》到原登記醫院申請變更。填寫(xiě)《天津市基本醫療保險門(mén)診特殊病種治療醫院變更申請表》，請診斷醫院予以變更。 </p> <p> -門(mén)特病登記有效時(shí)間為兩年。除糖尿病外的門(mén)特登記應在有效截止時(shí)間前一個(gè)月內到門(mén)特病登記診斷醫院申辦門(mén)特病復查登記。 </p> <p> -參保糖尿病患者如需辦理門(mén)診特殊病種登記，應到指定的15家鑒定機構進(jìn)行糖尿病門(mén)特鑒定。辦理糖尿病門(mén)特登記時(shí)，可就近選擇1家三級醫院、1家二級醫院、1家一級醫院(含門(mén)診部)作為糖尿病門(mén)特醫療服務(wù)機構，同時(shí)還可以就近選擇1家定點(diǎn)零售藥店，簽約糖尿病按人頭付費試點(diǎn)醫院的患者，僅可在簽約醫院就診，如需轉診轉院由簽約醫院負責。對于確需變更治療醫院的，參?；颊呖删徒骄哂刑悄虿≈委熱t院變更資格的醫院申請變更，但每年只能變更一次。 </p> <p> -本市13種門(mén)特病種類(lèi)：腎透析、腎移植術(shù)后抗排異治療;癌癥的放、化療和鎮痛治療;糖尿病;肺心病;紅斑狼瘡;偏癱;精神病;血友病;肝移植術(shù)后抗排異治療;癲癇;再生障礙性貧血;慢性血小板減少性紫癜等。 </p> <div id="2y8szwm" class="post-bottom-info"><p> <strong><span style="font-size:16px;">輕松保</span></strong>專(zhuān)業(yè)從事<a href="http://onliving.cn" target="_blank">個(gè)人人事外包</a>，<a href="http://onliving.cn" target="_blank">公司人事外包</a>，企業(yè)五險一金代辦，幫您實(shí)現足不出戶(hù)繳社保的愿望！<a href="http://onliving.cn" target="_blank">人事外包</a>，就上輕松保。在輕松保繳納社保，可與單位繳納社保享受同等待遇。獲取更多社保代理幫助請掃碼關(guān)注我們的微信公眾號，更多深度資訊政策解讀等你來(lái)。 </p> <div align="center"> <img alt="輕松保" src="https://youhro.com/upload/attached/image/20180531/20180531170233_31530.jpg" title="輕松保" width="180" height="180" /> </div></div> </article> <div 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