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              因病致貧家庭醫療救助

              日期:2016-07-28 來源:朝陽報

                  1.哪些人可以享受因病致貧家庭醫療救助?
                  具有本市戶籍,未享受城鄉居民最低生活保障或低收入等社會救助的城鄉居民及其共同生活的家庭成員,因罹患疾病,在本市醫療保險或新型農村合作醫療定點醫療機構就醫,一個自然年度內家庭支出醫療費用較高,在經過城鎮職工基本醫療保險、城鎮居民基本醫療保險、新型農村合作醫療或城鄉居民大病保險,以及商業保險報銷賠付和各種救助后,家庭負擔的合規醫療費用超過承受能力,基本生活出現嚴重困難的,可以申請享受因病致貧家庭醫療救助。
                  2.因病致貧家庭醫療救助認定條件是什么?
                  收支水平認定條件
                  在上一自然年度內,申請家庭總收入在扣除家庭成員因罹患疾病發生的合規醫療費用后,家庭月人均收入不超過本市同年職工最低工資標準。
                  家庭財產認定條件
                  家庭擁有應急之用的貨幣財產總額,人均應不超過24個月本市當年城鄉低收入家庭認定標準之和。其他財產情形應符合《北京市人民政府辦公廳轉發市民政局關于北京市社會救助家庭經濟狀況核對辦法和認定指導意見的通知》(京政辦發〔2011〕63號)相關規定。
                  家庭成員認定條件
                  共同生活的家庭成員應符合《北京市城鄉居民最低生活保障審核審批辦法(試行)》(京民社救發〔2014〕182號)相關規定。
                  3.因病致貧家庭醫療救助救助標準是多少?
                  申請家庭中共同生活的本市戶籍家庭成員,在上一自然年度內,因罹患疾病,在本市醫療保險或新型農村合作醫療定點醫療機構就醫發生的醫療費用,在扣除城鎮職工基本醫療保險、城鎮居民基本醫療保險、新型農村合作醫療或城鄉居民大病保險,以及商業保險報銷賠付和各種救助后,對于家庭負擔的合規醫療費用,由民政部門區分病種和費用予以救助。全年救助封頂線8萬元。同一自然年度內只能申請一次。
                  (1)按病種救助。對于罹患重大疾病的,按照3萬元(含)以下部分30%、3萬元以上至5萬元(含)以下部分40%、5萬元以上部分50%的比例分段給予醫療救助。
                  (2)按費用救助。對于罹患上述病種以外疾病的,設置救助起付線3萬元(含),家庭負擔的合規醫療費用3萬元以上至5萬元(含)以下部分40%、5萬元以上部分50%的比例分段給予醫療救助。
                  4.因病致貧家庭醫療救助需要提交哪些證明材料?
                  (1)戶口簿及身份證復印件;
                  (2)銀行、郵政儲蓄銀行等代理金融機構相關材料;
                  (3)《申請因病致貧家庭醫療救助經濟狀況和醫療費用支出情況登記表及聲明書》;
                  (4)年度收入證明和相關財產證明;(5)本市二級及以上醫保或新農合定點醫療機構出具的診斷證明;
                  (6)北京市醫療門診收費票據或北京市醫療住院收費票據,以及北京市城鎮職工基本醫療保險或城鎮居民基本醫療保險、新型農村合作醫療、商業保險主管部門出具的費用結算分割單;
                  (7)城鄉居民大病保險相關證明材料;
                  (8)民政部門認為需要提供的其他證明材料。
                  5.如何申請因病致貧家庭醫療救助?
                  按照屬地管理的原則,申請因病致貧家庭醫療救助應當在城鄉居民大病保險報銷后,由本人或共同生活的家庭成員向戶籍所在街道(地區)辦事處提出書面申請并提交相關證明材料。家庭成員申請有困難的,也可委托居(村)民委員會代為提交申請。
                  6.重大疾病參考名錄有哪些?
                  (1)惡性腫瘤;(2)終末期腎病(腎透析);(3)重性精神病;(4)I型糖尿病;(5)先天性心臟病;(6)白血病;(7)血友病;(8)再生障礙性貧血;(9)重大器官移植(與職工醫保一致);(10)耐多藥肺結核;(11)艾滋病機會性感染;(12)急性心肌梗塞;(13)腦梗死;(14)甲亢;(15)唇腭裂。
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