收藏：寻乌县医保慢性病办理流程
<div class="wx_rich_media_content" id="jsWxContainer"><section class="" data-tools="135编辑器" data-id="103" style='color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 17px; letter-spacing: 0.544px; line-height: 27.2px; text-align: justify; widows: 1; border: 0px none;'><section style='text-align: center;'><section class="" data-tools="135编辑器" data-id="103" style='border: 0px none;'><section class="_wxbEditor"><p><strong style='font-size: 16px; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; letter-spacing: 0px;'><span style='font-weight: bolder;'>门诊特殊慢性病医保政策及申办流程</span></strong></p></section></section></section></section><h1 style='font-size: 20px; color: rgb(51, 51, 51); text-align: justify; widows: 1; letter-spacing: 0px; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em;'><span style='font-family: 黑体, SimHei; font-size: 16px;'><strong><span style='font-weight: bolder;'>一、病种范围及待遇</span></strong></span></h1><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>门诊医保特殊慢性病分为两类，共有30种。</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; text-indent: 0em; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em;'><span style='font-family: 微软雅黑;'><strong><span style='color: rgb(240, 136, 0); font-weight: bolder; font-size: 16px;'>一类病种：8种</span></strong></span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>1.恶性肿瘤；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>2.系统性红斑狼疮；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>3.再生障碍性贫血；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-family: 宋体, SimSun;'>4.帕金森氏综合症；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>5.慢性肾功能衰竭（尿毒症期）；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>6.器官移植后抗排斥治疗；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>7.地中海贫血（含输血）；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>8.血友病。</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em;'><span style='color: rgb(240, 136, 0); font-weight: bolder; font-size: 16px; font-family: 微软雅黑;'>二类病种：22种</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>1.精神病；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>2.高血压病；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>3.糖尿病；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>4.结核病；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>5.冠状动脉粥样硬化性心脏病（心梗、搭桥术、支架植入术后）；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>6.慢性心功能衰竭（心脏合并心功能不全Ⅱ级以上）；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>7.慢性房颤；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>8.心肌病(原发性)；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>9.慢性肝炎；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>10.慢性支气管炎；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>11.慢性阻塞性肺疾病；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>12.慢性支气管哮喘；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>13.肝硬化；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>14.慢性肾病；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>15.脑卒中后遗症；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>16.癫痫；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>17.重症肌无力；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>18.血吸虫病；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>19.儿童生长激素缺乏症；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>20.痛风；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>21.股骨头坏死；</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>22.艾滋病。</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='font-size: 16px; font-family: 宋体, SimSun;'>以上30种病种可办理门诊特殊慢性病，但必须符合《赣州市城乡居民医疗保险门诊特殊慢性病鉴定标准（试行）》方可，敬请广大城乡居民朋友理解配合。</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em;'><span style='font-size: 16px;'><span style='color: rgb(240, 136, 0);'> </span></span><span style='color: rgb(240, 136, 0); font-weight: bolder; font-size: 16px; font-family: 微软雅黑;'> 报销比例：</span><span style='font-size: 16px;'><span style='font-family: 宋体, SimSun;'>一类、二类门诊特殊慢性病不设起付线，报销比例为60%。其中，年度最高基金支付限额一类与住院统筹基金最高支付限额合并计算，统一为10万元；二类为5000元。</span></span></h3><h1 style='font-size: 20px; color: rgb(51, 51, 51); text-align: justify; widows: 1; letter-spacing: 0px; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em;'><span style='font-family: 黑体, SimHei; font-size: 16px;'><strong><span style='font-weight: bolder;'>二、办理时间、地点、所需材料及申报程序</span></strong></span></h1><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='color: rgb(240, 136, 0); font-weight: bolder; font-size: 16px; font-family: 微软雅黑;'>1.办理时间：</span><span style='font-size: 16px; font-family: 宋体, SimSun;'>周一至周五，上午8:00-12:00，下午2:30-5:30；周六上午8:00-12:00。（法定节假日除外）</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='color: rgb(240, 136, 0); font-weight: bolder; font-size: 16px; font-family: 微软雅黑;'>2.申报材料：</span><span style='font-size: 16px; font-family: 宋体, SimSun;'>参保人员携本人医保卡，及按《赣州市城乡居民基本医疗保险门诊特殊慢性病鉴定标准（试行）》的规定提交能证明相关疾病的证明资料（如二级以上医院近期住院小结或近三年的门诊病历；近期的检验检查报告单等，如果现有检查材料不能认定的还需配合进一步检查）。</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='color: rgb(240, 136, 0); font-weight: bolder; font-size: 16px; font-family: 微软雅黑;'>3.鉴定受理部门与具体流程：</span></h3><p style='color: rgb(51, 51, 51); font-size: 17px; letter-spacing: 0.544px; line-height: 27.2px; text-align: justify; widows: 1; font-family: Helvetica, Arial, sans-serif;'><span class="wxart_image" wx-style='display:inline-block;width: 587px; height: auto !important; visibility: visible !important;'></span></p><h1 style='font-size: 20px; color: rgb(51, 51, 51); text-align: justify; widows: 1; letter-spacing: 0px; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em;'><span style='font-family: 黑体, SimHei; font-size: 16px;'><strong><span style='font-weight: bolder;'>三、费用报销</span></strong></span></h1><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='color: rgb(240, 136, 0); font-weight: bolder; font-size: 16px; font-family: 微软雅黑;'>1.可享受待遇的就诊机构：</span><span style='font-size: 16px; font-family: 宋体, SimSun;'>从2018年元月1日起，经县医保局批准后的县内门诊特殊慢性病人员，从批准的次月1日起，既可在县人民医院、县中医院就诊享受门诊特殊慢性病待遇，也可到参保地乡镇卫生院就诊享受门诊特殊慢性病待遇。</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='color: rgb(240, 136, 0); font-weight: bolder; font-size: 16px; font-family: 微软雅黑;'>2.用药诊疗范围：</span><span style='font-size: 16px; font-family: 宋体, SimSun;'>按《赣州市城乡居民基本医疗保险门诊特殊慢性病用药诊疗范围（试行）》的规定执行。</span></h3><h3 style='font-size: 17px; color: rgb(51, 51, 51); letter-spacing: 0.544px; text-align: justify; widows: 1; font-family: -apple-system-font, BlinkMacSystemFont, Arial, sans-serif; line-height: 2em; text-indent: 2em;'><span style='color: rgb(240, 136, 0); font-weight: bolder; font-size: 16px; font-family: 微软雅黑;'>3.费用结算：</span><span style='font-size: 16px; font-family: 宋体, SimSun;'>门诊特殊慢性病除异地安置人员及恶性肿瘤、红斑狼疮、生长激素缺乏症、器官移植抗排异等个别当地不能诊治的慢性病门诊费用可进行零星报销外（将县外就诊的门诊发票原件和费用清单带回所在乡镇卫生院申报医药费报销），其他的一般门诊特殊慢性病实行在县内定点医院直接刷卡报销，原则上不能进行零星报销。</span></h3></div>
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