[{"gicategorycode":"社会保障 ","giinfoid":"280675","giindentifier":"11532300mb16168868-/2023-1019003","giuuid":"B8CE4ABEFC3E497E82B35728B950F9B7","gititle":"【云•医保问答】参加居民医保后，参保人能够享受怎样的报销待遇？","subcatcode":"","gitcatcode":"","giccatcode":"","gipubcodes":"楚雄州医保局","gidate":"2023-01-10 17:21:51","gidocno":"","gisubterm":"","gipubcode":"cxzybj","summary":"问：参加居民医保后，参保人能够享受怎样的报销待遇？答：参保人在参加居民医疗保险后，在正常享受待遇期内于定点医药机构就医的，持社会保障卡进行刷卡即时结算。其中符合基本医疗保险药品目录、诊疗项目和医疗服务设施范围的医疗费用，按照规定从基本医疗保险基金中支付。从我省医保报销平均情况看，住院保障方面，居民医保政策范围内住院费用报销比例达到70%左右，统筹基金年最高支付限额达到当地居民年人均可支配收入的6..."},{"gicategorycode":"社会保障 ","giinfoid":"285478","giindentifier":"11532300mb16168868-/2023-1106011","giuuid":"4C635EDFD88049268B7475625C47A976","gititle":"【云•医保问答】参保人在非定点医疗机构发生的门诊抢救医疗费可以报销吗？","subcatcode":"","gitcatcode":"","giccatcode":"","gipubcodes":"楚雄州医保局、","gidate":"2023-01-09 17:01:29","gidocno":"","gisubterm":"","gipubcode":"cxzybj","summary":"问：参保人在非定点医疗机构发生的门诊抢救医疗费可以报销吗？答：参保人在非定点医疗机构的门诊抢救医疗费用由本人垫付，凭门诊抢救病历、病危通知单、检查报告、化验单、复式处方（二种以上的药品应标注每项药品的价格）和门诊发票到所属医保经办机构审核结算。参保人在非定点医疗机构门诊抢救后，符合住院标准的，待病情平稳后，应转入定点医疗机构住院治疗。"},{"gicategorycode":"社会保障 ","giinfoid":"280674","giindentifier":"11532300mb16168868-/2023-1019002","giuuid":"AD46AE073F3F45B0BDE06B5717B7094C","gititle":"【云•医保问答】中断缴费后，还能享受医保待遇吗","subcatcode":"","gitcatcode":"","giccatcode":"","gipubcodes":"楚雄州医保局、","gidate":"2023-01-06 17:08:46","gidocno":"","gisubterm":"","gipubcode":"cxzybj","summary":"问：中断缴费后，还能享受医保待遇吗？答：中断缴费后，从中断次月起，就不能享受住院、门诊特检、“两特病”等报销待遇，但仍可以在药店使用个人账户买药。问：中断缴费后，医疗保险年限会清零吗？答：中断缴费后，医疗保险缴费年限是不会清零的，因为在长期的医疗保险缴费过程中，可能会因为各种原因导致中断缴费，但实际的缴费年限都是可以累计计算的，不会随医保中断缴费而清零。"},{"gicategorycode":"社会保障 ","giinfoid":"285476","giindentifier":"11532300mb16168868-/2023-1106010","giuuid":"533E91C7B0AF4FF0B22E020F7B0E40C3","gititle":"【云•医保问答】这些情况下，医保不能报销，您都知道吗？","subcatcode":"","gitcatcode":"","giccatcode":"","gipubcodes":"楚雄州医保局、","gidate":"2023-01-05 17:38:35","gidocno":"","gisubterm":"","gipubcode":"cxzybj","summary":"问：这些情况下，医保不能报销，您都知道吗？答：按照《社会保险法》《国家医保局 财政部关于建立医疗保障待遇清单制度的意见》规定，下列医疗费用不纳入基本医疗保险基金支付范围：（一）应当从工伤保险基金中支付的。（二）应当由第三人负担的。（三）应当由公共卫生负担的。（四）在境外就医的。（五）体育健身、养生保健消费、健康体检。（六）国家规定的基本医疗保险基金不予支付的其他费用。遇对经济社会发..."},{"gicategorycode":"社会保障 ","giinfoid":"285473","giindentifier":"11532300mb16168868-/2023-1106009","giuuid":"C909367D69574FA2AFD3B24AE792BAB9","gititle":"【云•医保问答】同样是医保参保人，为什么有时候报销比例不一样？","subcatcode":"","gitcatcode":"","giccatcode":"","gipubcodes":"楚雄州医保局、","gidate":"2023-01-04 17:43:39","gidocno":"","gisubterm":"","gipubcode":"cxzybj","summary":"问：同样是医保参保人，为什么有时候报销比例不一样？答：可能有以下几种情况：（一）不同等级的医疗机构，报销比例有所差异。从效率上讲，有序就医是社会最优选择，国家鼓励患者小病在基层医院看，大病再去大医院看。医保部门为了对患者起到引导作用，在基层医院报销比例比在大医院高，而且基层医院的起付线也设置得比大医院低。因此同样类型的参保人在不同等级的医疗机构里产生的医疗费用，报销比例会不同。（二）在就..."},{"gicategorycode":"社会保障 ","giinfoid":"285471","giindentifier":"11532300mb16168868-/2023-1106008","giuuid":"587CB8ACDC2C4479B6D6566B4348BB87","gititle":"【云•医保问答】参保人的医保报销费用，如果超出基本医保封顶线的费用怎么办？","subcatcode":"","gitcatcode":"","giccatcode":"","gipubcodes":"楚雄州医保局、","gidate":"2022-12-01 17:52:34","gidocno":"","gisubterm":"","gipubcode":"cxzybj","summary":"问：参保人的医保报销费用，如果超出基本医保封顶线的费用怎么办？答：超过基本医保封顶线的部分，可根据实际医疗费用负担情况，纳入职工大额医疗费用补助和城乡居民大病保险范围。大病保险是基本医疗保障制度的拓展和延伸，主要对大病患者高额医疗费用在基本医保支付基础上再给予进一步支付。我省职工大病补充保险政策范围内费用支付比例达到90%，封顶线各统筹区不同，大部分统筹地区在40万左右，部分统筹地区没有封顶限额..."}]