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The author:(作者)aaapublished in(发表于) 2013/12/16 0:36:43 Guangzhou mental patients were included in the scope of major diseases for medical assistance
Text/yangcheng evening news reporter Zhang Lin
To perfect medical aid system, to further protect the interests of poor community yesterday, Guangzhou City, Guangzhou Civil Affairs Bureau issued eight sectors, such as the implementation of the needy people of critical illness insurance for medical assistance measures for the implementation of (hereinafter referred to as the rules). The biggest bright spot is that opportunistic infection for AIDS, schizophrenia, affective psychosis (manic attack, depression, or bipolar disorder) patients with relief. In addition, hopefully the people that suffer from serious diseases up to 330,000 yuan per person per year for medical assistance.
Guangzhou people in critical illness insurance for medical assistance (hereinafter referred to as "commercial insurance for medical assistance") is invested by the Government, to purchase commercial insurance professional services in social medical insurance and Government medical aid to needy people on the basis of important diseases supplements for medical assistance.
11 residents were included in the scope of bailout
The methods that, participating in social medical insurance in Guangzhou and meet the residents of one of the following conditions, under the Guangzhou City commercial insurance coverage Medicaid:
(1) the city's lowest life guarantee, members of low-income families; (2) the city "three noes" rural five guarantees of personnel, and (3) the institutionalization of social welfare of the City Government of dependent persons; (4) licensed for persons with severe handicaps in the city;
(5) enrolled at the College of the city's non-domicile students; (6) compliance with the Medicaid pilot rules on major diseases in Guangzhou (Guangzhou (2012), the same below) other personnel rescue conditions; (7) certified San、siji spirit of this city, and mental disabilities;
(8) the city poor workers family members (9) difficult families are particularly supportive of family planning workers in this city, (10) by the unit or by public security organs sent to hospitals for inpatient care residence in this city of people with mental disorders (11) approved the special difficulties of those personnel.
Interestingly, in the psychiatric patients were included in the scope of the bailout and detailed provisions. Approach under said, has following case one, by is located units or police organ rushed to medical institutions for hospital treatment of this city household spirit obstacles patients, and is not enjoy Guangzhou medical rescue pilot approach under, and Guangzhou heavy extra disease medical rescue pilot approach under and the this approach other rescue treatment of, its hospital basic medical costs personal since pays part deduction other government sector and social funded Hou, by 80% of proportion rescue: (a) has occurred hurt itself of acts, or has hurt itself of dangerous of; (ii ) Has been conduct that endangers the safety of others, or endanger the safety of others in danger.
Bailout totals a maximum of 330,000
In terms of programs, outpatient rescue and hospital relief covers almost most of the kinds of diseases. Reporters found that HIV/AIDS, depression, also be included.
Such as, difficult masses in general outpatient (or emergency) treatment end late nephropathy, and nephropathy integrated levy, and AIDS opportunities sexual infection, and schizophrenia, and emotional sexual psychiatric (manic attack, and depression attack or two-way obstacles) and rush critical syndrome pregnancy maternal, and children emergency treatment project of, its medication and clinic project meet commercial insurance medical rescue general outpatient Directory provides of personal burden medical costs (not containing has by Guangzhou medical rescue pilot approach under rescue of outpatient medical costs), by 80% of proportion be rescue, Towns in "three noes" personnel and assisted rural areas 100%. Every commercial insurance for medical assistance not exceeding 10,000 yuan, when accumulated, not grown.
Business insurance agencies should be according to the relevant requirements of the Government, in conjunction with other medical institutions jointly organized specialized medical aid, such as heart disease, leukemia, hemophilia, specific help programs separate.
Aid every year of commercial insurance for medical assistance Medicaid aggregate amount does not exceed a maximum of 150,000 yuan, when the Trojan, do not go over the year.
In recently of municipal executive conference press conference Shang, public councils Deputy Secretary Yi Lihua revealed, in Guangzhou has implementation of Guangzhou medical rescue pilot approach under, and Guangzhou heavy extra disease medical rescue pilot approach under, and Guangzhou funded difficult personnel participate in social medical insurance implementation approach under, three big policy of based Shang, once official implementation commercial insurance medical rescue, body patient major disease of difficult masses is expected to annually per person Supreme was 330,000 yuan medical rescue.
The formula is as follows: request of Guangzhou citizens ' basic medical aid up to a maximum of 140,000 yuan/year application for business insurance for medical assistance up to a maximum of 150,000 RMB per year and for charitable medical aid, highest standards of 30,000 yuan per person/year; apply for temporary medical assistance, highest standard of 10,000 yuan per person per year. Edit: he ping
(Original title: spike the mentally ill was included in the bailout yesterday issued the implementation scope approach)
文/羊城晚报记者 张林
为完善医疗救助体系，进一步保障困难群众医疗权益，昨日，广州市民政局等八部门印发实施《广州市困难群众重大疾病商业保险医疗救助实施办法》(以下简称《办法》)。最大亮点在于，将对艾滋病机会性感染、精神分裂症、情感性精神病(狂躁发作、抑郁发作或双向障碍)患者开展救助。此外，身患重大疾病的困难群众有望每年每人最高获33万元医疗救助。
广州市困难群众重大疾病商业保险医疗救助(以下称“商业保险医疗救助”)是通过政府投入资金，购买商业保险机构专业服务，在社会医疗保险和政府医疗救助的基础上对困难群众实施的重大疾病补充医疗救助。
11类居民被列入救助范围
《办法》指出，参加广州市社会医疗保险且符合下列条件之一的居民，纳入广州市商业保险医疗救助对象范围：
(1)本市最低生活保障对象、低收入困难家庭成员；(2)本市城镇“三无”人员、农村五保供养对象；(3)本市社会福利机构收养的政府供养人员；(4)本市持证重度残疾人；
(5)在本市大中专院校就读的非本市户籍困难学生；(6)符合《广州市重特大疾病医疗救助试行办法》(穗民〔2012〕262号，下同)救助条件的其他人员；(7)本市持证三、四级精神、智力残疾人；
(8)本市困难职工家庭成员；(9)本市困难计划生育家庭特别扶助人员；(10)由所在单位或公安机关送往医疗机构进行住院治疗的本市户籍精神障碍患者；(11)经批准的特殊困难人员。
引人注意的是，精神病患者被列入了救助范围并作出详细规定。《办法》称，具有下列情形之一，由所在单位或公安机关送往医疗机构进行住院治疗的本市户籍精神障碍患者，且未享受《广州市医疗救助试行办法》、《广州市重特大疾病医疗救助试行办法》及本办法其他救助待遇的，其住院基本医疗费用个人自付部分扣除其他政府部门和社会资助后，按80%的比例救助：(一)已经发生伤害自身的行为，或者有伤害自身的危险的；(二)已经发生危害他人安全的行为，或者有危害他人安全的危险的。
各种救助总计最高额33万
在救助项目方面，门诊救助和住院救助几乎涵盖了大部分的病种。记者发现，艾滋病、抑郁症等也被囊括其中。
例如，困难群众在普通门诊(或急诊)治疗终末期肾病、肾病综合征、艾滋病机会性感染、精神分裂症、情感性精神病(狂躁发作、抑郁发作或双向障碍)以及急危重症孕产妇、儿童紧急救治项目的，其用药和诊疗项目符合商业保险医疗救助普通门诊目录规定的个人负担医疗费用(不含已按《广州市医疗救助试行办法》救助的门诊医疗费用)，按80%的比例予以救助，其中城镇“三无”人员和农村五保对象救助比例为100%。每一个商业保险医疗救助年度最高不超过1万元，当年累计，不滚存。
商业保险经办机构应根据政府有关要求，会同其他医疗救助机构共同组织心脏病、白血病、血友病等专项医疗救助，具体救助程序另行制订。
救助对象每一个商业保险医疗救助年度的最高医疗救助累计金额不超过15万元，当年累计，不跨年度使用。
在不久前的市政府常务会议新闻发布会上，市民政局副局长易利华透露，在广州已实施的《广州市医疗救助试行办法》、《广州市重特大疾病医疗救助试行办法》、《广州市资助困难人员参加社会医疗保险实施办法》等三大政策的基础上，一旦正式实施商业保险医疗救助，身患重大疾病的困难群众有望每年每人最高获33万元医疗救助。
其计算办法大致如下：申请广州市民基本医疗救助，最高额14万元/年；申请商业保险医疗救助，最高额15万元/年；申请慈善医疗救助，最高标准每人3万元/年；申领临时医疗救助，最高标准每人1万元/年。编辑： 何平
(原标题：穗精神病人被列入救助范围 相关办法昨日印发实施)
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