淄博市统一医疗保障经办服务办事指南

                          目   录

 

一、职工医疗保障························································1

1.医疗保险参保登记····················································2

1.1单位基本医疗保险参保登记······································2 

1.2职工基本医疗保险参保登记······································6

1.3灵活就业人员基本医疗保险参保登记·························10

1.4单位变更登记·······················································14 

2.医疗保险关系转移接续·············································18 

  2.1医疗保险关系转出··············································18 

  2.2医疗保险关系转入··············································23 

3.参保缴费信息查询···················································28 

  3.1单位参保缴费信息查询········································28 

  3.2个人参保缴费信息（个人权益记录）查询···················32 

4.医疗保险个人账户一次性支付····································36 

5.参保地就医持卡联网结算··········································40 

6.异地就医备案·························································43 

  6.1长期异地就医备案··············································43 

  6.2转外就医备案····················································47 

  6.3异地急诊转住院联网备案·····································53 

7.医疗费用手工报销···················································57 

  7.1长期异地就医备案人员住院医疗费用手工报销··········57 

  7.2长期异地就医备案人员门诊慢性病医疗费用手工报销·····62 

  7.3转外就医医疗费用手工报销 ································66

8.门诊慢特病病种待遇认定··········································71 

9.生育保险待遇核准支付·············································76 

9.1生育医疗费支付·················································76 

9.2计划生育医疗费支付···········································81 

9.3生育津贴支付····················································85 

10.医疗救助对象手工（零星）报销·································89 

二、城乡居民医疗保障·················································93 

1.医疗保险参保登记···················································94

1.1城乡居民基本医疗保险参保登记····························94 

1.2学生基本医疗保险参保登记··································98 

2.参保地就医持卡联网结算········································102 

3.异地就医备案·······················································105 

3.1长期异地就医备案············································105 

3.2转外就医备案··················································109 

3.3异地急诊转住院联网备案···································115 

4.医疗费用手工报销·················································119 

4.1长期异地就医备案人员住院医疗费用手工报销········119 

4.2长期异地就医备案人员门诊慢性病医疗费用手工报销·124 

4.3转外就医医疗费用手工报销································128 

5.门诊慢特病病种待遇认定········································133 

6.生育医疗费支付····················································138 

7.医疗救助对象手工（零星）报销··································142 

三、协议定点医药机构···············································146 

1.新增协议定点医药机构···········································147 

2.基本医疗保险定点医疗机构费用结算·························152 

3.基本医疗保险定点零售药店费用结算·························157

 

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