关于与泛珠三角区域建立医保异地就医结算的设想.pdfVIP

《申国E生经济》第 28 卷第9 期(总第 319 期) 2∞9 :1f 9 月 关于与泛珠三角区域建立医保异地就医结算的设想 蕾安辉b，自志勤易，韩英伟2 摘 要: 9+2 区域是指泛珠三角区域。我国三大医保主要是指城镇职工基本医疗保险、城镇居民基本医疗保 险和新型农村合作医疗。按现行医保制度规定，参保人员异地就医，常先在参保地申请并指定异地就医的医疗机构， 医药费用回参保地报销。随着人口流动的加剧，特别是异地工作的农民工，报销十分不使。异地医保就医结算问题不 解决，将制约市场经济下的人才流动，进而影响地区经济发展，应尽快推行异地就医、联网结算模式。总体思 路:整体规划，分步实施，联网结算。整体规划的前提是实现区域内联网结算(一卡通)。旅行异地就医结算改革需 分 3 步走: (1)省区间协议确定互相认可的定点医院; (2) 委托代理异地就医服务及结算; (3) 联网管理，实现 一卡通 关键词:参保;异地;一卡通 中图分类号: F840.684 文献标识码:A 文章编号: 1 ∞3-0743(2∞9)09-0056-02 Envisagement about Practise of Medical Accounts Settling for Insuned Intercity Clients in Regions/CAO An-h时， BAI Zhi-qin, HAN Ying-we i// Chinese Health Economics, 2009 ,28(9): 56-57 Abstract: Nine plus two 陀gions include the area known as the Zhujiang triangle. China s three major medical health insurance providers refer to stafI members , residents and the new Medicare cooperation from the countryside. Under the cuπent health insurance system, the insu陀d persons must apply to the insurance agency which they had joined previously in their local area; at a designated medical institution. If they need medical treatment in different places they must submit their medical expenses account to the insurance agency. With an increasingly 110ating population , it is very inconvenient for reimbursement of medical expenses, especially to the migrant workers. It will constrain the 110w of talent within the market economy if the issue of settling accounts for intercity insured c1 ients is not solved and will thereby affect economic development in the regions.ηle mode of medical t陀atment for intercity c1ients and networking medical account settlement should be carried oul as soon 描 possible. 白le general idea: overall planning , impl