Guarantee Measures of Medical Treatment for Special-care Recipients

优抚对象医疗保障办法

Promulgating Institution: Ministry of Civil Affairs; Ministry of Finance; Ministry of Labour and Social Security; Ministry of Health

Document Number: Min Fa [2007] No. 101

Promulgating Date: 07/06/2007

Effective Date: 07/06/2007

颁布机关: 民政部; 财政部; 劳动和社会保障部; 卫生部

文      号: 民发[2007]101号

颁布时间: 07/06/2007

实施时间: 07/06/2007

  Article 1   For the purposes of guaranteeing the medical treatment for special-care recipients and practically settling their medical difficulties, these Measures are promulgated in accordance with the Regulations on Pensions and Preferential Treatment for Servicemen and other relevant regulations.  

       第一条  为保障优抚对象医疗待遇,切实解决优抚对象医疗困难问题,根据《军人抚恤优待条例》和其他有关规定,制定本办法。

  Article 2   These Measures shall be applicable to the disabled servicemen retired from service, demobilized servicemen staying at their native places, the veterans returned to their native places due to illness, and martyr dependents, the dependents of the servicemen sacrificed in course of duty, the dependents of the servicemen died of illness and retired servicemen who had joined battle who are entitled to State pensions, subsidies and living subsidies. For the purpose of these Measures, the above-mentioned recipients other than servicemen of disability of grade one to six shall mean other special-care recipients.  

       第二条  本办法适用于退出现役的残疾军人、在乡复员军人、带病回乡退伍军人,以及享受国家抚恤和生活补助的烈士遗属、因公牺牲军人遗属、病故军人遗属、参战退役人员。以上对象除一至六级残疾军人外,在本办法中简称其他优抚对象。

  Article 3   Special-care recipients shall participate in basic medical insurance for urban employees, basic medical insurance for urban residents, new rural cooperative medical system, or any other urban and rural medical security system based on the territorial principle. A medical subsidy system aiming at special-care recipients shall be established and the security level of the system shall adapt to the economic development level and financial bearing ability of local places. At the same time the level of current medical treatment that special-care recipients are entitled to shall not be lowered; preferential medical service shall be granted to special-care recipients.

       第三条  优抚对象按照属地原则相应参加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等城乡基本医疗保障制度;建立优抚对象医疗补助制度,保障水平应与当地经济发展水平和财政负担能力相适应,并保证优抚对象现有医疗待遇不降低;给予优抚对象医疗服务优惠和照顾。

  Article 4   The State shall guarantee the medical expenses of servicemen of disability of grade one to six. These servicemen shall be under the coverage of basic medical insurance for urban employees, on the basis of which they are entitled to medical subsidy for special-care recipients. With regard to specific measures, the Notice of the Ministry of Civil Affairs, the Ministry of Finance and the Ministry of Labor and Social Security on Printing and Circulating the Guarantee Measures of Medical Treatment for Servicemen of Disability of Grade one to Six (Min Fa [2005] No. 199) shall be applicable.

       第四条  国家对一至六级残疾军人的医疗费用予以保障。一至六级残疾军人参加城镇职工基本医疗保险,并在此基础上享受优抚对象医疗补助,具体办法按照《民政部、财政部、劳动和社会保障部关于印发〈一至六级残疾军人医疗保障办法〉的通知》(民发〔2005〕199号)规定执行。

  Article 5   Other special-care recipients employed at urban areas shall participate in basic medical insurance for urban employees and pay their insurance in accordance with regulations. Local government shall urge employers of the special-care recipients to pay and participate in insurance in accordance with regulations. Where an employer truly has difficulty in doing so, assistance shall be provided to the employer to participate in the insurance by raising fund through various local channels. 

       第五条  在城镇就业的其他优抚对象,参加城镇职工基本医疗保险,按规定缴费。地方政府应督促优抚对象所在单位按规定缴费参保,所在单位确有困难的,各地应通过多渠道筹资帮助其参保。

  Article 6   Other urban special-care recipients that are not under the coverage of basic medical insurance system for urban employees may participate in basic medical insurance for urban residents; other special-care recipients who reside at rural areas shall participate in new rural cooperative medical insurance. With regard to those who truly have difficulties, civil affairs departments at their places of residence shall assist them in paying and participating in insurance through urban and rural medical assistance fund and other ways. 

       第六条  不属于城镇职工基本医疗保险制度范围内的城镇其他优抚对象,可按规定参加城镇居民基本医疗保险;居住在农村的其他优抚对象,参加新型农村合作医疗。对确有困难的,由优抚对象所在地民政部门通过城乡医疗救助基金等帮助其缴费参保。

  Article 7   Other special-care recipients who have not participated in basic medical insurance for urban employees, basic medical insurance for urban residents, new rural cooperative medical insurance or another basic medical security system and those who have participated in one of the above-mentioned basic medical security systems, but have comparatively heavy burden of individual medical expenses shall be entitled to urban and rural medical assistance and medical subsidy for special-care recipients. 

       第七条  未参加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等基本医疗保障制度的,以及参加上述基本医疗保障制度但个人医疗费用负担较重的其他优抚对象,享受城乡医疗救助和优抚对象医疗补助。

  Article 8   All places shall raise a medical subsidy fund for special-care recipients through financial budget arrangement, public welfare funds of welfare lottery, social donation and other channels. Destinations of such subsidy fund shall be: medical subsidy for servicemen of disability of grade one to six; with regard to the medical expenses within specified limit, under the minimum payment standard, over the maximum payment limit and the medical expenses partly paid by individuals, proper subsidies shall be granted; with regard to the medical expenses out of the recurrence of previous injuries of servicemen of disability of grade seven to ten whose employers are unable to pay insurance or who are jobless, subsidies shall be granted; with regard to other special-care recipients who have not participated in basic medical insurance for urban employees, basic medical insurance for urban residents, new rural cooperative medical insurance or those who have comparatively heavy burden of individual medical expenses though being entitled to medical treatment in accordance with regulations of urban and rural basic medical security systems, subsidies shall be granted. 

Central finance shall grant adequate subsidy to difficult areas with comparatively large number of special-care recipients.

       第八条  各地应通过财政预算安排、福利彩票公益金,以及吸收社会捐赠等多种渠道,筹集优抚对象医疗补助资金,主要用于:一至六级残疾军人医疗补助,对规定范围内的、起付标准以下、最高支付限额以上,以及个人共付的医疗费用给予适当补助;对所在单位无力支付和无工作单位的七至十级残疾军人旧伤复发的医疗费用给予补助;对未参加城镇职工基本医疗保险、城镇居民基本医疗保险、新型农村合作医疗以及享受城乡基本医疗保障制度规定待遇后个人医疗费用负担较重的其他优抚对象给予补助。

    中央财政对优抚对象人数较多的困难地区给予适当补助。

  Article 9   The medical expenses arising out of the recurrence of previous injuries of servicemen of disability of grade seven to ten who have participated in occupational injury insurance shall be paid by occupational injury insurance fund; the equal medical expenses of those who have not participated in occupational injury insurance, where they are employed, shall be paid by their employers; where the employers are unable to pay or where they are jobless, the medical expenses shall be paid through the medical subsidy fund for special-care recipients by the local governments. 

       第九条  七至十级残疾军人旧伤复发的医疗费用,已经参加工伤保险的,由工伤保险基金支付;未参加工伤保险的,有工作的由工作单位解决;所在单位无力支付和无工作单位的,由当地政府从优抚对象医疗补助资金中解决。

  Article 10   The special-care recipients shall be entitled to priorities in registration, receiving medical diagnosis and treatment, getting drugs and hospitalization by presenting their certificates when seeking medical service at medical institutions; relevant departments shall support, encourage and direct medical institutions to voluntarily deduct and exempt corresponding medical service charges. 

       第十条  优抚对象到医疗机构就医时凭证件优先挂号、优先就诊、优先取药、优先住院;支持、鼓励和引导医疗机构自愿减免有关医疗服务费用。

  Article 11   Medical institutions shall publicize their preferential and priority medical service items for special-care recipients; they shall improve and implement all diagnosis and treatment specifications and management system, conducting reasonable examination, medication and charging. Appointed medical institutions shall, based on specified drug catalogue, catalogue of diagnosis and treatment items and catalogue of medical service facilities, provide medical service for special-care recipients. 

       第十一条  医疗机构应公开对优抚对象优先、优惠的医疗服务项目;应完善并落实各项诊疗规范和管理制度,合理检查、合理用药、合理收费。定点医疗机构应按照规定的用药目录、诊疗项目目录和医疗服务设施目录为优抚对象提供医疗服务。

  Article 12   The departments of civil affairs, finance, labor security, health and other relevant departments shall be responsible for carrying out the management and organizing the implementation of medical security work for special-care recipients; all departments concerned shall closely cooperate and practically perform their respective duties. 

       第十二条  优抚对象医疗保障工作由民政、财政、劳动保障、卫生等部门管理并组织实施,各部门应密切配合,切实履行各自职责。

  Article 13   Departments of civil affairs shall incorporate eligible special-care recipients in the urban and rural medical assistance system; they shall handle, in a unified manner, the formalities of jobless servicemen of disability of grade one to six participating in basic medical insurance for urban employees; they shall coordinate relevant departments to study upon and deal with the specific problems occurring in medical security work; they shall budget annual medical subsidy fund for special-care recipients in accordance with the requirements of budget management and submit the budget plan to financial departments at equal level for examination and verification; they shall adopt effective measures to make sure that special medical subsidy fund for special-care recipients is used for designated purposes.

       第十三条  民政部门应将符合条件的优抚对象纳入城乡医疗救助制度;统一办理无工作单位一至六级残疾军人参加城镇职工基本医疗保险等手续;协调有关部门研究处理医疗保障工作中遇到的具体问题;按预算管理要求编制年度优抚对象医疗补助资金预算,报同级财政部门审核;采取有效措施,确保优抚对象医疗补助资金专款专用。

  Article 14   A financial department shall reasonably arrange the medical subsidy fund for special-care recipients and, in conjunction with relevant departments, strengthen fund management, supervision and inspection. Management measures for medical subsidy fund for special-care recipients shall be separately formulated by the Ministry of Finance, the Ministry of Civil Affairs, the Ministry of Labor Security and the Ministry of Health.

       第十四条  财政部门应合理安排优抚对象医疗补助资金,并会同有关部门加强资金管理和监督检查。优抚对象医疗补助资金管理办法,由财政部、民政部、劳动保障部、卫生部另行制定。

  Article 15   A labor security department shall incorporate eligible special-care recipients into basic medical insurance for urban employees and basic medical insurance for urban residents; the labor security department shall properly handle the management work of medical insurance service regarding special-care recipients under the coverage of insurance, and guarantee in accordance with regulations that special-care recipients under the coverage of insurance be entitled to corresponding medical insurance treatment.

       第十五条  劳动保障部门应将符合条件的优抚对象纳入城镇职工基本医疗保险、城镇居民基本医疗保险;做好已参保优抚对象的医疗保险服务管理工作,按规定保障参保优抚对象享受相应的医疗保险待遇。

  Article 16   A health department shall incorporate eligible special-care recipients into new rural cooperative medical system; the health department shall organize medical institutions to provide quality medical service for special-care recipients; the health department shall also strengthen its supervision and management over medical institutions, regulating their medical service, enhancing their service quality and ensuring medical safety; the health department shall support, encourage and direct medical institutions to formulate relevant preferential service policies and implement quality service measures.

       第十六条  卫生部门应将符合条件的优抚对象纳入新型农村合作医疗;组织医疗机构为优抚对象提供优质医疗服务;加强对医疗机构的监督管理,规范医疗服务,提高服务质量,保障医疗安全;支持、鼓励和引导医疗机构制定相关优惠服务政策,落实优质服务措施。

  Article 17   Organizations and individuals concerned shall truthfully provide necessary information and make active cooperation in the investigation and verification of medical security work of special-care recipients.

       第十七条  有关单位、组织和个人应如实提供所需情况,积极配合优抚对象医疗保障工作的调查核实。

  Article 18   Departments of civil affairs, finance, labor and social security, and health of all provinces, autonomous regions and municipalities directly under the Central Government shall formulate specific implementing measures in accordance with these Measures and by considering the actual situation of their own places to practically ensure the implementation of medical treatment for special-care recipients. A Special-care recipient in double or multiple statuses shall be entitled to medical treatment in accordance with his or her most advantageous status.

       第十八条  各省、自治区、直辖市民政、财政、劳动和社会保障、卫生部门应根据本办法并结合本地区实际制定具体实施办法,切实保障优抚对象医疗待遇的落实。具有双重或多重身份的优抚对象,按照就高原则享受医疗待遇。

  Article 19   For the purpose of these Measures, the retired servicemen who had joined battle shall mean the personnel who had enlisted in the army after November 1, 1954 and had taken part in armed attacks or military actions against enemies for the purposes of resisting foreign invasion, accomplishing the unification of China, defending the integrity of China's territory and sovereignty, guarding State safety, and now have retired from military service, reside in rural areas or urban areas, but are staying jobless and have family living difficulties.  

       第十九条  本办法所称参战退役人员,是指1954年11月1日以后入伍并参加过为抵御外来侵略、完成祖国统一、捍卫国家领土和主权完整、保卫国家安全而进行的武力打击或抗击敌方的军事行动,迄今已经从军队退役的在农村的和城镇无工作单位且家庭生活困难的人员。

  Article 20   The Ministry of Civil Affairs, in conjunction with the Ministry of Finance, the Ministry of Labor and Social Security and the Ministry of Health, shall be responsible for the interpretation of these Measures.

       第二十条  本办法由民政部会同财政部、劳动和社会保障部、卫生部解释。