市医保局最新发布
<section style="margin-bottom: 0px;outline: 0px;font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;text-wrap: wrap;background-color: rgb(255, 255, 255);color: rgb(34, 34, 34);caret-color: rgba(0, 0, 0, 0);text-align: center;visibility: visible;line-height: normal;" data-mpa-powered-by="yiban.io"><span style="color: rgb(89, 89, 89); letter-spacing: 1px;">日前</span><br/></section><p></p><section data-role="outer" label="edit by 135editor" style="margin-bottom: 0px;outline: 0px;font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;background-color: rgb(255, 255, 255);visibility: visible;"><section style="text-align: center;line-height: 2em;"><span style="letter-spacing: 1px;color: rgb(89, 89, 89);">市医保局发布</span></section><section style="text-align: center;line-height: 2em;"><span style="letter-spacing: 1px;color: rgb(89, 89, 89);">十堰市基本医疗保险</span></section><section style="text-align: center;line-height: 2em;"><span style="letter-spacing: 1px;color: rgb(89, 89, 89);">门诊</span><span style="color: rgb(89, 89, 89);letter-spacing: 1px;font-size: var(--articleFontsize);">慢特病待遇及单独支付药品</span></section><section style="text-align: center;line-height: 2em;"><span style="letter-spacing: 1px;color: rgb(89, 89, 89);">备案经办服务指南</span></section><section data-tools="135编辑器" data-id="135393" style="outline: 0px;"><section style="margin: 10px auto;outline: 0px;"><section style="margin-bottom: 15px;outline: 0px;"><section style="margin-bottom: 10px;outline: 0px;display: flex;justify-content: flex-start;"><section style="outline: 0px;"><section style="padding: 4px 11px;outline: 0px;background-color: rgb(75, 150, 242);border-radius: 0px 10px;"><section style="outline: 0px;text-align: center;"><span style="outline: 0px;color: rgb(255, 255, 255);font-size: 17px;"><strong data-brushtype="text" style="outline: 0px;">一、门诊慢特病待遇申请人员范围</strong></span></section></section></section></section><section style="padding: 5px 10px;outline: 0px;background-color: rgb(245, 245, 245);border-radius: 0px 7px;"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 16px;color: rgb(51, 51, 51);background-color: transparent;"><p style="outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;font-size: 17px;color: rgb(89, 89, 89);">申请人应是十堰市城镇职工医疗保险、城乡居民医疗保险正常参保缴费，所患疾病在门诊慢特病病种清单范围内（见下表共37个病种），且符合门诊慢特病申请条件的人员。</span></p></section></section><section style="margin-top: -5px;outline: 0px;display: flex;justify-content: flex-end;"><section style="padding-right: 10px;outline: 0px;display: flex;align-items: center;"><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section></section></section></section><section style="margin-bottom: 15px;outline: 0px;"><section data-role="paragraph" style="outline: 0px;"><p style="outline: 0px;line-height: 1.5em;"></p><p style="margin-bottom: 20px;outline: 0px;text-align: center;line-height: 1.5em;"><span style="outline: 0px;font-size: 15px;color: rgb(63, 63, 63);">（点击可查看大图）</span></p></section><section style="margin-bottom: 10px;outline: 0px;display: flex;justify-content: flex-start;"><section style="outline: 0px;"><section data-width="85%" style="outline: 0px;max-width: 85%;width: 229.641px;height: 5px;background-color: rgb(255, 208, 131);border-radius: 0px 15px 0px 0px;overflow: hidden;"><br style="outline: 0px;"/></section><section style="padding: 4px 11px;outline: 0px;background-color: rgb(75, 150, 242);border-radius: 0px 10px;"><section style="outline: 0px;text-align: center;"><span style="outline: 0px;color: rgb(255, 255, 255);font-size: 17px;"><strong data-brushtype="text" style="outline: 0px;">二、门诊慢特病待遇实行分类管理</strong></span></section></section></section></section><section style="padding: 5px 10px;outline: 0px;background-color: rgb(245, 245, 245);border-radius: 0px 7px;"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 16px;color: rgb(51, 51, 51);background-color: transparent;"><section style="outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;font-size: 17px;letter-spacing: 1px;color: rgb(89, 89, 89);">门诊慢特病37个病种中，其中8个病种实行备案制管理（见下图），经二级及以上公立定点医疗机构明确诊断、参保人申请、医保经办人员查验材料符合办理条件的，按规定直接办理门诊慢特病病种待遇享受资格备案（定点医疗机构受理的，确认符合办理条件后及时推送医保经办机构备案），自备案审核通过之日开始享受待遇；其他29个病种实行准入制管理，参保人申请、经门诊慢特病鉴定专家鉴定、医保经办机构审核确认之日开始享受待遇。</span></section></section></section><section style="margin-top: -5px;outline: 0px;display: flex;justify-content: flex-end;"><section style="padding-right: 10px;outline: 0px;display: flex;align-items: center;"><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section></section></section><section data-role="paragraph" style="outline: 0px;"><p style="margin-top: 15px;outline: 0px;"></p><p style="margin-bottom: 20px;outline: 0px;text-align: center;line-height: 1.5em;"><span style="outline: 0px;font-size: 15px;color: rgb(63, 63, 63);">（点击可查看大图）</span></p></section></section><section style="margin-bottom: 10px;outline: 0px;display: flex;justify-content: flex-start;"><section style="outline: 0px;"><section data-width="85%" style="outline: 0px;max-width: 85%;width: 201.516px;height: 5px;background-color: rgb(255, 208, 131);border-radius: 0px 15px 0px 0px;overflow: hidden;"><br style="outline: 0px;"/></section><section style="padding: 4px 11px;outline: 0px;background-color: rgb(75, 150, 242);border-radius: 0px 10px;"><p style="outline: 0px;text-align: center;line-height: 2em;"><span style="outline: 0px;color: rgb(255, 255, 255);font-size: 17px;"><strong data-brushtype="text" style="outline: 0px;">三、门诊慢特病待遇申请途径</strong></span></p></section></section></section><section style="padding: 5px 10px;outline: 0px;background-color: rgb(245, 245, 245);border-radius: 0px 7px;"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 14px;color: rgb(51, 51, 51);background-color: transparent;"><p style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;letter-spacing: 1px;font-size: 17px;color: rgb(89, 89, 89);">1</span><span style="letter-spacing: 1px;font-size: 17px;"><span style="outline: 0px;color: rgb(51, 51, 51);font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 1.5px;text-indent: 34px;text-wrap: wrap;background-color: rgb(245, 245, 245);">.</span><span style="outline: 0px;color: rgb(56, 112, 232);"><strong style="outline: 0px;"><span style="outline: 0px;">线上途径：</span></strong></span></span><span style="outline: 0px;letter-spacing: 1px;font-size: 17px;color: rgb(89, 89, 89);">在“湖北医疗保障”微信小程序、“鄂医保”支付宝小程序等渠道提交门诊慢特病申请材料。</span></p><p style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;line-height: 1.75em;letter-spacing: 1px;font-size: 17px;color: rgb(89, 89, 89);">2</span><span style="outline: 0px;color: rgb(12, 12, 12);line-height: 1.75em;letter-spacing: 1px;font-size: 17px;"><span style="color: rgb(51, 51, 51);font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 1.5px;text-indent: 34px;text-wrap: wrap;background-color: rgb(245, 245, 245);">.</span><strong style="outline: 0px;"><span style="line-height: 1.75em;outline: 0px;color: rgb(56, 112, 232);">线下途径：</span></strong></span><span style="outline: 0px;line-height: 1.75em;letter-spacing: 1px;font-size: 17px;color: rgb(89, 89, 89);">全市二级及以上公立定点医疗机构医保窗口、各级政务服务大厅医保窗口等。</span></p><p style="outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;letter-spacing: 1px;font-size: 17px;color: rgb(89, 89, 89);">3</span><span style="letter-spacing: 1px;font-size: 17px;"><span style="outline: 0px;color: rgb(51, 51, 51);font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 1.5px;text-indent: 34px;text-wrap: wrap;background-color: rgb(245, 245, 245);">.</span><span style="outline: 0px;color: rgb(12, 12, 12);line-height: 1.75em;"><strong style="outline: 0px;"><span style="outline: 0px;line-height: 1.75em;color: rgb(56, 112, 232);">申请认定流程</span></strong></span></span><span style="outline: 0px;letter-spacing: 1px;font-size: 17px;color: rgb(89, 89, 89);">见《门诊慢特病待遇申请流程图》（见附件1)。</span></p></section></section><section style="margin-bottom: 15px;outline: 0px;line-height: 2em;"><section style="margin-top: -5px;outline: 0px;display: flex;justify-content: flex-end;"><section style="padding-right: 10px;outline: 0px;display: flex;align-items: center;"><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section></section></section></section></section></section><section style="margin-bottom: 15px;outline: 0px;line-height: 2em;"><section style="margin-bottom: 10px;outline: 0px;display: flex;justify-content: flex-start;"><section style="outline: 0px;"><section data-width="85%" style="outline: 0px;max-width: 85%;width: 257.75px;height: 5px;background-color: rgb(255, 208, 131);border-radius: 0px 15px 0px 0px;overflow: hidden;"><br style="outline: 0px;"/></section><section style="padding: 4px 11px;outline: 0px;background-color: rgb(75, 150, 242);border-radius: 0px 10px;"><section style="outline: 0px;text-align: center;"><span style="outline: 0px;color: rgb(255, 255, 255);font-size: 17px;"><strong data-brushtype="text" style="outline: 0px;">四、门诊慢特病待遇申请需提交的资料</strong></span></section></section></section></section></section><section style="padding: 5px 10px;outline: 0px;background-color: rgb(245, 245, 245);border-radius: 0px 7px;"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 16px;color: rgb(51, 51, 51);background-color: transparent;"><section style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;background-color: transparent;text-indent: 2em;font-size: 17px;color: rgb(89, 89, 89);">1.《门诊慢特病病种待遇认定申请表》（见附件2)；</span></section><section style="outline: 0px;text-indent: 2em;line-height: 2em;"><span style="font-size: 17px;color: rgb(89, 89, 89);">2.身份证或社保卡复印件；</span></section><section style="outline: 0px;text-indent: 2em;line-height: 2em;"><span style="font-size: 17px;color: rgb(89, 89, 89);">3.提供近3年内二级及以上公立定点医院出具的住院病历资料。包括：病历首页、出院小结、诊断证明及申请病种相关的理化检查检验报告等，并加盖经治医院病情证明章。</span></section></section></section><section style="margin: 10px auto;outline: 0px;line-height: 2em;"><section style="margin-top: -5px;outline: 0px;display: flex;justify-content: flex-end;"><section style="padding-right: 10px;outline: 0px;display: flex;align-items: center;"><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section></section></section></section><section style="margin-bottom: 15px;outline: 0px;line-height: 2em;"><section style="margin-bottom: 10px;outline: 0px;display: flex;justify-content: flex-start;"><section style="outline: 0px;"><section data-width="85%" style="outline: 0px;max-width: 85%;width: 201.516px;height: 5px;background-color: rgb(255, 208, 131);border-radius: 0px 15px 0px 0px;overflow: hidden;"><br style="outline: 0px;"/></section><section style="padding: 4px 11px;outline: 0px;background-color: rgb(75, 150, 242);border-radius: 0px 10px;"><section style="outline: 0px;text-align: center;"><span style="outline: 0px;color: rgb(255, 255, 255);font-size: 17px;"><strong data-brushtype="text" style="outline: 0px;">五、门诊慢特病待遇诊疗范围</strong></span></section></section></section></section></section><section style="padding: 5px 10px;outline: 0px;background-color: rgb(245, 245, 245);border-radius: 0px 7px;"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 16px;color: rgb(51, 51, 51);background-color: transparent;"><section style="outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;text-indent: 2.1875em;background-color: transparent;caret-color: red;font-size: 17px;letter-spacing: 1px;color: rgb(89, 89, 89);">与享受门诊慢特病病种临床诊疗规范相符的医保目录内的甲乙类药品、诊疗项目、医用材料等，丙类（自费）及非门诊慢特病病种相关的费用不得纳入门诊慢特病支付范围。乙类项目先行自付10%后，再按门诊慢特病待遇规定比例支付。</span></section></section></section><section style="outline: 0px;line-height: 2em;"><section style="margin-top: -5px;outline: 0px;display: flex;justify-content: flex-end;"><section style="padding-right: 10px;outline: 0px;display: flex;align-items: center;"><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section></section></section></section><section style="margin-bottom: 15px;outline: 0px;line-height: 2em;"><section style="margin-bottom: 10px;outline: 0px;display: flex;justify-content: flex-start;"><section style="outline: 0px;"><section data-width="85%" style="outline: 0px;max-width: 85%;width: 257.75px;height: 5px;background-color: rgb(255, 208, 131);border-radius: 0px 15px 0px 0px;overflow: hidden;"><br style="outline: 0px;"/></section><section style="padding: 4px 11px;outline: 0px;background-color: rgb(75, 150, 242);border-radius: 0px 10px;"><section style="outline: 0px;text-align: center;"><span style="outline: 0px;color: rgb(255, 255, 255);font-size: 17px;"><strong data-brushtype="text" style="outline: 0px;">六、享受门诊慢特病待遇人员异地就医</strong></span></section></section></section></section></section><section style="padding: 5px 10px;outline: 0px;background-color: rgb(245, 245, 245);border-radius: 0px 7px;"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 14px;color: rgb(51, 51, 51);background-color: transparent;"><section style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="font-size: 17px;letter-spacing: 1px;"><strong style="outline: 0px;text-indent: 2.1875em;background-color: transparent;caret-color: red;font-size: 16px;line-height: 1.75em;"><span style="font-size: 17px;outline: 0px;color: rgb(56, 112, 232);">省内：</span></strong></span><span style="outline: 0px;text-indent: 2.1875em;background-color: transparent;caret-color: red;font-size: 17px;letter-spacing: 1px;color: rgb(89, 89, 89);">所有门诊慢特病无需办理备案在省内门诊慢性病定点医药机构均能直接结算报销；</span></section><section style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="font-size: 17px;letter-spacing: 1px;"><strong style="outline: 0px;font-size: 16px;line-height: 1.75em;"><span style="font-size: 17px;outline: 0px;color: rgb(56, 112, 232);">跨省：</span></strong></span><span style="outline: 0px;font-size: 17px;letter-spacing: 1px;color: rgb(89, 89, 89);">省外门诊慢特病目前仅5个病种（高血压、糖尿病、恶性肿瘤门诊放化疗、尿毒症透析、器官移植术后抗排异）无需办理备案在当地门诊慢特病定点医药机构可直接结算报销。其他门诊慢特病都不能直接结算报销，需在年底将异地门诊慢特病定点医药机构发生的合规门诊资料（有效发票、处方）拿回参保地审核，实行手工报销。</span></section></section></section><section style="margin-bottom: 0px;outline: 0px;font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;text-wrap: wrap;background-color: rgb(255, 255, 255);line-height: 2em;"><section style="margin-top: -5px;outline: 0px;display: flex;justify-content: flex-end;"><section style="padding-right: 10px;outline: 0px;display: flex;align-items: center;"><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section></section></section></section><section style="margin-bottom: 15px;outline: 0px;line-height: 2em;"><section style="margin-bottom: 10px;outline: 0px;display: flex;justify-content: flex-start;"><section style="outline: 0px;"><section data-width="85%" style="outline: 0px;max-width: 85%;width: 201.516px;height: 5px;background-color: rgb(255, 208, 131);border-radius: 0px 15px 0px 0px;overflow: hidden;"><br style="outline: 0px;"/></section><section style="padding: 4px 11px;outline: 0px;background-color: rgb(75, 150, 242);border-radius: 0px 10px;"><section style="outline: 0px;text-align: center;"><span style="outline: 0px;color: rgb(255, 255, 255);font-size: 17px;"><strong data-brushtype="text" style="outline: 0px;">七、门诊慢特病待遇享受期限</strong></span></section></section></section></section></section><section style="padding: 5px 10px;outline: 0px;background-color: rgb(245, 245, 245);border-radius: 0px 7px;"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 16px;color: rgb(51, 51, 51);background-color: transparent;"><section style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;text-indent: 2.1875em;background-color: transparent;caret-color: red;font-size: 17px;letter-spacing: 1px;color: rgb(89, 89, 89);">对纳入门诊慢特病待遇保障范围的参保人员，待遇享受资格起始日期以医保经办机构批准当日开始计算；下表14个病种待遇享受资格截止日期不超过该病种规定的复审期限，其余23个病种待遇享受资格长期有效，脑瘫待遇享受资格至14周岁终结，儿童生长激素缺乏症待遇享受资格至18周岁终结。</span></section><section style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;font-size: 17px;letter-spacing: 1px;color: rgb(89, 89, 89);">有复审期限需要复审的病种应在规定复审期结束前6个月内申请复审，复审流程与申请病种流程一致，未在规定时间内提出复审申请的，复审期限截止后不再继续享受相应待遇，如因病情需要且符合病种范围及申请条件的需重新申请。复审流程与申请流程一致，复审所需资料须提供近一年内的住院病历资料。复审结果确定后，按照复审结果执行。</span></section></section></section><section style="margin: 10px auto;outline: 0px;line-height: 2em;"><section style="margin-top: -5px;outline: 0px;display: flex;justify-content: flex-end;"><section style="padding-right: 10px;outline: 0px;display: flex;align-items: center;"><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section></section></section></section><section data-role="paragraph" style="outline: 0px;"><section style="margin-top: 15px;outline: 0px;text-align: center;line-height: 2em;"><span style="outline: 0px;color: rgb(63, 63, 63);font-size: 17px;">（点击可查看大图）</span></section></section><section style="margin-bottom: 15px;outline: 0px;line-height: 2em;"><section style="margin-bottom: 10px;outline: 0px;display: flex;justify-content: flex-start;"><section data-role="paragraph" style="outline: 0px;"><p style="outline: 0px;"><br style="outline: 0px;"/></p></section><section data-role="paragraph" style="outline: 0px;"><p style="outline: 0px;"><br style="outline: 0px;"/></p></section><section style="outline: 0px;"><section data-width="85%" style="outline: 0px;max-width: 85%;width: 398.391px;height: 5px;background-color: rgb(255, 208, 131);border-radius: 0px 15px 0px 0px;overflow: hidden;"><br style="outline: 0px;"/></section><section style="padding: 4px 11px;outline: 0px;background-color: rgb(75, 150, 242);border-radius: 0px 10px;"><section style="outline: 0px;text-align: center;"><span style="outline: 0px;color: rgb(255, 255, 255);font-size: 17px;"><strong data-brushtype="text" style="outline: 0px;">八、医保关系转移或职工、居民参保身份转换门诊慢特病待遇</strong></span></section></section></section></section></section><section style="padding: 5px 10px;outline: 0px;background-color: rgb(245, 245, 245);border-radius: 0px 7px;"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 16px;color: rgb(51, 51, 51);background-color: transparent;"><section style="outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;text-indent: 2.1875em;background-color: transparent;caret-color: red;font-size: 17px;letter-spacing: 1px;color: rgb(89, 89, 89);">省内参保人员办理基本医疗保险关系转移接续（含职工、居民身份转换转移接续的）至本市的，其门诊慢特病病种待遇享受资格随参保关系一同转移，按转移后的参保身份接续享受门诊慢特病待遇，年度内不得重复享受同一病种待遇。</span></section></section></section><section style="outline: 0px;line-height: 2em;"><section style="margin-top: -5px;outline: 0px;display: flex;justify-content: flex-end;"><section style="padding-right: 10px;outline: 0px;display: flex;align-items: center;"><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section></section></section></section><section style="margin-bottom: 15px;outline: 0px;line-height: 2em;"><section style="margin-bottom: 10px;outline: 0px;display: flex;justify-content: flex-start;"><section style="outline: 0px;"><section data-width="85%" style="outline: 0px;max-width: 85%;width: 342.125px;height: 5px;background-color: rgb(255, 208, 131);border-radius: 0px 15px 0px 0px;overflow: hidden;"><br style="outline: 0px;"/></section><section style="padding: 4px 11px;outline: 0px;background-color: rgb(75, 150, 242);border-radius: 0px 10px;"><section style="outline: 0px;text-align: center;"><span style="outline: 0px;color: rgb(255, 255, 255);font-size: 17px;letter-spacing: 1px;"><strong data-brushtype="text" style="outline: 0px;">九、门诊慢特病鉴定定点医疗机构及可受理鉴定病种</strong></span></section></section></section></section></section><section style="padding: 5px 10px;outline: 0px;background-color: rgb(245, 245, 245);border-radius: 0px 7px;"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 16px;color: rgb(51, 51, 51);background-color: transparent;"><section style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="font-size: 17px;outline: 0px;letter-spacing: 1px;color: rgb(89, 89, 89);">全市门诊慢特病二级及以上公立定点医疗机构，可受理鉴定病种明细清单见《十堰市门诊慢特病鉴定定点医疗机构受理病种清单》（见附件3）。</span></section></section></section><section style="margin-bottom: 0px;outline: 0px;font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;text-wrap: wrap;background-color: rgb(255, 255, 255);line-height: 2em;"><section style="margin-top: -5px;outline: 0px;display: flex;justify-content: flex-end;"><section style="padding-right: 10px;outline: 0px;display: flex;align-items: center;"><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section><section style="margin-right: 3px;margin-left: 3px;outline: 0px;width: 0px;height: 1px;border-top: 4px solid transparent;border-bottom: 4px solid transparent;border-left: 7px solid rgb(255, 208, 131);overflow: hidden;"><br style="outline: 0px;"/></section></section></section></section><section style="outline: 0px;line-height: 2em;"><section style="margin-bottom: 10px;outline: 0px;display: flex;justify-content: flex-start;"><section style="outline: 0px;"><section data-width="85%" style="outline: 0px;max-width: 85%;width: 229.641px;height: 5px;background-color: rgb(255, 208, 131);border-radius: 0px 15px 0px 0px;overflow: hidden;"><br style="outline: 0px;"/></section><section style="padding: 4px 11px;outline: 0px;background-color: rgb(75, 150, 242);border-radius: 0px 10px;"><section style="outline: 0px;text-align: center;"><span style="outline: 0px;color: rgb(255, 255, 255);font-size: 17px;"><strong data-brushtype="text" style="outline: 0px;">十、门诊慢特病待遇申请办结时间</strong></span></section></section></section></section></section><section style="padding: 5px 10px;outline: 0px;background-color: rgb(245, 245, 245);border-radius: 0px 7px;"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 16px;color: rgb(51, 51, 51);background-color: transparent;"><section style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="font-size: 17px;outline: 0px;color: rgb(89, 89, 89);">参保人员享受门诊慢特病病种待遇认定应在20个工作日内办结</span><span style="font-size: 17px;outline: 0px;color: rgb(12, 12, 12);">。</span></section></section></section><section data-role="paragraph" style="outline: 0px;"><section style="outline: 0px;line-height: 2em;"><br/></section></section><section style="margin-bottom: unset;outline: 0px;letter-spacing: 0.544px;visibility: visible;line-height: 2em;"><section style="margin-bottom: 10px;outline: 0px;display: flex;justify-content: flex-start;"><section style="outline: 0px;"><section data-width="85%" style="outline: 0px;max-width: 85%;width: 229.641px;height: 5px;background-color: rgb(255, 208, 131);border-radius: 0px 15px 0px 0px;overflow: hidden;"><br style="outline: 0px;"/></section><section style="padding: 4px 11px;outline: 0px;background-color: rgb(75, 150, 242);border-radius: 0px 10px;"><section style="outline: 0px;text-align: center;"><span style="outline: 0px;color: rgb(255, 255, 255);font-size: 17px;"><strong data-brushtype="text" style="outline: 0px;">十一、单独支付药品申请备案程序</strong></span></section></section></section></section></section><section style="padding: 5px 10px;outline: 0px;background-color: rgb(245, 245, 245);border-radius: 0px 7px;"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 16px;color: rgb(51, 51, 51);background-color: transparent;"><p style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;text-indent: 2.1875em;background-color: transparent;caret-color: red;font-size: 17px;letter-spacing: 1px;color: rgb(89, 89, 89);">参保人员在三级定点医疗机构（含异地公立三级定点医疗机构，县市区以对外公布的单独支付药品鉴定定点医疗机构为准 ）就诊时，根据用药条件由双通道责任医师提出用药资格建议，指导填写《湖北省单独支付药品用药申请表》，提供临床诊断依据，提出治疗用药方案，经责任医师签字后交本医疗机构医保管理部门认定盖章，将符合条件的参保人员登记存档，将签字盖章的申请表及身份相关信息传递至医保经办机构备案，参保人可通过两个途径向医保经办机构提交备案申请。</span></p><p style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;font-size: 17px;letter-spacing: 1px;color: rgb(89, 89, 89);">1.线上途径：参保人可通过“湖北医疗保障”微信小程序、“鄂医保”支付宝小程序等渠道向医保经办机构提交备案申请；</span></p><p style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;font-size: 17px;letter-spacing: 1px;color: rgb(89, 89, 89);">2.线下途径：参保人可向各级政务服务大厅医保窗口提交备案申请；</span></p><p style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;font-size: 17px;letter-spacing: 1px;color: rgb(89, 89, 89);">3.提交备案申请资料包括：①由定点医疗机构双通道责任医师签字、医院医保管理部门认定盖章的《湖北省单独支付药品用药申请表》（见附件4)；②医保电子凭证或有效身份证件或社保卡。</span></p><p style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;font-size: 17px;letter-spacing: 1px;color: rgb(89, 89, 89);">4.医保经办机构受理备案申请资料后进行审核（终审），自审核（终审）之日开始享受待遇。</span></p><p style="margin-bottom: 5px;outline: 0px;text-indent: 2.1875em;line-height: 2em;"><span style="outline: 0px;font-size: 17px;letter-spacing: 1px;color: rgb(89, 89, 89);">5.申请流程见《双通道定点医疗机构用药资格备案办理流程图》（见附件5)</span></p></section></section><section data-role="paragraph" style="margin-bottom: 0px;outline: 0px;font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;text-wrap: wrap;background-color: rgb(255, 255, 255);"><section data-id="102749" data-tools="135编辑器" style="outline: 0px;"><section style="margin: 10px auto;outline: 0px;text-align: center;height: 0px;overflow: hidden;line-height: 2em;"><br/></section></section><section style="outline: 0px;line-height: 2em;"><section style="padding-bottom: 10px;outline: 0px;display: flex;justify-content: center;"><section style="outline: 0px;width: 35px;"></section></section></section></section><section data-role="paragraph" style="margin-bottom: 0px;outline: 0px;font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;text-wrap: wrap;background-color: rgb(255, 255, 255);"><section style="outline: 0px;line-height: 2em;"><section style="margin: 10px auto;outline: 0px;display: flex;justify-content: flex-start;"><section style="padding-right: 10px;outline: 0px;flex-shrink: 0;display: flex;align-items: center;"><section style="margin-left: 5px;outline: 0px;"><section style="outline: 0px;width: 5px;height: 9px;background-color: rgb(39, 191, 255);overflow: hidden;transform: skew(45deg);"><br style="outline: 0px;"/></section><section style="outline: 0px;width: 5px;height: 9px;background-color: rgb(39, 191, 255);overflow: hidden;transform: skew(-45deg);"><br style="outline: 0px;"/></section></section><section style="margin-left: 5px;outline: 0px;"><section style="outline: 0px;width: 5px;height: 9px;background-color: rgb(39, 191, 255);overflow: hidden;transform: skew(45deg);"><br style="outline: 0px;"/></section><section style="outline: 0px;width: 5px;height: 9px;background-color: rgb(39, 191, 255);overflow: hidden;transform: skew(-45deg);"><br style="outline: 0px;"/></section></section></section><section style="outline: 0px;display: flex;"><section style="padding-right: 15px;padding-left: 15px;outline: 0px;font-size: 16px;color: rgb(255, 255, 255);background-color: rgb(55, 134, 230);line-height: 32px;"><span style="font-size: 17px;"><strong data-brushtype="text" style="outline: 0px;">附件</strong></span></section><section style="outline: 0px;flex-shrink: 0;display: flex;align-items: center;"><section style="outline: 0px;width: 0px;height: 1px;border-left: 14px solid rgb(55, 134, 230);border-top: 16px solid transparent;border-bottom: 16px solid transparent;overflow: hidden;"><br style="outline: 0px;"/></section></section></section></section></section><section style="padding: 5px 10px;outline: 0px;background-color: rgb(245, 245, 245);border-radius: 0px 7px;"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 16px;background-color: transparent;"><section style="margin-bottom: 5px;outline: 0px;color: rgb(51, 51, 51);text-indent: 0em;line-height: 2em;"><span style="outline: 0px;background-color: transparent;caret-color: red;font-size: 17px;color: rgb(89, 89, 89);">1.《门诊慢特病待遇申请流程图》（附件1)</span></section><p style="margin-bottom: 5px;outline: 0px;color: rgb(51, 51, 51);text-indent: 0em;line-height: 1.5em;"><span style="outline: 0px;background-color: transparent;caret-color: red;color: rgb(12, 12, 12);"></span></p><p style="margin-bottom: 20px;outline: 0px;text-align: center;color: rgb(51, 51, 51);text-indent: 0em;line-height: 1.5em;"><span style="outline: 0px;background-color: transparent;caret-color: red;font-size: 15px;color: rgb(63, 63, 63);">（点击可查看大图）</span></p><p style="outline: 0px;color: rgb(51, 51, 51);"><span style="outline: 0px;color: rgb(12, 12, 12);">2.<a class="weapp_text_link js_weapp_entry wx_tap_link js_wx_tap_highlight" data-miniprogram-appid="wx5c9674e6177b0f6a" data-miniprogram-path="file/down?id=9b35502120334309bc841a4440704e40" data-miniprogram-applink="" data-miniprogram-nickname="小正方助手" data-miniprogram-type="text" data-miniprogram-servicetype="" style="padding-right: 0px;padding-left: 0px;outline: 0px;color: var(--weui-LINK);cursor: pointer;font-size: 16px;" href>《门诊慢特病病种待遇认定申请表》（附件2)</a></span></p><p draggable="true" style="outline: 0px;color: rgb(51, 51, 51);"><span style="outline: 0px;color: rgb(12, 12, 12);">3.<a class="weapp_text_link js_weapp_entry wx_tap_link js_wx_tap_highlight" data-miniprogram-appid="wx5c9674e6177b0f6a" data-miniprogram-path="file/down?id=722122d8888944c78988889eeade6d31" data-miniprogram-applink="" data-miniprogram-nickname="小正方助手" data-miniprogram-type="text" data-miniprogram-servicetype="" style="padding-right: 0px;padding-left: 0px;outline: 0px;color: var(--weui-LINK);cursor: pointer;font-size: 16px;" href>十堰市门诊慢特病鉴定定点医疗机构受理病种清单（附件3)</a></span></p><p style="outline: 0px;color: rgb(51, 51, 51);"><span style="outline: 0px;color: rgb(12, 12, 12);">4.<a class="weapp_text_link js_weapp_entry wx_tap_link js_wx_tap_highlight" data-miniprogram-appid="wx5c9674e6177b0f6a" data-miniprogram-path="file/down?id=67ddcc7c018c48adaec9fb220f29ddf3" data-miniprogram-applink="" data-miniprogram-nickname="小正方助手" data-miniprogram-type="text" data-miniprogram-servicetype="" style="padding-right: 0px;padding-left: 0px;outline: 0px;color: var(--weui-LINK);cursor: pointer;font-size: 16px;" href>《湖北省单独支付药品用药申请表》（附件4)</a></span></p><p style="outline: 0px;color: rgb(51, 51, 51);"><span style="outline: 0px;color: rgb(89, 89, 89);">5.《双通道定点医疗机构用药资格备案办理流程图》（附件5)</span></p><p style="outline: 0px;color: rgb(51, 51, 51);"><span style="outline: 0px;color: rgb(12, 12, 12);"></span></p></section></section></section><section data-role="paragraph" style="margin-bottom: unset;outline: 0px;visibility: visible;"><br/></section><h2 style="margin-bottom: 0em;outline: 0px;font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;text-wrap: wrap;background-color: rgb(255, 255, 255);color: rgb(34, 34, 34);letter-spacing: 2px;widows: 1;text-align: right;caret-color: rgb(255, 0, 0);min-height: 1em;line-height: 1.75em;vertical-align: inherit;"><hr style="outline: 0px;color: rgb(96, 92, 92);font-family: -apple-system-font, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;text-align: center;visibility: visible;"/><section style="outline: 0px;text-align: left;letter-spacing: 0.544px;visibility: visible;line-height: 1.6em;"><span style="outline: 0px;color: rgb(136, 136, 136);font-size: 15px;letter-spacing: 0.544px;text-align: justify;">来源 | 十堰医保</span></section></h2></section><p></p><p style="display: none;"><mp-style-type data-value="3"></mp-style-type></p><p><br/></p><link rel="stylesheet" href="//www.hbrdcm.com/source/plugin/wcn_editor/public/wcn_editor_fit.css?v134_ZsF" id="wcn_editor_css"/>
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