A, within the administrative area of this Municipality, all kinds of full-time ordinary colleges and universities (including private colleges and universities), scientific research institutes (hereinafter referred to as colleges and universities) receive full-time undergraduate, junior college students and graduate students (hereinafter referred to as college students), in accordance with the principle of territorial management and voluntariness, unified into the basic medical insurance for urban residents in this Municipality (hereinafter referred to as urban medical insurance). These measures are not applicable to foreign students studying in Hangzhou.
Two, college students living in urban medical insurance to implement municipal co-ordination, enjoy the treatment of inpatient and outpatient medical insurance. The medical security of college students' general outpatient service will continue to be implemented in accordance with the existing regulations.
Encourage college students to participate in commercial supplementary medical insurance on the basis of participating in urban medical insurance to improve the level of medical security.
Article 3 The municipal labor and social security administrative department is in charge of medical insurance for college students in Hangzhou, and the Municipal Medical Insurance Management Service Bureau (hereinafter referred to as the medical insurance agency) is specifically responsible for the implementation of these Measures. Colleges and universities in Hangzhou should cooperate with medical insurance agencies to do a good job in promoting medical insurance policies for college students, paying insurance premiums, issuing cards and other related work.
Education, finance, health, civil affairs and other departments in accordance with their respective responsibilities, coordinate the implementation of these measures.
Four, the establishment of urban medical insurance fund for college students. The overall fund consists of individual student contributions, financial subsidies and social donations. The urban medical insurance co-ordination fund for college students is used to pay the hospitalization and outpatient medical expenses for specific diseases that meet the scope of medical insurance expenses and should be borne by the urban medical insurance co-ordination fund for college students.
Five, college students' urban medical insurance fund into the financial accounts management, earmarking, no unit or individual may misappropriate. The financial and auditing departments shall regularly supervise and audit the collection, management and use of urban medical insurance funds for college students.
Six, college students live in the city of medical insurance premiums paid annually, the payment standard is per person per year 120 yuan, of which college students pay 30 yuan, financial assistance to 90 yuan; Students who hold the People's Republic of China (PRC) Disabled Persons' Card issued by the civil affairs departments at or above the county level (hereinafter referred to as the Disabled Persons' Card) or the Difficult Family Assistance Card (including the minimum living allowance, hereinafter referred to as the Difficult Card) shall be fully subsidized by the finance at the same level.
The payment standard remains unchanged in the same settlement year.
Seven, college students to participate in (continued) insurance payment time is from September 1 to June 10+05 every year, by the colleges and universities for participation (continued) insurance registration and payment procedures. New college students who meet the conditions of insurance should go through the insurance procedures in accordance with the regulations within 3 months of being included in the insurance scope. After 10 and 15 every year, college students who transfer or drop out of school should go to the municipal medical insurance agency for cancellation of registration in time.
The urban medical insurance premiums paid by college students are collected by their universities, and the collected urban medical insurance premiums are paid to the municipal medical insurance agency before the end of 10 every year. Government subsidy funds, according to the affiliation of colleges and universities, are arranged by the finance at the same level and included in the financial accounts of Hangzhou Social Security Fund before the end of each year.
Eight, the settlement year of urban medical insurance for college students is from September 1 day to August 3 1 day of the following year. College students who apply for insurance (continuation) payment procedures within the specified time can enjoy urban medical insurance benefits within the payment settlement year. Failing to go through the insurance (continuation) payment procedures within the specified time, due to school reasons, from the next month after completing the insurance (continuation) payment procedures, enjoy the medical insurance treatment for urban residents in the remaining months of the settlement year; For personal reasons, you can enjoy the treatment of urban medical insurance in the remaining months of the settlement year after you have gone through the payment procedures for insurance (renewal) for 6 months. Those who meet the insurance conditions and go through the insurance payment procedures in accordance with the regulations will enjoy the urban medical insurance benefits for the remaining months of the settlement year from the next month of payment.
If a college student is cancelled by the school, he will stop enjoying the urban medical insurance benefits from the date when the school handles the cancellation procedures for him, and the urban medical insurance premium paid by him will not be refunded.
If a college student goes through the formalities of dropping out of school due to illness or other reasons, during the period of dropping out of school, the school should go through the formalities of insurance (renewal) payment for him, and can continue to enjoy the medical insurance benefits for urban residents according to the regulations.
Nine, in a settlement year, college students meet the requirements of medical insurance coverage's inpatient medical expenses and outpatient medical expenses according to the following standards:
(1) When hospitalized, individuals should pay the minimum threshold first, specifically: tertiary medical institution 800 yuan, secondary medical institution 600 yuan, other medical institutions and community health service institution 300 yuan.
The part exceeding Qifubiaozhun shall be borne by the overall fund in proportion, specifically:
1. hospitalization qifubiaozhun is more than 20,000 yuan (inclusive), and 64% of the expenses incurred in tertiary medical institutions shall be borne by the overall fund; The expenses incurred in secondary medical institutions shall be borne by the overall fund by 70%; The expenses incurred in other medical institutions and community health service institutions shall be borne by the overall fund of 76%.
22,000 yuan to 40,000 yuan (inclusive), 70% of the expenses incurred in tertiary medical institutions shall be borne by the overall fund; The expenses incurred in secondary medical institutions shall be borne by the overall fund by 75%; The expenses incurred in other medical institutions and community health service institutions shall be borne by the overall fund 80%.
34,000 yuan to 6.5438+0.5 million yuan (inclusive), and 76% of the expenses incurred by tertiary medical institutions shall be borne by the overall fund; The expenses incurred in secondary medical institutions shall be borne by the overall fund 80%; The expenses incurred in other medical institutions and community health service institutions shall be borne by the overall fund 84%.
4.10.5 million yuan, and the expenses incurred by tertiary medical institutions shall be borne by the overall fund, 82%; The expenses incurred in secondary medical institutions shall be borne by the overall fund of 85%; The expenses incurred in other medical institutions and community health service institutions shall be borne by the overall fund 88%.
(two) in a settlement year, the provisions of outpatient medical expenses according to a hospitalization settlement, no Qifubiaozhun.
Ten, college students can choose their own medical treatment in the designated medical institutions announced by the municipal labor and social security administrative department. When seeking medical treatment, college students should show their basic medical insurance certificates or special medical records for outpatient service of specific diseases.
Eleven, college students need to be hospitalized in medical institutions outside Hangzhou for emergency treatment, you can choose the local medical insurance designated medical institutions for medical treatment, and in the hospital 15 days according to the provisions of the registration procedures; If you are hospitalized in a non-designated medical institution in Hangzhou, you should go through the registration formalities within 3 days after hospitalization; The medical expenses incurred after the individual pays in full shall be audited and settled by the municipal medical insurance agency in accordance with the regulations.
College students suffering from difficult and serious diseases cannot be diagnosed and treated in designated medical institutions in this city due to technical or equipment constraints. If it is really necessary to transfer to other places for medical treatment, the third-level and corresponding designated medical institutions shall fill in the Registration Form for the Transfer of Urban Basic Medical Insurance to Other Places for Emergency Treatment. After being registered by the municipal medical insurance agency, they can be transferred to other places (Shanghai and Beijing only) for medical treatment. After the medical expenses incurred are paid in full by the individual, they shall be audited and settled by the municipal medical insurance agency according to the regulations.
Twelve, college students meet the scope of medical insurance expenses of medical expenses according to the following provisions:
(a) in the designated medical institutions in this Municipality, the hospitalization and outpatient medical expenses for the treatment of specified diseases shall be settled according to the relevant provisions of Article 9 of these Measures, of which the self-funded, self-care and self-financing expenses shall be paid by individuals.
(II) During the winter and summer vacations, suspension from school due to illness, and internship meeting the management regulations of institutions of higher learning, the medical expenses that meet the scope of medical insurance expenses in the relevant residences and internships shall be settled in accordance with the relevant provisions of Article 9 of these Measures. Among them, after registration, the medical expenses that meet the scope of medical insurance payment in secondary and above medical institutions outside municipalities directly under the central government, provincial capital cities and cities under separate state planning are transferred to Shanghai, Beijing or temporarily go out, and the individual will pay 10% first, and the rest will be settled according to the relevant provisions of Article 9 of these Measures.
(three) the medical expenses incurred due to emergency treatment and off-site medical treatment or referral treatment shall go through the examination and settlement procedures at the municipal medical insurance agency within 30 days after the end of treatment. When going through the formalities of medical expenses audit and settlement, the Registration Form of Urban Basic Medical Insurance in Hangzhou for Emergency Treatment, medical records, original receipt of effective medical expenses, detailed list of expenses and grade certificate of medical institutions shall be issued.
Thirteen, college students should continue to participate in the insurance payment during their study in Hangzhou until graduation. The years of continuous participation in urban medical insurance during school and the years of participation in basic medical insurance for urban workers in Hangzhou are calculated together.
Fourteen, the term "prescribed diseases" as mentioned in these Measures refers to all kinds of malignant tumors, systemic lupus erythematosus, hemophilia, aplastic anemia, schizophrenia, affective psychosis and chronic renal failure dialysis treatment and anti-rejection treatment after organ transplantation.
15. Matters not covered in these Measures shall be handled in accordance with the Measures for Basic Medical Security in Hangzhou (No.42 [2007] of the Municipal Party Committee), the Notice of the General Office of the Municipal Party Committee and the General Office of the Municipal Government on Printing and Distributing the Implementation Rules for the Measures for Basic Medical Security in Hangzhou (No.4 [2008] of the General Office of the Municipal Party Committee) and the Measures for Handling Violations of Basic Medical Security in Hangzhou (Decree No.2465433 of the Municipal Government)
Sixteen, these Measures shall be interpreted by the Municipal Labor and Social Security Bureau and shall come into force as of September 6, 2009.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.