daxueshengcanjiajibenyiliaobaoxianshiyidengxiaopinglilunhe“sangedaibiao”zhongyaosixiangweizhidao，jianchiyirenweiben，luoshikexuefazhanguandebiranyaoqiu；jianliyidabingtongchouweizhudedaxueshengjibenyiliaobaoxianzhidu，shitigaodaxueshengyiliaodaiyushuiping，jiejuehuanteshubingxueshengdeyiliaofeiyong，jianqinggerenhejiatingjingjifudandeyixiangcuoshi。weilezuohaoxueshengjibenyiliaobaoxiantongchouguanli，baozhangxueshengdeliyi，genju《yunnanshengdaxueshengjibenyiliaobaoxianshishixize（shixing）》wenjianjingshenyaoqiu，tezhidingyunnanjiaotongzhiyejishuxueyuandaxueshengjibenyiliaobaoxianshishibanfa。

一、门诊用药及诊疗项目报销范围、报销比例

1、menzhenxueshengyongyaofanweishixing《yunnanshengjibenyiliaobaoxianhegongshangbaoxianyaopinmulu》dejialei、yileiyaowu，chaochuciyongyaofanweideyaofei，youxueshengzixingchengdan。

2、menzhenzhenliaoxiangmubaoxiaofanwei：①menzhenzhenliaoxiangmufuheyunnanshengchengzhenjuminjibenyiliaobaoxiandeguiding。

②jianchaxiangmu：xguangjiancha、bxingchaoshengjiancha、xindiantuhezhiliaofeidengxiaoyiyuanjizhidingyiyuankaizhandezhenliaoxiangmu。

3、menzhenyaofei、jianchafei、zhiliaofeibaoxiaobili：menzhenyaofei、jianchafei、zhiliaofeibaoxiaobiliwei60%，xueshengzifu40%。

二、住院医疗待遇

1、qifubiaozhun

xuenianneidiyicizhuyuan：yijiyiliaojigou100yuan，erjiyiliaojigou200yuan，sanjiyiliaojigou300yuan；diercizhuyuanqifufeijianban；disanci（han）yishangzhuyuandebuzaijiaonaqifufei。

2、zhuyuanqijianfashengdeteshujiancha、teshuzhiliaoheyileiyaopingerenzifu。ruoshiyongleyaopinmuluyiwaideqiangjiuyaopinshi，yousuozaidingdianyiliaojigoushenpibeianhoufangkeshiyong，yaopinfeiyougerenzifu。

3、baoxiaobilihezuigaozhifuxiane

（1）jibenyiliaobaoxian

xuenianneifuhejibenyiliaobaoxianfanweineidezhuyuanyiliaofeiyongbaoxiaobiliwei60%；tongchoujijinzuigaozhifuxianewei1.6wanyuan，youdingdianyiyuancanzhaoyibaoguidingyugerenjiesuan。

（2）buchongyiliaobaoxian

xueniannei，zaicanjiajibenyiliaobaoxiandetongshi，youcanjialebuchongyiliaobaoxiandedaxuesheng，fuhejibenyiliaobaoxianbaoxiaofanweineidezhuyuanyiliaofeiyongbaoxiaobilitigaodao90%；buchongyiliaobaoxianzuigaozhifuxianeshangbufengding，bingchengdanyiwaishanghaishengu、jibingshengu10000yuandepeifuzeren，chengdanyiwaishangcanandengjizuigao10000yuandepeifuheyiwaishanghaimenzhenfeiyong100yuanyishang5000yuanyinei90%depeifuzeren。

三、有下列情形之一的，门诊统筹医疗费不予报销

1、jibenyiliaoyaopindemulu、zhenliaoxiangmuhefuwusheshibiaozhunyiwaidefeiyong。

2、jiankangtijian、jihuamianyi、yufangbaojian、jiankangjiaoyudengweishengfuwufeiyong。

3、weibanlizhuanzhenzhuanyuanshenpibeianshouxuzixingwaichujiuyifashengdeyiliaofeiyong（jizhenchuwai）。

4、zhengxing、meirong、xidu、dajiadouou、zishazican、zifen、xujiudengxingweisuozhideyiliaofeiyong，yijiyinyiliaoshigusuozengjiadefeiyong。

5、anyouguanguidingbuyuzhifudeqitafeiyong。

四、就医管理

1、benbanfashiyongfanwei：canjialeyunnanshengdaxueshengjibenyiliaobaoxiandequanrizhibenzhuankexueshenghefeizaizhiyanjiusheng。

2、xinshengcongbaodaozhiriqi，sangeyueneiweiruxuetijianfuchaqi。yiyuanjianggenju“putonggaodengxuexiaozhaoshengtijianbiaozhun”jinxingtijian，hegezhe，sangeyuehoufangnengqudexueji。xinshengzaitijianfuchaqineibuxiangshoujibenyiliaomenzhenbaoxiao。

3、xueshengdeshouzhenyiyuanweixiaoyiyuan，jiuyishibixuxiedaibenrenjibenyiliaobaozhangkajixueshengzheng。

4、xueshengdaoyuanwaijiuzhen、jianchafeiyongzili。zaijiaqi、shixi、xiuxueqijianyinjiweizhongzhengxujizhenjiuyihuoyidizhuyuanzhiliaozhe，yuanzeshangzaidangdiyibaodingdianyiliaojigoujiuyi，bingzaiyizhouneixiangxiaoyiyuanbaogaobeian，suofashengdeyiyaofeiyougerenquanedianfu。zhiliaozhongjiehou，menzhenfeiyongfuheyaopinmulu、zhenliaoxiangmufanweidepingmenzhenjizhenbingli、shuangchufangyouxiaoyiyuananguidingbaoxiao；zhuyuanfeiyongyouyibaozhongxinanguidingbaoxiao。

5、xueshengyinbingqingxuyaozhuanzhenzhuanyuanzhiliaode，youjingzhuzhiyishengtichuyijianjingyiyuanlingdaotongyihou，kaijuzhuanzhenzhuanyuanzhengming，fangkedaozhidingdeyibaodingdianyiyuanjiuzhen（jizhenqiangjiuchuwai）。zhuanshengwaijiuyide，xutigongzhishaoersuosanjidingdianyiliaojigouzhurenyishihuizhenyijian，youzhuanchuyiyuangaizhanghousongyibaozhongxinshendingbeian，gerenzifubilizaiyuanjichushangtigaoergebaifendian，feiyongyouxuexiaohuoxueshengbenrenquanedianfu。

6、huanteshubingdedaxuesheng，youbenrentichushumianshenqing，anzhaoyibaozhongxindeyaoqiuzhunbeixiangjiaocailiao，youxiaoyiyuansongyibaozhongxinshenhehoufaji《teshubingjiuzhenka》，chiyou《teshubingjiuzhenka》dehuanzhe，fangkexiangshouxiangyingdeteshubingyiliaodaiyu。

7、fashengwuzerenrendeyiwaishanghaizhuyuan，qifeiyongkepingdingdianyiliaojigouzhenduanzhengmingjixiaoyiyuanchujudexiangguanzhengminganguidingbaoxiao。

8、xueshengruxueqiansuohuanjibing（yiruxuetijianjilinchuangzhenduanweiyiju），ruxuehoufufachanshengdemenzhenyiliaofeizili。xiuxue、tuixuechanshengdemenzhenyiliaofeiyongyoubenrenzili。

五、参保登记及缴费

daxueshengcanbaodengjishijianweimeinian9yue1rizhicinian8yue31rizhi，zaixiaoshengmeinian6yuejinxingxinxidengji，bingtongshishouqubuchongyiliaobaoxianfei。xinshengruxueshitianxiedaxueshengcanbaoshenqingdengjibiao，tongshishouqushehuibaozhangkakafeijibuchongyiliaobaoxianfei，9yuediyiqianwanchengxinxishoujihuizong，baosongshengyibaozhongxinshencha、faka。

六、上述实施办法未阐明部分按照《云南省城镇居民基本医疗保险试点实施办法》（云政发[2007]130号）和《云南省学生基本医疗保险实施细则（试行）》（云劳社发[2008]8号）文件执行。

七、未尽事宜另行规定。

八、本实施办法自发布之日起执行。

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