一、保障范围
shengshuzaikundegaodengxuexiao、suoshukeyanyuansuo(yixiajiancheng“gaodengxuexiao”)zhongjieshouputonggaodengjiaoyudequanrizhibenzhuankesheng、feizaizhiyanjiusheng(yixiajiancheng“daxuesheng”),zaiyunnanshengyiliaobaoxianjijinguanlizhongxin(yixiajiancheng“shengyibaozhongxin”)canbao。
二、筹资水平
(yi)shengshuzaikundegaodengxuexiaodaxueshengmeirenmeinianjibenyiliaobaoxianchouzishuipingwei80yuan。buzhuhejiaofeibiaozhunwei:
1.yuanxiangshougongfeiyiliaodedaxueshengjibenyiliaobaoxianfeimeixuenianrenjunshengcaizhengbuzhu80yuan,gerenbujiaofei。
2.weixiangshougongfeiyiliaodedaxueshengjibenyiliaobaoxianfeimeixuenianrenjunshengcaizhengbuzhu40yuan,suozaigaodengxuexiaobuzhu30yuan,gerenjiaofei10yuan。
yuanxiangshougongfeiyiliaodedaxueshengzhi:anyuanxiangshougongfeiyiliaodeguiding,guojiazhengshixiaozhunshezhideputonggaodengxuexiao(buhanjunshiyuanxiao)jihuaneizhaoshoudeputongbenzhuankezaixiaoxuesheng、yanjiusheng(buhanweituopeiyang、zifei、ganbuzhuanxiuxuesheng)。
(er)gulidaxueshengziyuancanjiabuchongyiliaobaoxian,buchongyiliaobaoxianfeiyoudaxueshenggerenmeixueniananbudiyu50yuanjiaona。
三、参保登记
(yi)daxueshengchishenfenzheng、xueshengzhengdengyouguanziliao,zaibenxiaotianxie《yunnanshengchengzhenjuminjibenyiliaobaoxian(daxuesheng)canbaoshenqingdengjibiao》,banlicanbaodengjihejiaofeishouxu。
(er)gaodengxuexiaoduiyishangziliaohe《dengjibiao》neirongjinxingshenhe;bingjiangcaijidecanbaoxinxiluruyiliaobaoxianxinxicaijixitong。
(san)yibaozhongxinyijucanbaoxinxishengchengjiaofeiqingce,tongzhigaodengxuexiaoanjiaofeiqingcedaishougerenyingjiaodejibenyiliaobaoxianfei。
(si)yiliaobaoxianfeijingyibaozhongxinshenhewuwuhou,youkaihuyinxinghuarucaizhengzhuanhu,bingyouyinxingxianggaodengxuexiaochuju《yunnanshengshehuibaoxianfeijiaokuanshouju》。
(wu)shengshehuibaozhangkazhizuofaxingzhongxingenjucanbaoxinxi,zhizuo《zhonghuarenmingongheguoshehuibaozhangka》(yixiajiancheng“shehuibaozhangka”),jiaoyousuozaigaodengxuexiaofafang。
四、待遇水平
shengshuzaikundegaodengxuexiaozhixingyixiadaiyubiaozhun:
(yi)daxueshengjibenyiliaobaoxianjijinzhuyaoyongyuzhifuzhuyuan、putongmenzhenheteshubingmenzhenyiliaofeiyong;buchongyiliaobaoxianzhuyaoduizhuyuanhemenzhenteshubingyiliaofeiyongjinxingbuzhu。
(er)daxueshengjibenyiliaobaoxiandeyaopinmulu,zhenliaoxiangmujifuwusheshibiaozhunanzhaoyunnanshengchengzhenjuminjibenyiliaobaoxianyouguanguidingzhixing。
(san)canbaohoubanlilexiuxue、tuixueshouxudedaxuesheng,zaicanbaoshixianneifashengdeyiliaofeiyong,renganyouguanguidingbaoxiao。
(si)zhuyuanyiliaodaiyu
1.qifubiaozhun
xuenianneidiyicizhuyuan:yijiyiliaojigou100yuan,erjiyiliaojigou200yuan,sanjiyiliaojigou300yuan;diercizhuyuanqifufeijianban;disanci(han)yishangzhuyuandebuzaijiaonaqifufei。
2.zhuyuanqijianfashengdeteshujiancha、teshuzhiliaoheyileiyaopingerenxianzifu10%;ruoshiyongleyaopinmuluyiwaideqiangjiuyaopinshi,yousuozaidingdianyiliaojigoushenpibeianhoufangkeshiyong,yaopinfeiyougerenxianzifu40%。
3.baoxiaobilihezuigaozhifuxiane
(1)jibenyiliaobaoxian
xueniannei,fuhejibenyiliaobaoxianbaoxiaofanweineidezhuyuanyiliaofeiyongbaoxiaobiliwei60%;tongchoujijinzuigaozhifuxianewei1.6wanyuan。
(2)buchongyiliaobaoxian
xueniannei,zaicanjiajibenyiliaobaoxiandetongshi,youcanjialebuchongyiliaobaoxiandedaxuesheng,fuhejibenyiliaobaoxianbaoxiaofanweineidezhuyuanyiliaofeiyongbaoxiaobilitigaodao90%;buchongyiliaobaoxianzhifuxianeshangbufengding,bingchengdanyiwaishanghaishigu、jibingshengu10000yuandepeifuzeren,chengdanyiwaishangcanandengjizuigao10000yuandepeifuheyiwaishanghaimenzhenfeiyong100yuanyishang5000yuanyinei90%depeifuzeren。
(wu)menzhenyiliaodaiyu
1.putongmenzhen
menzhenyiliaofeitongchoubiaozhunzandingweimeirenmeixuenian30yuan,youshengyibaozhongxinandaxueshengcanbaorenshuhuaruxiaoyiyuan(yiwushi)baoganshiyong。baoganfeiyongjieyuzai10%yineideguixiaoyiyuan(yiwushi),jieyuchaoguo10%defeiyongyouyibaozhongxinshouhui;ruoxuenianneifashengchaozhibufenyoushengyibaozhongxinfudan30%,gaodengxuexiaofudan70%。
2.teshubingmenzhen
(1)exingzhongliu(menzhenfang、hualiao)、manxingshengongnengshuaijie(menzhentouxi)、qiguanyizhi(shuhoukangpaiyi)、xitongxinghongbanlangchuang、zaishengzhangaixingpinxueteshubingmenzhenfashengdeyiliaofeiyong,qifuxianyishangfeiyongbaoxiaobilihezuigaozhifuxianeyuzhuyuandaiyuyizhi。
(2)huanteshubingdedaxuesheng,youbenrenxiangjiuduyuanxiaotichushumianshenqing,jingshengyibaozhongxinanguidingchengxushenhehoufaji《teshubingjiuzhenka》,chiyou《teshubingjiuzhenka》dedaxueshenghuanzhe,fangkexiangshouxiangyingdeteshubingyiliaodaiyu。
(liu)youxialieqingkuangzhiyide,suofashengdeyiliaofeiyong,jibenyiliaobaoxianjijinhebuchongyiliaobaoxianzijinbuyuzhifu:
1.jibenyiliaoyaopinmulu、zhenliaoxiangmuhefuwusheshibiaozhunyiwaidefeiyong(jijiuchuwai)。
2.jiankangtijian、jihuamianyi、yufangbaojian、jiankangjiaoyudenggonggongweishengfuwudefeiyong。
3.weibanlizhuanzhenzhuanyuanshenpibeianshouxu,zixingwaichujiuyideyiliaofeiyong。
4.zhengxing、meirong、xujiu、xidu、dajiadouou、zishazican、zifendengweifafanzuixingweisuozhideyiliaofeiyong。
5.anyouguanguidingbuyuzhifudeqitafeiyong。
五、就医管理和费用结算
(yi)gaodengxuexiaoanzhaojiujinjiuyideyuanzexuanzeyizhierjiadingdianyiliaojigou(buhanxiaoyiyuan),zuoweibenxiaodaxueshengxiaowaizhuyuandedingdianyiliaojigou。
(er)gaodengxuexiaoxiaoyiyuan(yiwushi)fuzedaxueshengputongmenzhen,wuxiaoyiyuandegaodengxuexiaoyouyibaozhongxinzhidinglinjinshequweishengfuwuzhongxinqianshuxieyi,weidaxueshengtigongputongmenzhenjizhenyiliaofuwu。
(san)daxueshengpingshehuibaozhangkahexueshengzhengdaozhidingdedingdianyiliaojigoujiuyi,suofashengdezhuyuanheteshubingmenzhenyiliaofeiyong,anguidingyingyougerenfudandefeiyongyougerenzhifu,yingyoutongchoujijinhuobuchongyiliaobaoxianzhifudefeiyong,youyibaozhongxinyudingdianyiliaojigouzhijiejiesuan。
(si)daxueshengzaijiaqi、shixi、xiuxueqijianyinjiweizhongzhengxuyidizhuyuanzhiliaode,yuanzeshangzaidangdiyibaodingdianyiliaojigoujiuyi,bingzaiyizhouneitongguojiuduyuanxiaoxiangyibaozhongxinbeian,suofashengdeyiliaofeiyongxianyougerenquanedianfu,yiliaozhongjiehouyoujiuduyuanxiaotongyidaoyibaozhongxinanguidingbaoxiao;menzhenfeiyongyoujiuduyuanxiaoyiliaojigouanguidingbaoxiao。
(wu)fashengwuzerenrendeyiwaishanghaishi,qifeiyongkepingdingdianyiliaojigouzhenduanzhengminghejiuduyuanxiaochujudexiangguanzhengminganguidingbaoxiao。
(liu)yinbingqingxuyaojinxingzhuanzhenzhuanyuande,junyouxiaoyiyuan(yiwushi)huoweituodeshequweishengfuwuzhongxinchujuzhuanzhenzhuanyuanzhengming,dingdianyiliaojigoufangkeshouzhizhuyuan(jizhenqiangjiuchuwai)。
zhuanshengwaijiuyide,xutigongzhishaoersuosanjidingdianyiliaojigouzhurenyishihuiyiyijian,youzhuanchuyiyuangaizhanghousongyibaozhongxinshendingbeian,gerenzifubilizaiyuanjichushangtigaoergebaifendian,feiyongyoujiuduyuanxiaohuoxueshengbenrenquanedianfu。
(qi)xueniannei,daxueshengzhuyuanrenshuyuanzeshangbuchaoguocanbaozongrenshude2%,duichaoguodexiaoyiyuanjiangshiqingkuangjianshaoxianiandumenzhenyiliaobaogantongchoufeiyong。
六、其它
jibenyiliaobaoxiandejiesuannianduweimeixueniande9yue1rizhiciniande8yue31ri,yougaodengxuexiaobanlilebiyeshouxudedaxueshengzai9yuetingzhixiangshouyiliaobaoxiandaiyu。daxueshengzaiduqijianyinglianxucanbao。