武汉出台核酸、抗体检测医保支付标准,可用医保个人账户支付

2020-05-06 武汉发布 澎湃新闻·澎湃号·政务

为保证核酸检测、抗体检测纳入医保政策落地,武汉市医保局5日确定相关项目医保支付标准。其中,个人自付比例确定为10%,同时允许使用医保个人账户支付相关检测费用,确保我市参保人最大限度享受医保报销,支付标

为保证核酸检测、抗体检测纳入医保政策落地,武汉市医保局5日确定相关项目医保支付标准。其中,个人自付比例确定为10%,同时允许使用医保个人账户支付相关检测费用,确保我市参保人最大限度享受医保报销,支付标准6日起同步执行。

日前,湖北省将新型冠状病毒核酸检测、新型冠状病毒抗体检测项目临时纳入湖北省基本医疗保险诊疗目录,按乙类支付。同时规定,医保支付具体标准由我省各地根据本地实际,自行确定。

什么是按乙类支付?武汉市参保人

如何享受待遇?武汉市医保局

相关负责人进行了解答:

据介绍,国家《药品目录》相关规定,参保人员在住院使用乙类药品时,要先按比例扣除一定的个人自付费用,将余下费用再纳入报销范围,按比例进行报销。根据湖北省相关规定,我省乙类药品个人自付比为10%—30%。为了最大限度减轻我市参保人员经济负担,武汉市将个人自付比例确定为10%。

我市核酸检测、抗体检测

医保支付标准包括:

一是我市参保人员住院进行核酸、抗体检测。由参保人个人先付10%,剩余部分再根据一级、二级、三级医院的住院标准按比例报销。

二是我市参保人员在门诊进行核酸、抗体检测。职工医保参保人员允许使用医保个人账户支付相关检测费用,居民医保可使用医保门诊统筹基金参保人当期的额度支付。

三是确诊和疑似患者在定点医疗机构隔离治疗期间核酸、抗体检测费用,按照国家卫生健康委制定的诊疗方案最新版明确的医疗服务项目临时性纳入医保基金支付范围。

此外,湖北省核酸检测、抗体检测费用实行省级统一定价限价,我市也将根据相关要求,实行动态调整。

目前,根据相关规定,要保证“应检人群”不因医疗负担问题错过关键检测,做到“应检尽检”。多位专家表示,核酸检测是一个医疗行为,不是消费行为,不提倡非危险的普通人群去做核酸检测,特别是不提倡扎堆做核酸检测。

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    2020-05-08 marongnuan
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