1、中华人民共和国残疾人医保中华人民共和国残疾人保障法DECREE BY THE PRESIDENT OF THE PEOPLES REPUBLIC OF CHINA中华人民共和国残疾人保障法是为了保护残疾人的合法权益，进展残疾人事业，保障残疾人平等地充分参与社会生活，共享社会物质文化功效，依照宪法而制定的法规。于年月日修订通过，自年月日起实施。(Adopted at the 17th Meeting of the Standing Committee of the Seventh National Peoples Congress on December 28,1990.)第二章康复Chapte
2、r 2 Rehabilitation第十三条国家和社会采取康复方法，帮忙残疾人恢复或补偿功能，增强其参与社会生活的能力。Article 13 Responsibilities The state and society shall adopt measures of rehabilitation to help disabled persons regain normal functions or compensate for lost functions, thus enhancing their ability to participate in social life.第十四条康复工作应
3、当从实际动身，将现代康复技术与我国传统康复技术相结合；以康复机构为骨干，社区康复为基础，残疾人家庭为依托；Article 14 Guiding Principle The work of rehabilitation shall, proceeding from the actual conditions, combine modern rehabilitation techniques with traditional Chinese techniques, with rehabilitation institutions as the core and the community-base
4、d rehabilitation as the basis and relying on the families of disabled persons for support.以有效、易行、受益广的康复内容为重点，并开展康复新技术的研究、开发和应用，为残疾人提供有效的康复效劳。Emphasis shall be laid on rehabilitation projects which are practical, easy to realize and widely beneficial. Efforts shall also be made in the research, explo
5、ration and application of new rehabilitation technology so as to provide more effective service for disabled persons.第十五条政府和有关部门有打算地在医院设立康复医学科（室），举行必要的专门康复机构，开展康复医疗与训练、科学研究、人员培训和技术指导工作。Article 15 Implementation The governments and departments concerned should establish in a planned way medical rehab
6、ilitation departments (sections) in hospitals, set up appropriate special institutions of rehabilitation and carry out clinical practice and training, scientific research, personnel training and work of technical guidance in the field of rehabilitation.各级人民政府和有关部门，应当组织和指导城乡社区效劳网、医疗预防保健网、残疾人组织、残疾人家庭和
7、其他社会力量，开展社区康复工作。The peoples government and departments concerned at various levels should organize and guide urban and rural community service networks, medical preventionnd health care networks, organizations and families of disabled persons and other social forces in carrying out community-based r
8、ehabilitation work.残疾人教育机构、福利性企业事业组织和其他为残疾人效劳的机构，应当制造条件，开展康复训练活动。Departments of education, welfare enterprises and institutions and other service organizations for disabled persons should create conditions for rehabilitation training activities.残疾人在专业人员的指导和有关工作人员、志愿工作者及亲属的帮忙下，应当尽力进行功能、自理能力和劳动技术的训练。D
9、isabled persons with guidance from professional personnel and help from relevant staff, volunteers and family members, should actively take part in training programmes for functional recovery, and acquiring self-care ability and work skills.国务院和有关部门分时期确信康复重点项目，制定打算，组织力量实施。The State Council and depar
10、tments concerned shall determine priority rehabilitation projects by stages, formulate plans thereof and organize forces for their implementation.第十六条医学院校和其他有关院校应当有打算地开设康复课程、设置康复专业，培育各类康复专业人材。Article 16 Personnel Training Medical colleges and schools and other relevant eductional institutes should,
11、in a planned way, offer curricula and specialities on rehabilitation so as to train various kinds of rehabilitation specialists.国家和社会采取多种形式对从事康复工作的人员进行技术培训；向残疾人、残疾人亲属、有关工作人员和志愿工作者普及康复知识，教授康复。The state and society shall provide various forms of technical training for personnel engaged in rehabilitati
12、on work, popularize knowledge of rehabilitation among disabled persons, their family members, relevant staff and volunteers and teach them methods of rehabilitation.第十七条政府有关部门应当组织和扶持残疾人康复器械、生活自助具、特殊用品和其他辅助器具的研制、生产、供给、维修效劳。Article 17 Appliances Governmental departments concerned should organize and s
13、upport the research, production, supply and maintenance of rehabilitation equipment, appliances for self service, special utensils and other aids for disabled persons.上海市医疗保险局、上海市残疾人联合会、上海市民政局等关于印发Shanghai Medical Insurance Bureau, the Shanghai Disabled Persons Federation, the Shanghai Civil Affairs
14、 Bureau关于将本市城镇重残人员纳入大体医疗保障的试行意见的通知With regard to the city severely disabled persons into the urban basic medical insurance pilot view 关于将本市城镇重残人员纳入大体医疗保障的试行意见为了完善本市医疗保障制度，为妥帖解决本市城镇重残无医疗保障人员的大体医疗保障问题，现就将本市城镇重残人员纳入大体医疗保障提出如下试行意见：In order to improve the city medical insurance system for the proper sett
15、lement of the city town severely disabled persons without health insurance basic health care issues, is now the city will be severely disabled persons into the urban basic medical insurance pilot made the following comments：一、对象范围Target range具有本市城镇户籍，年满16周岁，持有中华人民共和国残疾人证并符合本市重残标准的无医疗保障人员（以下简称重残无保人员）
16、。Urban household registration with the city over 16 years of age, holders of Republic of China Disabled Persons Permit and meet the standards of the city severely disabled persons without health insurance (hereinafter referred to as the severely disabled persons without bail).二、治理部门与职责management and
17、 responsibilities市医保局负责重残无保人员大体医疗保障的治理工作；市残联负责重残无保人员参保资格认定和重残无保人员大体医疗保障资金（以下简称保障资金）统一筹集的工作；市民政局负责做好相关复核工作；市财政局负责按有关规定做好保障资金的监督和治理工作。Municipal Medical Insurance Bureau is responsible for severely disabled persons without bail in the management of basic health care; City CDPF responsible for the sever
18、ely disabled person without bail, disability insurance and re-qualification of basic health care without insurance funds (hereinafter referred to as security funds) raised a unified work; Municipal Civil Affairs Bureau is responsible for reviewing related work to do; City Department of Finance is re
19、sponsible for doing security funds according to relevant provisions of the supervision and management.三、资金筹集与治理Fund raising and management重残无保人员大体医疗保障资金的筹资标准暂定为每人每一年1200元。其中，三分之二由市残联从残疾人就业保障金中筹集，三分之一由市民政局从社会福利彩票公益金中筹集。尔后筹资水平随资金平稳情形作相应调整。上述资金由市残联统一筹集后，归入大体医疗保险基金统一治理。Severely disabled people without b
20、asic health care insurance fund is tentatively scheduled for the financing of the standard 1,200 yuan per person per year. Among them, two-thirds of the municipal federations from a disability in the employment security fund raising, one-third of the municipal Civil Affairs Bureau in from the lotter
21、y to raise social welfare. The future level of funding with the balance of funds be adjusted accordingly.Unified municipal federations to raise these funds, the classified to the basic medical insurance fund unified management四、保障待遇Security benefits重残无保人员自参保资格被确认的次月起，享受大体医疗保障待遇，其中：门急诊医疗发生的费用，由保障资金报销
22、50%；住院医疗发生的费用，由保障资金报销70%；其余部份由个人承担。Severely disabled persons without bail since insurance status is confirmed the next month, the access to basic health care benefits, including: outpatient and emergency medical expenses incurred by the security fund reimbursement of 50%; inpatient medical costs inc
23、urred, reimbursement of 70% by the security funds ; the remainder borne by the individual.Read phoneticallyDictionary - 1.verb 1.have2.possess3.be provided with五、就医治理Medical management重残无保人员的参保资格经市残联、市民政局确认后，可到医保经办机构办理相关手续并领取就医凭证。重残无保人员持就医凭证在本市医保定点的社区卫生效劳中心（或一级医疗机构）就医，因病情需要转诊至二、三级医疗机构就医的，须在社区卫生效劳中心（
24、或一级医疗机构）办理转诊手续。重残无保人员在本市或外省市医保定点医疗机构急诊就医发生的费用，保障资金按规定予以支付。重残无保人员在外省市长期居住的，应向医保经办机构提出就医关系转移申请，经核准后，在外省市医保定点医疗机构发生的医疗费用，保障资金按规定予以支付。I severely disabled uninsured persons eligible for insurance by the City Disabled Persons Federation, Municipal Civil Affairs Bureau confirmed, the health insurance agenc
25、ies can handle the relevant procedures and obtain medical certificates.Ii severely disabled persons who seek medical treatment without insurance health insurance certificate in the city designated a community health service center (or a medical institution) for medical treatment, whose condition req
26、uires referral from the three-tier medical institutions, and to be in the community health service centers (Or a medical institution) for referral procedures.Iii severely disabled persons without bail in the city or other provinces and cities designated medical institutions for emergency medical hea
27、lth care costs incurred to protect the funds required to be paid.Iv severely disabled persons in other provinces without bail permanent residence, medical treatment should be made between health care agencies transfer applications approved after the designated medical institutions outside the provin
28、cial health insurance medical expenses incurred to protect the funds required to be paid.ListenRead phoneticallyDictionary - 1.verb 1.have2.possess3.be provided with六、医疗费报销Reimbursement of medical expenses重残无保人员就医发生的符合规定的医疗费，由个人用现金支付后，凭就医凭证、医疗费收据、相关病史和转诊凭证等资料到医保经办机构申请报销。如委托他人办理的，被委托人需同时出示本人身份证件。Seve
29、rely disabled medical treatment without bail compliance occurred in medical expenses, are paid in cash by individuals, with medical certificates, medical expenses receipts, certificates and other relevant medical history and referral information to health care agencies to apply for reimbursement. If
30、 commissioned for, and was the principal must present their own identification cards.七、补充医疗保障Supplementary Medical Insurance以区县残联为单位成立重残人员大病、重病医疗帮困专项资金，按每人每一年200元的标准筹资，由市、区两级残疾人就业保障金分担，对自大高额医疗费有特殊困难的城镇重残人员提供医疗帮困。CDPF as a unit set up by county personnel severely disabled, ill, ill health special fun
31、ds for helping the vulnerable, according to the standard of 200 yuan per person per year funding, municipal and district levels, employment security fund share of persons with disabilities, medical expenses are high on the ego Severely disabled with special difficulties of urban medical personnel he
32、lping the vulnerable.八、其他other重残无保人员的用药范围、诊疗项目和效劳设施等治理参照本市城镇职工大体医疗保险有关规定执行，但不实行按比例分类自大方法。重残无保人员享受本试行意见规定的医疗保障待遇后，原享受家眷劳保医疗待遇的，再也不享受。重残无保人员享受本试行意见规定的医疗保障待遇后，再也不重复享受其他大体医疗保障待遇。本试行意见的操作细那么，由市医疗保险事务治理中心另行制定。I severely disabled persons without insurance range of medication, treatment facilities, and management of projects and services the city with reference to the basic medical insurance for urban workers, the relevant provisions, but doe
