序号 | 病种名称 | 年度起付标准(元) | 报销比例 | 年度限额 | 备注 |
城镇职工 | 城乡居民 | 城镇职工 | 城乡居民 |
1 | 慢性心力衰竭 | 600 | 350 | 80% | 65% | 3000 |
|
2 | 中枢神经系统脱髓鞘疾病 | 600 | 350 | 80% | 65% | 3600 |
|
3 | 银屑病 | 600 | 350 | 80% | 65% | 4000 |
|
4 | 股骨头坏死 | 600 | 350 | 80% | 65% | 4000 |
|
5 | 重症肌无力 | 600 | 350 | 80% | 65% | 5000 |
|
6 | 支气管哮喘 | 600 | 350 | 80% | 65% | 5000 |
|
7 | 高血压 | 600 | 350 | 80% | 65% | 5000 |
|
8 | 糖尿病 | 600 | 350 | 80% | 65% | 5000 |
|
9 | 心脏瓣膜病 | 600 | 350 | 80% | 65% | 5000 |
|
10 | 肺结核活动期 | 600 | 350 | 80% | 65% | 5000 |
|
11 | 耐药性结核病 | 600 | 350 | 80% | 65% | 5000 |
|
12 | 心肌病 | 600 | 350 | 80% | 65% | 5000 |
|
13 | 癫痫 | 600 | 350 | 80% | 65% | 5000 |
|
14 | 甲状腺功能异常 | 600 | 350 | 80% | 65% | 5000 |
|
15 | 系统性硬化症 | 600 | 350 | 80% | 65% | 5000 |
|
16 | 肝硬化失代偿期 | 600 | 350 | 80% | 65% | 8000 |
|
17 | 病毒性肝炎 | 600 | 70% | 80% | 65% | 8000 |
|
18 | 肾病综合征 | 600 | 350 | 80% | 65% | 8000 |
|
19 | 强直性脊柱炎 | 600 | 350 | 80% | 65% | 8000 |
|
20 | 类风湿性关节炎 | 600 | 350 | 80% | 65% | 8000 |
|
21 | 帕金森病 | 600 | 350 | 80% | 65% | 8000 |
|
22 | 系统性红斑狼疮 | 600 | 350 | 80% | 65% | 8000 |
|
23 | 冠心病 | 600 | 350 | 80% | 65% | 8000 |
|
24 | 慢性阻塞性肺疾病 | 600 | 350 | 80% | 65% | 8000 |
|
25 | 免疫性血小板减少症 | 600 | 350 | 80% | 65% | 8000 |
|
26 | 肝豆状核变性 | 600 | 350 | 80% | 65% | 8000 |
|
27 | 脑血管病后遗症 | 600 | 350 | 80% | 65% | 8000 |
|
28 | 精神疾病 | 600 | 350 | 80% | 65% | 8000 |
|
29 | 慢性肾小球肾炎 | 600 | 350 | 80% | 65% | 8000 |
|
30 | 肺源性心脏病 | 600 | 350 | 80% | 65% | 8000 |
|
31 | 慢性骨髓炎 | 600 | 350 | 80% | 65% | 8000 |
|
32 | 特发性肺间质纤维化 | 600 | 350 | 80% | 65% | 8000 |
|
33 | 运动神经元病 | 600 | 350 | 80% | 65% | 8000 |
|
34 | 儿童苯丙酮尿症 | / | 350 | / | 65% | 8000 | 0-18岁,限居民医保 |
35 | 慢性肾功能不全失代偿期 | 600 | 350 | 80% | 65% | 10000 |
|
36 | 血友病 | 600 | 350 | 80% | 65% | 20000 |
|
37 | 恶性肿瘤康复治疗 | 600 | 350 | 80% | 65% | 20000 |
|
38 | 再生障碍性贫血 | 600 | 350 | 80% | 65% | 20000 |
|
39 | 器官移植抗排异检查及辅助用药 | 600 | 350 | 80% | 65% | 20000 |
|
40 | 尿毒症期 | 600 | 350 | 80% | 65% | 20000 |
|
41 | 脑瘫 | / | 350 | / | 65% | 20000 | 限居民医保 |
42 | 儿童生长激素缺乏症 | / | 350 | / | 65% | 20000 | 限居民医保 |
43 | 大骨节病 | 0 | 0 | 70% | 70%% | 517 |
|
44 | 氟骨病 | 0 | 0 | 70% | 70% | 693 |
|
45 | 克山病 | 0 | 0 | 70% | 70% | 1650 |
|
备注:
1.只有慢性病资格认定后,才可以进行门诊慢性病报销。
2.在我院就诊的西安市慢性病患者,产生的相关门诊费用(检查费、治疗费、药品费)可以直接结算,个人只需支付个人负担部分,个人负担部分还可以使用医保个人账户支付。
3.门诊慢性病补助标准按认定病种年度费用限额确定,认定多个门诊慢性病病种的,补助标准按最高的病种限额确定。
4.一个年度内,个人承担一个起付线,当门诊慢性病结算金额累计到起付线时,可按比例报销。