{"id":17565,"date":"2024-04-05T17:47:49","date_gmt":"2024-04-05T10:47:49","guid":{"rendered":"http:\/\/kenh69.info\/?p=17565"},"modified":"2024-04-05T17:52:55","modified_gmt":"2024-04-05T10:52:55","slug":"17565-2","status":"publish","type":"post","link":"https:\/\/kenh69.info\/?p=17565","title":{"rendered":"Ng\u01b0\u1eddi d\u00e2n \u0111\u00f3ng BHYT \u0111\u1ee7 5 n\u0103m li\u00ean t\u1ee5c \u0111\u01b0\u1ee3c &#8216;\u0111\u1eb7c c\u00e1ch&#8217; m\u1ed9t quy\u1ec1n l\u1ee3i, n\u00ean n\u1eafm r\u00f5 k\u1ebbo thi\u1ec7t th\u00f2i"},"content":{"rendered":"<p><strong>N\u1ebfu m\u1ecdi\u00a0 ng\u01b0\u1eddi tham gia b\u1ea3o hi\u1ec3m y t\u1ebf th\u00ec nh\u1ea5t \u0111\u1ecbnh ph\u1ea3i n\u1eafm r\u00f5 v\u1ec1 quy \u0111\u1ecbnh n\u00e0y nh\u00e9. Theo lu\u1eadt b\u1ea3o hi\u1ec3m, nh\u1eefng ng\u01b0\u1eddi tham gia b\u1ea3o hi\u1ec3m y t\u1ebf \u0111\u00f3ng \u0111\u1ee7 5 n\u0103m li\u00ean t\u1ee5c tr\u1edf l\u00ean s\u1ebd \u0111\u01b0\u1ee3c h\u01b0\u1edfng th\u00eam nhi\u1ec1u quy\u1ec1n l\u1ee3i &#8216;\u0111\u1eb7c c\u00e1ch&#8217;.<\/strong><\/p>\n<p>C\u1ee5 th\u1ec3 \u0111\u00f3 l\u00e0 g\u00ec, th\u00f4ng tin n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u0103ng t\u1ea3i tr\u00ean c\u00e1c trang b\u00e1o ch\u00ed, m\u00ecnh s\u1ebd chia s\u1ebb l\u1ea1i trong b\u00e0i vi\u1ebft b\u00ean d\u01b0\u1edbi cho ai \u0111ang quan t\u00e2m \u0111\u01b0\u1ee3c bi\u1ebft nh\u00e9!<\/p>\n<p><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/KiKVAf1kaoBpnpRJOKGsddfM2BSopGlDxTQVFhCH0QGu9vLVTu6WxNML29zb1yx6wjMkq80Hd-pbss18lBBPI31AXHGOlnvEBZKEdJ2llw=w622\" alt=\"h\u00ecnh \u1ea3nh\" data-height=\"0\" data-width=\"0\" \/><\/p>\n<p><em>C\u00e1ch ki\u1ec3m tra BHYT \u0111\u1ee7 5 n\u0103m li\u00ean t\u1ee5c, \u1ea3nh: dSD<\/em><\/p>\n<p><strong>Tr\u01b0\u1edbc h\u1ebft, m\u1ecdi ng\u01b0\u1eddi n\u00ean hi\u1ec3u v\u1ec1 kh\u00e1i ni\u1ec7m &#8216;B\u1ea3o hi\u1ec3m y t\u1ebf 5 n\u0103m li\u00ean t\u1ee5c&#8217;\u00a0l\u00e0 nh\u01b0 th\u1ebf n\u00e0o?<\/strong><\/p>\n<p>Theo \u0110i\u1ec1u 12 Ngh\u1ecb \u0111\u1ecbnh 146\/2018\/N\u0110-CP, BHYT 5 n\u0103m li\u00ean t\u1ee5c l\u00e0 tr\u01b0\u1eddng h\u1ee3p ng\u01b0\u1eddi tham gia BHYT c\u00f3 th\u1eddi gian \u0111\u00f3ng 05 n\u0103m li\u00ean ti\u1ebfp, trong \u0111\u00f3 \u0111\u01b0\u1ee3c ph\u00e9p gi\u00e1n \u0111o\u1ea1n t\u1ed1i \u0111a 03 th\u00e1ng.<\/p>\n<p>Th\u1eddi \u0111i\u1ec3m ng\u01b0\u1eddi tham gia BHYT \u0111\u1ee7 05 n\u0103m li\u00ean t\u1ee5c \u0111\u01b0\u1ee3c ghi nh\u1eadn tr\u1ef1c ti\u1ebfp tr\u00ean th\u1ebb BHYT. Theo Quy\u1ebft \u0111\u1ecbnh 1666\/Q\u0110-BHXH v\u1ec1 m\u1eabu th\u1ebb BHYT, vi\u1ec7c ghi nh\u1eadn th\u1eddi gian 05 n\u0103m li\u00ean t\u1ee5c \u0111\u01b0\u1ee3c quy \u0111\u1ecbnh nh\u01b0 sau:<\/p>\n<p>&#8211; Ng\u01b0\u1eddi \u0111\u00e3 c\u00f3 \u0111\u1ee7 05 n\u0103m tham gia BHYT li\u00ean t\u1ee5c t\u00ednh \u0111\u1ebfn ng\u00e0y 01\/01\/2015 th\u00ec in t\u1eeb ng\u00e0y 01\/01\/2015.<\/p>\n<p>&#8211; T\u1eeb ng\u00e0y 01\/01\/2015 tr\u1edf \u0111i, ng\u01b0\u1eddi tham gia BHYT ch\u01b0a \u0111\u1ee7 ho\u1eb7c b\u1eaft \u0111\u1ea7u \u0111\u1ee7 05 n\u0103m li\u00ean t\u1ee5c th\u00ec in t\u1eeb ng\u00e0y \u0111\u1ea7u ti\u00ean c\u1ee7a n\u0103m th\u1ee9 s\u00e1u.<\/p>\n<p><strong>Ng\u01b0\u1eddi \u0111\u00f3ng BHYT 5 n\u0103m li\u00ean t\u1ee5c \u0111\u01b0\u1ee3c h\u01b0\u1edfng\u00a0quy\u1ec1n l\u1ee3i \u0111\u1eb7c bi\u1ec7t n\u00e0o<\/strong><\/p>\n<p>M\u1ee9c h\u01b0\u1edfng BHYT 5 n\u0103m li\u00ean t\u1ee5c \u0111\u01b0\u1ee3c quy \u0111\u1ecbnh th\u1ec3 t\u1ea1i \u0111i\u1ec3m c kho\u1ea3n 1 \u0110i\u1ec1u 22 Lu\u1eadt BHYT s\u1ed1\u00a025\/2008\/QH12, s\u1eeda \u0111\u1ed5i b\u1edfi Lu\u1eadt s\u1ed1 46\/2014\/QH13 nh\u01b0 sau:<\/p>\n<p>Ng\u01b0\u1eddi tham gia b\u1ea3o hi\u1ec3m y t\u1ebf khi \u0111i kh\u00e1m b\u1ec7nh, ch\u1eefa b\u1ec7nh theo quy \u0111\u1ecbnh t\u1ea1i c\u00e1c \u0111i\u1ec1u 26, 27 v\u00e0 28 c\u1ee7a Lu\u1eadt n\u00e0y th\u00ec \u0111\u01b0\u1ee3c qu\u1ef9 b\u1ea3o hi\u1ec3m y t\u1ebf thanh to\u00e1n chi ph\u00ed kh\u00e1m b\u1ec7nh, ch\u1eefa b\u1ec7nh trong ph\u1ea1m vi \u0111\u01b0\u1ee3c h\u01b0\u1edfng v\u1edbi m\u1ee9c h\u01b0\u1edfng nh\u01b0 sau:<\/p>\n<p>\u0110\u01b0\u1ee3c thanh to\u00e1n 100% chi ph\u00ed kh\u00e1m b\u1ec7nh, ch\u1eefa b\u1ec7nh khi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1eddi gian tham gia b\u1ea3o hi\u1ec3m y t\u1ebf 5 n\u0103m li\u00ean t\u1ee5c tr\u1edf l\u00ean v\u00e0 c\u00f3 s\u1ed1 ti\u1ec1n c\u00f9ng chi tr\u1ea3 chi ph\u00ed kh\u00e1m b\u1ec7nh, ch\u1eefa b\u1ec7nh trong n\u0103m l\u1edbn h\u01a1n 6 th\u00e1ng l\u01b0\u01a1ng c\u01a1 s\u1edf, tr\u1eeb tr\u01b0\u1eddng h\u1ee3p t\u1ef1 \u0111i kh\u00e1m b\u1ec7nh, ch\u1eefa b\u1ec7nh kh\u00f4ng \u0111\u00fang tuy\u1ebfn.<\/p>\n<p>Theo \u0111\u00f3, m\u1ee9c h\u01b0\u1edfng BHYT 5 n\u0103m li\u00ean t\u1ee5c l\u00e0 100% chi ph\u00ed kh\u00e1m, ch\u1eefa b\u1ec7nh trong ph\u1ea1m vi \u0111\u01b0\u1ee3c h\u01b0\u1edfng.<\/p>\n<p><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/vNhtb6Pb_Hs9MoYTVQETMFTk_P6NBgdlbibJI6ZIRp6FVVTux82Pd4smHLUc11rL22vNrLDpJQCZc_pywWV967uJzIavDh4bWpSDAFYkxw=w622\" alt=\"h\u00ecnh \u1ea3nh\" data-height=\"0\" data-width=\"0\" \/><\/p>\n<p><em>Ng\u01b0\u1eddi tham gia BHYT \u0111\u1ee7 5 n\u0103m li\u00ean t\u1ee5c c\u00f3 quy\u1ec1n l\u1ee3i \u0111\u1eb7c bi\u1ec7t, \u1ea3nh: dSD<\/em><\/p>\n<p><strong>Nh\u01b0 v\u1eady, \u0111\u1ec3 \u0111\u01b0\u1ee3c thanh to\u00e1n 100% chi ph\u00ed kh\u00e1m, ch\u1eefa b\u1ec7nh theo m\u1ee9c h\u01b0\u1edfng BHYT 5 n\u0103m li\u00ean t\u1ee5c, ng\u01b0\u1eddi b\u1ec7nh ph\u1ea3i \u0111\u00e1p \u1ee9ng \u0111\u1ee7 c\u00e1c \u0111i\u1ec1u ki\u1ec7n nh\u01b0 sau:<\/strong><\/p>\n<p><strong>Th\u1ee9 nh\u1ea5t:\u00a0Tham gia BHYT 5 n\u0103m li\u00ean t\u1ee5c tr\u1edf l\u00ean:<\/strong><\/p>\n<p>\u0110\u01b0\u1ee3c ghi nh\u1eadn th\u1eddi \u0111i\u1ec3m \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n ngay tr\u00ean th\u1ebb BHYT. T\u1ee9c l\u00e0, tr\u00ean th\u1ebb BHYT c\u00f3 d\u00f2ng ch\u1eef: &#8220;Th\u1eddi \u0111i\u1ec3m \u0111\u1ee7 05 n\u0103m li\u00ean t\u1ee5c: T\u1eeb \u2026\/\u2026\/\u2026&#8221;.<\/p>\n<p>L\u01b0u \u00fd: N\u1ebfu c\u00f3 th\u1eddi gian gi\u00e1n \u0111o\u1ea1n th\u00ec ch\u1ec9 \u0111\u01b0\u1ee3c gi\u00e1n \u0111o\u1ea1n t\u1ed1i \u0111a kh\u00f4ng qu\u00e1 03 th\u00e1ng.<\/p>\n<p><strong>Th\u1ee9 hai: C\u00f3 s\u1ed1 ti\u1ec1n c\u00f9ng chi tr\u1ea3 chi ph\u00ed kh\u00e1m, ch\u1eefa b\u1ec7nh trong n\u0103m l\u1edbn h\u01a1n 6 th\u00e1ng l\u01b0\u01a1ng c\u01a1 s\u1edf<\/strong><\/p>\n<p>S\u1ed1 ti\u1ec1n \u0111\u1ed3ng chi tr\u1ea3 \u0111\u01b0\u1ee3c hi\u1ec3u l\u00e0 kho\u1ea3n ti\u1ec1n m\u00e0 ng\u01b0\u1eddi b\u1ec7nh ph\u1ea3i c\u00f9ng chi tr\u1ea3 v\u1edbi c\u01a1 quan BHXH theo t\u1ef7 l\u1ec7 % \u0111\u01b0\u1ee3c h\u01b0\u1edfng tr\u00ean th\u1ebb BHYT.<\/p>\n<p>Hi\u1ec7n nay, l\u01b0\u01a1ng c\u01a1 s\u1edf \u00e1p d\u1ee5ng m\u1ee9c 1,8 tri\u1ec7u \u0111\u1ed3ng\/th\u00e1ng th\u00ec s\u1ed1 ti\u1ec1n c\u00f9ng chi tr\u1ea3 ph\u1ea3i l\u1edbn h\u01a1n 6 x 1,8 tri\u1ec7u \u0111\u1ed3ng = 10,8 tri\u1ec7u \u0111\u1ed3ng.<\/p>\n<p><strong>Th\u1ee9 ba, l\u00e0 ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n \u0111i kh\u00e1m, ch\u1eefa b\u1ec7nh \u0111\u00fang tuy\u1ebfn.<\/strong><\/p>\n<p>C\u0103n c\u1ee9 Th\u00f4ng b\u00e1o 2298\/TB-BHXH ng\u00e0y 14\/11\/2018, h\u1ed3 s\u01a1 l\u00e0m th\u1ee7 t\u1ee5c h\u01b0\u1edfng BHYT 5 n\u0103m li\u00ean t\u1ee5c g\u1ed3m:<\/p>\n<p>&#8211; Th\u1ebb BHYT;<\/p>\n<p>&#8211; Gi\u1ea5y t\u1edd t\u00f9y th\u00e2n c\u00f3 \u1ea3nh (b\u1ea3n sao);<\/p>\n<p>&#8211; H\u00f3a \u0111\u01a1n, ch\u1ee9ng t\u1eeb thanh to\u00e1n vi\u1ec7n ph\u00ed (b\u1ea3n ch\u00ednh).<\/p>\n<p>Sau khi c\u00f3 \u0111\u1ee7 c\u00e1c gi\u1ea5y t\u1edd n\u00e0y, ng\u01b0\u1eddi b\u1ec7nh n\u1ed9p h\u1ed3 s\u01a1 t\u1ea1i c\u01a1 quan BHXH n\u01a1i tham gia BHYT \u0111\u1ec3 \u0111\u01b0\u1ee3c gi\u1ea3i quy\u1ebft.<\/p>\n<p>V\u1edbi quy \u0111\u1ecbnh n\u00e0y c\u00f3 th\u1ec3 th\u1ea5y, khi \u0111i kh\u00e1m, ch\u1eefa b\u1ec7nh, ng\u01b0\u1eddi b\u1ec7nh n\u00ean l\u01b0u gi\u1eef h\u00f3a \u0111\u01a1n, ch\u1ee9ng t\u1eeb c\u1ea9n th\u1eadn \u0111\u1ec3 c\u00f3 c\u0103n c\u1ee9 cho c\u01a1 quan BHXH gi\u1ea3i quy\u1ebft ch\u1ebf \u0111\u1ed9 \u0111\u1ea3m b\u1ea3o quy\u1ec1n l\u1ee3i cho m\u00ecnh.<\/p>\n<p><img decoding=\"async\" src=\"https:\/\/lh3.googleusercontent.com\/Q_8SiJi6XdAX_ZtPH2Kzg5mjJkr8TxlOKcDarF6qE3cTU3v3kldEa1sBBjTzQajBQ9FSoi-Ipheqe0Wnv9lsl61d_KYmxEpDef8uT8hFJQ=w622\" alt=\"h\u00ecnh \u1ea3nh\" data-height=\"0\" data-width=\"0\" \/><\/p>\n<p><em>Th\u1eddi \u0111i\u1ec3m BHYT \u0111\u1ee7 5 n\u0103m li\u00ean t\u1ee5c, \u1ea3nh: dSD<\/em><\/p>\n<p>Theo \u0111i\u1ec3m c kho\u1ea3n 1 \u0110i\u1ec1u 22 Lu\u1eadt B\u1ea3o hi\u1ec3m y t\u1ebf quy \u0111\u1ecbnh:<\/p>\n<p>Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c qu\u1ef9 BHYT thanh to\u00e1n 100% chi ph\u00ed kh\u00e1m, ch\u1eefa b\u1ec7nh trong ph\u1ea1m vi \u0111\u01b0\u1ee3c h\u01b0\u1edfng n\u1ebfu \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u ki\u1ec7n t\u1ea1i m\u1ee5c 2.<\/p>\n<p><strong>C\u1ee5 th\u1ec3, t\u1ea1i Ngh\u1ecb \u0111\u1ecbnh 146\/2018\/N\u0110-CP h\u01b0\u1edbng d\u1eabn thanh to\u00e1n chi ph\u00ed kh\u00e1m b\u1ec7nh, ch\u1eefa b\u1ec7nh \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1eddi gian tham gia BHYT 5 n\u0103m li\u00ean t\u1ee5c tr\u1edf l\u00ean nh\u01b0 sau:<\/strong><\/p>\n<p>&#8211; Tr\u01b0\u1eddng h\u1ee3p ng\u01b0\u1eddi b\u1ec7nh c\u00f3 s\u1ed1 ti\u1ec1n c\u00f9ng chi tr\u1ea3 t\u1ea1i m\u1ed9t l\u1ea7n ho\u1eb7c nhi\u1ec1u l\u1ea7n kh\u00e1m b\u1ec7nh, ch\u1eefa b\u1ec7nh t\u1ea1i c\u00f9ng c\u01a1 s\u1edf kh\u00e1m b\u1ec7nh, ch\u1eefa b\u1ec7nh \u0111\u00f3 l\u1edbn h\u01a1n 6 th\u00e1ng l\u01b0\u01a1ng c\u01a1 s\u1edf th\u00ec c\u01a1 s\u1edf kh\u00e1m b\u1ec7nh, ch\u1eefa b\u1ec7nh kh\u00f4ng thu s\u1ed1 ti\u1ec1n c\u00f9ng chi tr\u1ea3 l\u1edbn h\u01a1n 6 th\u00e1ng l\u01b0\u01a1ng c\u01a1 s\u1edf c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n<p>C\u01a1 s\u1edf kh\u00e1m b\u1ec7nh, ch\u1eefa b\u1ec7nh c\u00f3 tr\u00e1ch nhi\u1ec7m cung c\u1ea5p h\u00f3a \u0111\u01a1n thu \u0111\u1ed1i v\u1edbi s\u1ed1 ti\u1ec1n c\u00f9ng chi tr\u1ea3 \u0111\u1ee7 6 th\u00e1ng l\u01b0\u01a1ng c\u01a1 s\u1edf \u0111\u1ec3 ng\u01b0\u1eddi b\u1ec7nh c\u00f3 c\u0103n c\u1ee9 \u0111\u1ec1 ngh\u1ecb c\u01a1 quan BHXH x\u00e1c nh\u1eadn kh\u00f4ng ph\u1ea3i c\u00f9ng chi tr\u1ea3 trong n\u0103m \u0111\u00f3;<\/p>\n<p>&#8211; Tr\u01b0\u1eddng h\u1ee3p ng\u01b0\u1eddi b\u1ec7nh c\u00f3 s\u1ed1 ti\u1ec1n c\u00f9ng chi tr\u1ea3 l\u0169y k\u1ebf trong n\u0103m t\u00e0i ch\u00ednh t\u1ea1i c\u00e1c c\u01a1 s\u1edf kh\u00e1m b\u1ec7nh, ch\u1eefa b\u1ec7nh kh\u00e1c nhau ho\u1eb7c t\u1ea1i c\u00f9ng m\u1ed9t c\u01a1 s\u1edf kh\u00e1m b\u1ec7nh, ch\u1eefa b\u1ec7nh l\u1edbn h\u01a1n 6 th\u00e1ng l\u01b0\u01a1ng c\u01a1 s\u1edf th\u00ec ng\u01b0\u1eddi b\u1ec7nh mang ch\u1ee9ng t\u1eeb \u0111\u1ebfn c\u01a1 quan BHXH n\u01a1i c\u1ea5p th\u1ebb BHYT \u0111\u1ec3 thanh to\u00e1n s\u1ed1 ti\u1ec1n c\u00f9ng chi tr\u1ea3 l\u1edbn h\u01a1n 06 th\u00e1ng l\u01b0\u01a1ng c\u01a1 s\u1edf v\u00e0 nh\u1eadn gi\u1ea5y x\u00e1c nh\u1eadn kh\u00f4ng ph\u1ea3i c\u00f9ng chi tr\u1ea3 trong n\u0103m \u0111\u00f3;<\/p>\n<p>&#8211; Tr\u01b0\u1eddng h\u1ee3p ng\u01b0\u1eddi b\u1ec7nh c\u00f3 s\u1ed1 ti\u1ec1n c\u00f9ng chi tr\u1ea3 v\u01b0\u1ee3t qu\u00e1 6 th\u00e1ng l\u01b0\u01a1ng c\u01a1 s\u1edf \u0111\u01b0\u1ee3c t\u00ednh t\u1eeb ng\u00e0y 1\/1, qu\u1ef9 b\u1ea3o hi\u1ec3m y t\u1ebf thanh to\u00e1n 100% chi ph\u00ed kh\u00e1m b\u1ec7nh ch\u1eefa b\u1ec7nh trong ph\u1ea1m vi quy\u1ec1n l\u1ee3i c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh k\u1ec3 t\u1eeb th\u1eddi \u0111i\u1ec3m ng\u01b0\u1eddi b\u1ec7nh tham gia \u0111\u1ee7 5 n\u0103m li\u00ean t\u1ee5c \u0111\u1ebfn h\u1ebft ng\u00e0y 31\/12 c\u1ee7a n\u0103m \u0111\u00f3.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>N\u1ebfu m\u1ecdi\u00a0 ng\u01b0\u1eddi tham gia b\u1ea3o hi\u1ec3m y t\u1ebf th\u00ec nh\u1ea5t \u0111\u1ecbnh ph\u1ea3i n\u1eafm r\u00f5 v\u1ec1 quy \u0111\u1ecbnh n\u00e0y nh\u00e9. Theo lu\u1eadt b\u1ea3o hi\u1ec3m, nh\u1eefng ng\u01b0\u1eddi tham gia b\u1ea3o hi\u1ec3m y t\u1ebf \u0111\u00f3ng \u0111\u1ee7 5 n\u0103m li\u00ean t\u1ee5c tr\u1edf l\u00ean s\u1ebd \u0111\u01b0\u1ee3c h\u01b0\u1edfng th\u00eam nhi\u1ec1u quy\u1ec1n l\u1ee3i &#8216;\u0111\u1eb7c c\u00e1ch&#8217;. 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