长期护理险如何使用?|最新高清无码专区

  广州日报讯 (全媒体记者 赵冬芹)随着我国老龄化程度加深,家庭照护的负担日益沉重,受到社会关注。目前,我国已推出长期护理保险(简称“长护险”)政策,广州市是长护险的全国首批试点城市之一。广州市长期护理险要自行购买吗?如何申请享受长护险待遇?

  个人缴费直接从医保个账划转

  广州目前的定点医疗机构一共有269家。本市职工社会医疗保险参保人员、年满18周岁的城乡居民社会医疗保险参保人员,在参加广州市社会医疗保险(简称医保)的同时参加广州市长期护理保险,由医保经办机构为其建立长护险参保关系。

  在筹资及缴费标准方面,以职工参保人为例,参保长护险通过单位缴费和个人缴费筹资。其中,单位缴费由医保经办机构从职工医保统筹基金按月划转,个人缴费由医保经办机构从其职工医保个人账户按月代扣代缴。居民参保人员参加长护险通过个人缴费和财政补助筹资,由医保经办机构分别从城乡居民医保基金个人缴费和财政补助部分中按年度划转。

  线上申请待遇全程不超过13个工作日

  据悉,长护险基金可支付长护险定点护理服务机构按规定提供护理服务发生的床位费;长护险服务项目范围内的生活照料费、与之相关的医疗护理费(含护理耗材费,下同)、设备使用费等。

  根据长护险评估线上申办流程,参保人可通过“粤医保”小程序、“穗好办”APP或经办机构提交失能评估申请。评估机构在13个工作日内完成受理审核及评估实施。评估公示并告知申请人后,参保人员可选择长护定点护理服务机构,按评估结论在机构享受照护服务。

  分级享受待遇 居家护理报销比例更高

  根据评估结果,职工参保人和居民参保人均可享受长护险1级、2级和3级待遇。在支付比例方面,职工参保人员由长护险基金按机构护理75%、居家护理90%的比例支付;居民参保人员由长护险基金按机构护理70%、居家护理85%的比例支付。以享受长护险3级待遇的长期失能人员为例,职工参保人机构护理可享受报销限额为“120元×75%”,实际长护险可支付90元/天。

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