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為增進遭遇職業傷病被保險人醫療給付權益，ttypacking 發表在 痞客邦 留言(0) 人氣(0)
✸ 因職業傷病醫療需要，選用健保所定自付差額特殊材料品項，可申請差額費用補助！
❏ 勞工職業災害保險及保護法上路後，被保險人因職業傷病及其引起之疾病，經全民健康保險特約醫院或診所醫師認定有醫療上需要使用自付差額特殊材料品項者，於先行墊付自付差額後，得向勞工保險局申請核退該差額費用！
➊持由投保單位填發的「職業傷病門診單」或「職業傷病住院申請書」，並繳驗全民健康保險卡及國民身分證或其他足以證明身分的文件。
➋前往全民健康保險特約醫院或診所診療。
➌經醫師認定有醫療上的需要，選用全民健康保險法第45條第1項所定自付差額特殊材料品項者，得向勞保局申請核退該差額費用。
✪ 前述自付差額特殊材料品項，以衛生福利部公告者為限，如被保險人選用「全自費」之醫療材料，非屬職災醫療給付範圍，仍需由被保險人自行負擔喔！
❖勞工職業災害保險自墊醫療費用核退申請書及給付收據 ➥https://pse.is/5nna7k
❖健保自付差額類別及品項 ➥https://pse.is/5nn9vf
❖法令依據 ➥https://pse.is/5mhz3l---
After the implementation of the Labor Occupational Accident Insurance and Protection Act. If due to illness caused by occupational injuries and diseases the insured is identified as having medical needs by the physicians in the NHI hospital or clinic and such insured selects special materials and items, after paying the difference in advance, he may apply to the insurer (the Bureau of Labor Insurance) for the reimbursement of the amount of difference.
➊Hold an occupational injury or disease Clinic Visit Form or Hospitalization Application Form that filled out by the insured unit. And submit the Certificate of National Health Insurance and National Identity Card or other documents sufficient to prove the identity.
➋The insured person who suffers occupational injury or disease shall seek treatment from a contracted hospital or clinic of national health insurance.
➌If the insured is identified as having medical needs by the physicians in the NHI hospital or clinic and such insured selects special materials and items specified in Paragraph 1 of Article 45 of the National Health Insurance Act, after paying the difference in advance, he may apply to the insurer for the reimbursement of the amount of difference.
✪Regarding the aforementioned special materials and items, it is limited to those announced by the Ministry of Health and Welfare. If the insured chooses to use medical materials under "full self-payment," which are not within the scope of occupational injury or disease medical care benefits, the insured is still responsible for bearing the cost.
❖Labor Insurance Occupational Accident Insurance Up-front Medical Expense Reimbursement Application Form and benefit receipt➥
https://pse.is/5nna7k❖The special materials and items specified of the National Health Insurance Act➥
https://pse.is/5nn9vf❖Labor Occupational Accident Insurance Medical Care Benefit Item and Payment Standards➥
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「#在宅急症照護」是已被歐美、日本醫療體系認可的住院替代服務，也稱「在宅住院」
肺炎/尿路感染/軟組織感染患者
居家醫療服務的個案
專業醫療團隊（醫師、護理人員、呼吸治療師、藥事人員）提供 8大貼心照護：
專業訪視 & 遠距醫療
https://gov.tw/jL7
補助標準
https://www.bli.gov.tw/0005066.html
退費申請文件：
貼心提醒
常有人問：
和大家澄清：
病患的住院日數是由診治醫師視病情治療需要，依據臨床專業判斷決定。
如果有遇到類似問題，請向健保署各轄區業務組詢問喔
https://gov.tw/ACy
更多資訊，請參考連結
全民健保行動快易通｜健康存摺APP
Android：https://goo.gl/dwD1aC
健保諮詢服務專線:0800-030-598
手機請撥02-4128-678
可受理虛擬卡就醫之院所名單：https://gov.tw/B5H
最後也提醒大家，使用虛擬健保卡之前，還是要記得跟醫院診所確認，能不能使用虛擬健保卡喔～
現在就拿起手機下載虛擬健保卡吧
健保出國停復保 相關規定報您知
在國內設有 #戶籍，不論住在國內或國外，都應依規定持續加保及繳納保險費，並享有健保醫療保障。
繼續加保：不需申請，出國期間每月持續繳納健保費，繼續享有健保醫療權益。
旅外國人停、復保相關資訊請看
旅外國人因應疫情影響健保權益相關資訊請看
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