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<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif"><span style="font-family:"新細明體",serif">一、本市醫療費用補助對象：據本市市民醫療補助辦法，設籍本市且符合下列規定者，於期間所生於全民健康保險地區級以上特約醫院就醫所生符合補助項目之醫療費用，得依本辦法申請補助：</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">(<span style="font-family:"新細明體",serif">一</span>)<span style="font-family:"新細明體",serif">列冊低收入戶。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">(<span style="font-family:"新細明體",serif">二</span>)<span style="font-family:"新細明體",serif">列冊中低收入戶患嚴重傷、病，所需醫療費用非其本人或扶養義務人所能負擔。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">(<span style="font-family:"新細明體",serif">三</span>)<span style="font-family:"新細明體",serif">前</span>2<span style="font-family:"新細明體",serif">款之外，患嚴重傷、病，家庭總收入平均分配全家人口，每人每月不超過當年度臺中市低收入戶最低生活費</span>1.5<span style="font-family:"新細明體",serif">倍，且符合下列資格之一者：</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">1.<span style="font-family:"新細明體",serif">領有經濟弱勢兒童及少年生活扶助。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">2.<span style="font-family:"新細明體",serif">具有特殊境遇家庭生活扶助身分。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">3.<span style="font-family:"新細明體",serif">領有身心障礙生活補助費。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">4.<span style="font-family:"新細明體",serif">領有中低收入老人生活津貼。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">(<span style="font-family:"新細明體",serif">四</span>)<span style="font-family:"新細明體",serif">生活陷困或其他特殊情形，致本人或扶養義務人未能負擔醫療費用，經社會局指派社會工作員訪視評估有必要補助者。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif"><span style="font-family:"新細明體",serif">前項第三款、第四款最近</span>3<span style="font-family:"新細明體",serif">個月依全民健康保險就醫之自付醫療費用累計達新臺幣</span>5<span style="font-family:"新細明體",serif">萬元以上。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif"><span style="font-family:"新細明體",serif">第三款所稱全家人口及家庭總收入計算基準，依社會救助法及其相關規定辦理。參加全民健康保險可取得醫療給付者，不得申請補助。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif"><span style="font-family:"新細明體",serif">二、補助及不補助項目：</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">(<span style="font-family:"新細明體",serif">一</span>)<span style="font-family:"新細明體",serif">補助項目為</span><span style="font-family:"新細明體",serif">因疾病、傷害事故於全民健康保險地區級以上特約醫院就醫所生全民健康保險法第</span>43<span style="font-family:"新細明體",serif">條及第</span>47<span style="font-family:"新細明體",serif">條規定</span><span style="font-family:"新細明體",serif">應自行負擔</span><span style="font-family:"新細明體",serif">之</span><span style="font-family:"新細明體",serif">費用。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">(<span style="font-family:"新細明體",serif">二</span>)<span style="font-family:"新細明體",serif">但下列項目不予補助：</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">1.<span style="font-family:"新細明體",serif">全民健康保險法第</span>51<span style="font-family:"新細明體",serif">條規定所列之項目。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">2.<span style="font-family:"新細明體",serif">鑲牙、洗牙、齒列矯正、牙周病統合照護、器官捐贈、指定藥品、材料及衛材、自購器材、疾病預防及非因治療疾病而施行之檢查、篩檢、藥物使用、手術或節育結紮。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">3.<span style="font-family:"新細明體",serif">就醫期間之照護、營養品、膳食、雜費、電話費、行政費及其他與醫療無直接相關之項目。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">4.<span style="font-family:"新細明體",serif">使用全民健康保險不給付之自費材料、檢查、藥品、手術。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:Calibri,sans-serif">5.<span style="font-family:"新細明體",serif">依全民健康保險醫療服務給付項目及支付標準、全民健康保險藥物給付項目及支付標準，應於使用前審查之項目，未依規定事前申請核准，或不符合上開標準所訂適應症，而自費使用給付項目。</span></span></span></p>
<p><span style="font-size:12px"><span style="font-family:"新細明體",serif"><span style="font-family:"新細明體",serif">前項第</span><span style="font-family:"Calibri",sans-serif">4</span><span style="font-family:"新細明體",serif">款及第</span><span style="font-family:"Calibri",sans-serif">5</span><span style="font-family:"新細明體",serif">款情形，如經原診治醫院評估患嚴重傷、病且情況緊急，為治療所必須者，不在此限。</span></span></span></p>
