5
07
11110226000113347H
北京市平谷区山东庄镇人民政府
低保、特困等困难群众医疗救助
11110226000113347H5000736001000
0
b53061f7-c8dc-4fcf-91e6-08e65d6ba5c5
f79f2ddb-3a6b-410c-beb8-9b838f6868bf
3^5
07
平谷区山东庄镇
110117102000
北京市平谷区山东庄镇人民政府
工作日09:00-17:00,周六预约，办公时间09:00-15:00
北京市平谷区山东庄镇政务服务中心：北京市平谷区山东庄镇府前路9号：一层综合窗口3号
申请家庭应当填写《申请因病致贫家庭医疗救助经济状况和医疗费用支出情况登记表及声明书》，如实申报家庭经济状况和医疗费用支出情况，授权区医疗救助主管部门对其家庭收入、家庭财产和医疗费用支出情况进行核查，同时提交上一自然年度共同生活家庭成员的以下证明材料： ①户口簿及身份证复印件。 ②《申请因病致贫家庭医疗救助经济状况和医疗费用支出情况登记表及声明书》。 ③年度收入证明和相关财产证明。 ④本市二级及以上医保或新农合定点医疗机构出具的诊断证明。 ⑤北京市医疗门诊收费票据或北京市医疗住院收费票据，以及北京市城镇职工基本医疗保险或城镇居民基本医疗保险、新型农村合作医疗、商业保险主管部门出具的费用结算分割单。 ⑥其他证明材料。 乡镇人民政府（街道办事处）社会保障事务所应当对申请家庭提交的材料进行审查，材料齐备的予以受理。
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[]
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