It is always a problem that medical treatment is expensive and difficult in China. The new rural cooperative medical system (NRCMS) has greatly helped farmers to see the doctor difficultly and become poor, which is a real preferential policy for farmers. What is the proportion of NCMS reimbursement in 2019? For many poor families, the NCMS reimbursement is really a benefit to the people. So what's the new rural cooperative reimbursement ratio?
What is the reimbursement ratio of NCMS?
1、 New rural cooperative outpatient reimbursement ratio
1. The reimbursement rate of rural clinics and health centers is 60%;
2. Reimbursement rate of township health center 40%
3. 30% of secondary hospitals
4. Reimbursement proportion of tertiary hospitals: 20%
5. Reimbursement limit of township level cooperative medical outpatient service is 5000 yuan / year.
2、 Proportion of hospitalization reimbursement of NCMS
1. Reimbursement of 60% by township hospital;
2. 40% reimbursement for the second level hospital;
3. The third level hospital reimburses 30%.
3、 Proportion of reimbursement for serious illness in NCMS
1. The proportion of rural and village subsidies for outpatient co-ordination increased to 65% and 75% respectively.
2. If the hospitalization expenses of the first-class medical institutions are less than 400 yuan, there is no starting line
3. The subsidy proportion of secondary medical institutions increased to 75% ~ 80%
4. The subsidy proportion of tertiary medical institutions increased to 55% ~ 60%.
5. The subsidy proportion of medical institutions at the provincial level was increased to 55%.
6. 70% of the new rural cooperative allowance for 8 serious diseases such as children's congenital heart disease, 12 serious diseases such as lung cancer, and 70% of the new rural cooperative allowance.
Hospitalization reimbursement standard of NCMS
1. New EEG, X-ray fluoroscopy, radiography, laboratory test, physical therapy, acupuncture, CT, MRI and other auxiliary examination items are reimbursed 200 yuan
2. The operating expenses shall be reimbursed according to the national standard within 1000 yuan of the starting line, and those exceeding 1000 yuan shall be reimbursed according to 1000 yuan
3. The inpatient treatment fee and nursing fee for the elderly over 60 can be reimbursed 10 yuan per day, with a limit of 200 yuan
The reimbursement scope of NCMS in 2017 (the following contents are not included in the reimbursement scope of NCMS)
1. Self purchase drug fee;
2. The cost of drugs beyond the basic drug list of new rural cooperative medical system;
3. Registration fee, outpatient medical record cost, outpatient fee, traditional Chinese medicine decoction fee, ambulance fee, accompanying bed fee, bed fee, special care fee, consultation fee, air conditioning (including heating) fee, television fee, telephone fee, personal living expenses, nursing fee, etc;
4. Expenses for non basic medical treatment (special outpatient service, expert outpatient service, bed fee exceeding 35 yuan / day, medical cosmetology, family sickbed, etc.);
5. Medical expenses caused by fights, alcoholism, drug abuse, detoxification, venereal diseases, industrial injuries and injuries in the course of labor service, traffic accidents, intentional self injury, unproductive pesticide poisoning, occupational poisoning, medical accidents, violations of laws and disciplines and other reasons;
6. Induced abortion;
7. Various cosmetic, orthopedic, weight-loss, correction of physiological defects and various health care, preventive diagnosis and treatment projects and drug costs;
8. The cost of purchasing organs or tissues for organ and tissue transplantation and artificial organ installation;
9. All expenses incurred for medical services, inspection and treatment without the approval of the price and health departments, and for raising the charging standard without authorization;
10. There are fraudulent medical expenses such as not being in hospital under a registered name or being in hospital under a false name;
11. Having obtained basic medical insurance for urban employees, basic medical insurance compensation for urban residents and other basic medical insurance compensation;
12. Medical expenses incurred abroad;
13. Other provisions of the new rural cooperative medical system.
Compensation standard of NCMS
1、 Outpatient compensation standard
1. 60% of the medical expenses are reimbursed by the village health office and the village central health office. The limit of the prescription drug fee for each visit is 10 yuan, and the limit of the temporary rehydration prescription drug fee for the doctors in the hospital is 50 yuan.
2. 40% of the medical expenses are reimbursed by the township health center. The limit of each examination fee and operation fee is 50 yuan, and the limit of prescription medicine fee is 100 yuan.
3. The reimbursement of the second level hospital is 30%. The limit of each examination and operation fee is 50 yuan, and the limit of prescription medicine fee is 200 yuan.
4. The third level hospital reimburses 20% of the medical expenses, and the limit of each examination fee and operation fee is 50 yuan, and the limit of prescription drug fee is 200 yuan.
5. The invoice of traditional Chinese medicine is attached with the limit of 1 yuan for each prescription.
6. The annual compensation limit for township level cooperative medical outpatient service is 5000 yuan.
2、 Compensation standard for hospitalization of NCMS
1. Medicine cost: auxiliary examination: the examination cost limit of ECG, X-ray fluoroscopy, radiography, laboratory test, physical therapy, acupuncture, CT, MRI and other examinations is 200 yuan; the operation cost (refer to the national standard, if more than 1000 yuan, it will be reimbursed as 1000 yuan).
2. The elderly over 60 years old are hospitalized in Xingta town health center, and the treatment fee and nursing fee are compensated by 10 yuan per day, with a limit of 200 yuan.
3、 Compensation standard for serious diseases in NCMS
1. Compensation of town risk fund: for inpatients who participate in cooperative medical treatment, one-time or annual accumulative medical expenses should be more than 5000 yuan, i.e. 5001-10000 yuan for 65% and 10001-18000 yuan for 70%.
2. The annual limit of compensation for hemodialysis, radiotherapy and chemotherapy in inpatient and uremic outpatient of township level cooperative medical treatment is 11000 yuan.