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What is the reimbursement ratio of NCMS inpatients? Is NCMS hospitalization reimbursement high

What is the proportion of hospitalization reimbursement for the new rural cooperative medical system in 2019? It is always a problem that it is expensive and difficult to see a doctor in China, which needs to be solved urgently. The new rural cooperative medical system (NCMS) has greatly helped farmers to see a doctor, which has made it difficult for them to see a doctor and cause poverty. What is the reimbursement ratio of the new rural cooperative medical system in 2018? The reimbursement of the new rural cooperative medical system mainly includes outpatient reimbursement, hospitalization reimbursement and serious illness reimbursement.

What is the reimbursement ratio of the new rural cooperative medical system?

1、 Reimbursement ratio of NCMS clinic

1. The reimbursement rate of rural clinics and clinics was 60%;

2. 40% reimbursement rate of township hospitals

3. The proportion of patients in secondary hospitals is 30%

4. Reimbursement rate of tertiary hospitals is 20%

5. The reimbursement limit of town level cooperative medical clinic is 5000 yuan / year.

2、 New rural cooperative medical system hospitalization reimbursement proportion

1. The reimbursement rate of township hospitals was 60%;

2. 40% in the second level hospitals;

3. The reimbursement rate of tertiary hospitals was 30%.

3、 Reimbursement ratio of serious diseases in new rural cooperative medical system

1. The proportion of township and village subsidies for outpatient co-ordination increased to 65% and 75% respectively.

2. If the hospitalization expenses of first-class medical institutions are less than 400 yuan, there is no starting line

3. The subsidy proportion of secondary medical institutions should be increased to 75% ~ 80%

4. The subsidy proportion of tertiary medical institutions should be increased to 55% ~ 60%.

5. The subsidy proportion of provincial three-level medical institutions should be increased to 55%.

6. For 8 serious diseases such as congenital heart disease of children, 70% of the quota of new rural cooperative medical system subsidy diseases, and 12 kinds of serious diseases such as lung cancer, strive to achieve 70% of the quota.

New rural cooperative medical system hospitalization reimbursement standard

1. Reimbursement of items such as acupuncture and moxibustion, X-ray examination, X-ray examination, X-ray examination, etc

2. The operating expenses within 1000 yuan shall be reimbursed according to the national standard, and those exceeding 1000 yuan shall be reimbursed according to 1000 yuan

3. The hospitalization and nursing expenses for the elderly over 60 years old can be reimbursed 10 yuan per day, with a limit of 200 yuan

Reimbursement scope of new rural cooperative medical system in 2017 (the following contents are not included in the reimbursement scope of new rural cooperative medical system)

1. Self purchase drug fee;

2. The cost of drugs exceeding the basic drug list of new rural cooperative medical system in Jiangsu Province;

3. Registration fee, outpatient medical record cost, visiting fee, Chinese medicine decocting fee, ambulance fee, accompanying bed fee, bed wrapping fee, special care fee, consultation fee, air conditioning (including heating), TV fee, telephone fee, personal living expenses, nursing fee, etc;

4. Non basic medical expenses (including special outpatient service, specialist outpatient service, bed fee exceeding 35 yuan / day, medical cosmetology, family sickbed, etc.);

5. Medical expenses caused by fighting, alcoholism, drug abuse, drug addiction, venereal disease, work-related injury, injury in the process of labor service, traffic accident, intentional self injury and self mutilation, non productive pesticide poisoning, occupational poisoning, medical accident, violation of law and discipline and other reasons;

6. Induced labor by flow;

7. All kinds of plastic surgery, orthopedics, 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. Medical service, examination and treatment items not approved by the price and health departments, and all expenses incurred in raising the charging standard without authorization;

10. There are fraudulent medical expenses such as not being hospitalized by name or substituting for hospitalization;

11. Those who have obtained compensation from basic medical insurance for urban employees, basic medical insurance 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 new rural cooperative medical system

1、 Outpatient compensation standard

1. The reimbursement rate of village clinics and Village Central clinics is 60%, and the limit of prescription drug cost for each visit is 10 yuan, and that for temporary rehydration prescription of doctors in health centers is 50 yuan.

2. 40% of the expenses were reimbursed. The examination and operation expenses were limited to 50 yuan for each visit, and 100 yuan for prescription medicine.

3. The reimbursement rate of the second level hospital is 30%. The examination fee and operation fee are limited to 50 yuan per visit, and the prescription medicine fee is limited to 200 yuan.

4. The reimbursement rate of tertiary hospitals is 20%. The examination and operation expenses are limited to 50 yuan per visit, and the prescription medicine fee is 200 yuan.

5. Prescription is attached to the invoice of traditional Chinese medicine, with a limit of 1 yuan per paste.

6. The annual compensation limit of town level cooperative medical service outpatient service is 5000 yuan.

2、 New rural cooperative medical system hospitalization compensation standard

1. Medical expenses: auxiliary examination: the limit of examination expenses for ECG, X-ray fluoroscopy, film making, laboratory test, physical therapy, acupuncture, CT, MRI, etc. is 200 yuan; operation expenses (refer to the national standard, those exceeding 1000 yuan will be reimbursed according to 1000 yuan).

2. The elderly over 60 years old are hospitalized in Xingta town health center. The compensation for treatment and nursing expenses is 10 yuan per day, with a limit of 200 yuan.

3、 Compensation standard for serious diseases of new rural cooperative medical system

1. Town risk fund compensation: for the inpatients who participate in the cooperative medical system, the one-time or annual accumulative medical expenses that should be reported more than 5000 yuan shall be compensated by stages, that is, 65% compensation shall be made for 5001-10000 yuan, and 70% compensation shall be made for 10001-18000 yuan.

2. The annual compensation limit of Township cooperative medical system is 11000 yuan.