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What is the scope and proportion of reimbursement of the new rural cooperative medical system? New r

The new rural cooperative medical system is an important measure to solve the problem of farmers' medical treatment and improve their medical and health level. But how much do you know about the reimbursement scope and reimbursement proportion of the new rural cooperative medical system? What materials do you need for new rural medical reimbursement? What is the specific process? The following is your answer.

1、 Reimbursement scope of new rural cooperative medical system

Farmers who participate in the new rural cooperative medical system (NCMS) can get reimbursement from the new rural cooperative medical system (NCMS) in the outpatient and inpatient clinics of designated medical institutions. The reimbursement scope mainly includes drug reimbursement, inspection expense reimbursement, bed expense reimbursement, etc. Taking drug reimbursement as an example, class a drugs can be basically reimbursed, some class B drugs can be reimbursed, and class C drugs can not be reimbursed; taking inpatient reimbursement as an example, hospitalization bed expenses or outpatient bed expenses can also be reimbursed.

The reimbursement scope of NCMS is as follows:

Outpatient compensation: 60% of the reimbursement was made to the village clinics and Village Central clinics, with a limit of 10 yuan for each visit and 50 yuan for temporary rehydration prescriptions.

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. 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. 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. Prescription is attached to the invoice of traditional Chinese medicine, with a limit of 1 yuan per paste. The annual compensation limit of town level cooperative medical service outpatient service is 5000 yuan.

2、 Reimbursement ratio of new rural cooperative medical system

1、 Reimbursement ratio of NCMS clinic

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

2. The reimbursement rate of township hospitals was 40%;

3. The reimbursement rate of secondary hospitals was 30%;

4. The reimbursement rate of tertiary hospitals was 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. New EEG, X-ray fluoroscopy, film, laboratory test, physical therapy, acupuncture, CT, nuclear magnetic resonance and other auxiliary examination items are limited to reimbursement of 200 yuan;

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;

4. The reimbursement proportion of hospitals at all levels is: 60% for township hospitals, 40% for secondary hospitals and 30% for tertiary hospitals.

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 will be increased to 75% ~ 80%;

4. The subsidy proportion of tertiary medical institutions will be increased to 55% - 60%.

5. The subsidy proportion of provincial three-level medical institutions was 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, should strive to reach 70%.

3、 The specific process of medical reimbursement

The new rural cooperative medical card of Chun'an County will be issued by the county agricultural medical office to the personnel participating in the county new rural cooperative medical system. The original "Chun'an County new rural cooperative medical card" will continue to be valid. The personnel who participate in the new rural cooperative medical system of the county can apply for reimbursement by swiping card immediately according to the reimbursement proportion of cooperative medical system when they are out-patient or hospitalized in the designated medical institutions of the county. The expenses for special diseases and medical expenses in outpatient and hospitalization of designated medical institutions outside the county level shall be paid by myself. After the end of medical treatment, the township will be declared by the registered residence in the relevant data.

4、 Information required for medical reimbursement

1. Original and copy of medical expense invoice;

2. Original and copy of detailed list of medical expenses;

3. Other relevant medical documents and supporting materials;

4. For outpatients, the original and copy of medical records shall be provided.

5. For inpatients, a copy of discharge summary shall be provided;

6. In case of death, a copy of death certificate shall be provided.

The above is the relevant information compiled for you. In our daily life, we should have some understanding of some common legal knowledge, so that we can use legal knowledge to protect our rights when we need help.