1. When the patient leaves the hospital, the basic medical insurance, serious illness insurance and medical assistance will be reimbursed in one stop.
2. Cross-city medical treatment in different places needs to pay normal fees. However, the reimbursement rate will be appropriately increased. Proportion of hospitalization compensation: the reimbursement rate of hospitalization medical expenses of insured persons in designated medical institutions in counties and districts is 90%; Hospitalization in medical institutions outside the county: 80% in secondary medical institutions and 65% in tertiary medical institutions in the city; Transfer to medical institutions outside the city is 50%. 40% without medical insurance agency filing reimbursement.
Second, what are the procedures for the hospitalization of precision poverty alleviation households?
1, accurate poverty alleviation households are hospitalized, and hospitalization procedures are handled with ID cards. If they apply for the new rural cooperative medical system, they can be reimbursed for medical expenses, but if they do not apply for the new rural cooperative medical system, they cannot be reimbursed for hospitalization medical expenses.
2. The poor people in rural areas are hospitalized, and they are paid after treatment (paying less for the time being). When they go through the hospitalization procedures, patients provide the hospital with the Handbook of Accurate Poverty Alleviation, residents' medical insurance cards, ID cards or household registration books.
3. During the patient's hospitalization, the hospital will provide the patient with a list of daily expenses for the patient to inquire; If you need to use drugs (materials) at your own expense, you will inform the patients or their families in advance and sign the notification form.
4. The hospital will inform the patient of the general expenses during hospitalization and the amount that the individual should bear within 1-2 days before the patient leaves the hospital.
5. When the patient leaves the hospital, he shall truthfully pay the medical expenses borne by himself during the detention period to the hospital. The policy of paying after diagnosis and treatment is applicable to the poor people who set up files and set up cards.
Third, is hospitalization for traffic accidents reimbursed by the new rural cooperative medical system?
1, the accident belongs to the expenses borne by a third party, which is not within the reimbursement scope of the village cooperative medical system. Only when the injurer fails to pay or the injurer cannot be determined, the New Jiahe Fund will pay in advance in accordance with the prescribed proportion.
2, the new rural cooperative medical fund can only be used for medical expenses compensation of participants.
Four, the following medical expenses are not included in the scope of payment of the new rural cooperative medical fund:
1, borne by public health;
2, should be paid from the industrial injury insurance fund;
3, should be borne by a third person;
4, due to intentional crime, alcoholism, drug abuse, suicide, self-mutilation, fighting, etc. ;
5. Go abroad for medical treatment;
6, beyond the scope of reimbursement of new rural cooperative medical care of basic drugs, basic diagnosis and treatment projects and medical service facilities directory.
Medical expenses that should be borne by a third party according to law. If the third person is unable to pay or cannot determine the third person, the new rural cooperative medical fund will pay in advance according to the prescribed proportion. After the new rural cooperative medical fund pays in advance, it has the right to recover from the third party.
legal ground
People's Republic of China (PRC) social insurance law
Article 24 The state establishes and improves the new rural cooperative medical system.
Measures for the administration of the new rural cooperative medical system shall be formulated by the State Council.
Article 25 The state establishes and improves the basic medical insurance system for urban residents.
The basic medical insurance for urban residents combines individual contributions with government subsidies.
People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.