Motorcycle falls can generally be reimbursed by rural cooperative medical care, but if there is a third-party accident liability, the medical expenses caused by personal injury shall be borne by the third-party responsible party according to law, such as traffic accidents, medical accidents and work-related injuries. Rural cooperative medical care cannot be reimbursed.
The reimbursement scope of rural cooperative medical care is: medical expenses, examination expenses, laboratory expenses, operation expenses, treatment expenses and nursing expenses incurred by the insured in designated hospitals due to illness during the overall planning period, which are in line with the reimbursement scope of urban workers' medical insurance (that is, effective medical expenses).
The new rural cooperative medical fund payment set up Qifubiaozhun and maximum payment limit. The hospitalization expenses below the annual deductible line of the hospital shall be paid by the individual. In the same overall period, if the Qifubiaozhun is reached, the hospitalization expenses incurred by two or more hospitalizations can be reimbursed cumulatively. The hospitalization expenses exceeding Qifubiaozhun shall be calculated in sections and reimbursed cumulatively, and there is a maximum amount of accumulative reimbursement per person per year.
Legal objectivity:
The Opinions of the Ministry of Health on Standardizing the Health Examination of the New Rural Cooperative Medical System (NCMS) reasonably determines the payment standard of the new rural cooperative medical system fund according to the established charging standard of the new rural cooperative medical system health examination items and the preferential conditions provided by medical institutions, so that the medical institutions providing health examination services can accept it, the new rural cooperative medical system fund can bear it and the subjects can be satisfied. After the completion of the medical examination, the management institution of the new rural cooperative medical system should carefully check the health examination of the new rural cooperative medical system according to the service agreement of the new rural cooperative medical system and the application materials of the medical institutions, and widely publicize the medical institutions, the list of subjects, the medical examination items and the medical examination expenses. Only when there is no objection and no report during the publicity period can the medical examination funds be allocated to medical institutions. It is not allowed to directly allocate health examination funds to medical institutions through budget arrangement or pre-allocation.