If you are hospitalized in a different place, if the new rural cooperative medical insurance you buy is a file, the deductible line is 900 yuan, after deducting your own expenses, part B will be reimbursed 60%; If it is the second gear, the deductible line is 900 yuan, and the self-funded part is deducted, and the second part is reimbursed by 70%.
Specifically, you can call the insurance company and be sure to prepare the materials needed for reimbursement. Medical expenses of individual medical insurance accounts can be transferred to Zigui Medical Insurance Bureau regularly, and hospitals in other provinces should be designated hospitals for local medical insurance. The reimbursement rate is 88% for the threshold fee above 3,000 yuan, 90% for 3,000-5,000 yuan, 92% for 5,000-10000 yuan, and 95% for the maximum payment limit above10000 yuan, including 80% for class B drugs, 70% for expensive drugs, special inspection and special treatment.
How to reimburse for going home after being discharged from hospital across provinces:
Rural cooperatives in other provinces can be reimbursed by registering, issuing certificates and going to the participating places.
Process of reimbursement for medical treatment in different places:
1, before hospitalization or within 3 days after hospitalization, call the consultation number of the new rural cooperative medical system in my hometown to register the hospitalization situation;
2. After discharge, the residence certificate must be issued by the neighborhood office or neighborhood committee. If you work outside, you need a work certificate issued by your work unit;
3, after discharge with a copy of medical records, summary list, hospitalization documents, discharge certificate, and then with the patient ID card, cooperative medical certificate and proof of residence or work back to the insured place for reimbursement;
4. If you go directly to a hospital outside the province for chemotherapy from the participating place, you must go through the procedures of referral and transfer before you can go to the other place for hospitalization;
5. The reimbursement rate outside the province is the lowest, and the general deductible is around 2,000, and the reimbursement rate is 45% of the reasonable expenses. If you spend less, it is difficult to reimburse a few dollars. The lower the hospital level, the higher the reimbursement ratio.
Legal basis:
People's Republic of China (PRC) Basic Medical Care and Health Promotion Law
Eighty-fifth basic medical insurance fund payment scope shall be formulated by the competent department of medical security in the State Council, and listen to the opinions of the competent department of health and health, the competent department of traditional Chinese medicine, the drug supervision and administration department and the financial department in the State Council. The people's governments of provinces, autonomous regions and municipalities directly under the Central Government may, in accordance with the relevant provisions of the state, supplement and determine the specific items and standards paid by the basic medical insurance fund within their respective administrative areas, and report them to the competent medical security department of the State Council for the record. The competent department of medical security in the State Council should carry out evidence-based medicine and economic evaluation on the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards, etc. included in the scope of payment, and should listen to the opinions of the competent department of health and health in the State Council, the competent department of traditional Chinese medicine, the drug supervision and administration department, the financial department and other relevant parties. The evaluation results should be used as the basis for adjusting the payment scope of the basic medical insurance fund.
People's Republic of China (PRC) social insurance law
Thirty-second individuals across the overall regional employment, the basic medical insurance relationship with my transfer, the cumulative payment period.
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.