The new rural cooperative medical care (New Rural Cooperative Medical Care) is mainly for the insurance of major diseases, and is usually not reimbursed for the cost of maternity checkups. According to China's Social Insurance Law, only medical expenses that are in line with the basic medical insurance drug list, diagnostic and treatment items, medical service facility standards, as well as emergency and rescue medical expenses can be paid out of the basic medical insurance fund in accordance with state regulations. Therefore, the cost of maternity checkups, as a routine pregnancy medical service, is not included in the reimbursement scope of the new rural cooperative.
The scope of reimbursement under the New Rural Cooperative:
1. Basic medical services: covering diagnosis and treatment costs for common and frequent diseases;
2. Inpatient medical expenses: including bed fees, treatment fees, surgical fees and other costs incurred during hospitalization;
3. Partial outpatient expenses: some reimbursement of outpatient treatment costs of specific chronic or major diseases;
4.
4. Pharmaceutical expenses: including the costs of Western medicines, proprietary Chinese medicines and some Chinese herbal medicines purchased in the hospital;
5. Diagnostic and therapeutic expenses: such as examination fees, laboratory fees and other medical service fees;
6. Medical service facility usage fees: such as the costs incurred for the use of medical equipment such as X-ray machines and ultrasound machines.
In summary, the NPS does not include reimbursement for routine pregnancy medical services, including the cost of maternity tests.
Legal basis:
The Social Insurance Law of the People's Republic of China
Article 28
Medical expenses that are in line with the basic medical insurance drug catalog, diagnostic and therapeutic items, and standards of medical service facilities, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.
Article 29
The portion of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units. The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.