1. Reimbursement rate
①. Village health center and village center health center reimbursement 60%;
②. 40% for township health centers;
③. 30% for secondary hospitals. 30% reimbursement for visits to secondary hospitals;
④. 20% reimbursement for tertiary hospital visit;
2. Starting payment standard
①. Limit of 10 yuan per visit for prescription medication, and 50 yuan for prescription medication for temporary rehydration by doctors in health centers.
②. Limit of 50 yuan per visit for each examination and surgery, and 100 yuan for prescription drugs.
③. For secondary hospitals, the limit of each examination and operation fee is RMB 50 yuan and the limit of prescription drug fee is RMB 200 yuan per visit.
④. For tertiary hospitals, each visit is limited to RMB 50 yuan for each examination and operation and RMB 200 yuan for each prescription.
5. Chinese medicine invoice with prescription is limited to RMB 1 yuan per sticker.
6. Annual limit of 5,000 RMB for outpatient compensation for township-level cooperative medical care.
II. Rural hospitalization reimbursement
1. Reimbursement ratio
①. 60% reimbursement from township health centers;
②. 40% reimbursement from secondary hospitals;
3. Secondary hospitals reimburse 40%;
3. Tertiary hospitals reimburse 30%.
2. Reimbursement Criteria
①. Drugs: auxiliary examinations: EKG, X-ray, radiography, laboratory tests, physiotherapy, acupuncture, CT, nuclear magnetic **** vibration and other examinations are limited to 200 yuan; surgical fees (with reference to the national standard, more than 1,000 yuan will be reimbursed according to 1,000 yuan).
II. The elderly over 60 years of age hospitalized in the health center, treatment costs and nursing care costs are compensated 10 yuan per day, a limit of 200 yuan.
III. Rural major disease reimbursement rate (over 5,000 yuan)
1.5001-10000 yuan reimbursement 65%
2.10001-18000 yuan reimbursement 70%.
3. Annual limit of 11,000 yuan for reimbursement of township-level cooperative medical care for hospitalization and outpatient blood dialysis for uremia, and outpatient radiotherapy and chemotherapy for oncology.
4. Reimbursement ratio and starting standard for all types of people under rural medical insurance
1. Reimbursement ratio and starting standard for students and children (below 180,000 yuan)
1. 55% for tertiary hospitals
2. 60% for secondary hospitals. 60% reimbursement rate for secondary hospitals;
3. 65% reimbursement rate for Level 1 hospitals.
2. Starting standard
①. The starting standard for tertiary hospitals is 500 yuan;
②. The starting standard for Level II hospitals is 300 RMB;
③. First-class hospitals do not have a starting standard.
2. Reimbursement rate and starting standard for senior citizens over 70 years old (under 100,000 yuan)
1. Reimbursement rate for tertiary hospitals is 50%;
②. 60% reimbursement rate for secondary hospitals;
3. 65% reimbursement rate for Level I hospitals.
2. Starting standard
①. The starting standard for tertiary hospitals is 500 yuan;
②. The starting standard for Level II hospitals is 300 RMB;
③. First-class hospitals do not have a starting standard.
3. Reimbursement rate and starting standard for rural residents (less than 100,000 yuan)
1. Reimbursement rate for tertiary hospitals is 50%;
②. 55% reimbursement rate for secondary hospitals
3. 60% reimbursement rate for Level 1 hospitals.
Starting standard
①. The starting standard for tertiary hospitals is 500 yuan;
②. The starting standard for Level II hospitals is 300 RMB;
③. There is no starting standard for Level I hospitals.
I hope the above can help you, if you have other questions please consult a professional lawyer.
Legal basis: "Chinese people*** and the State Social Insurance Law" Article 28 in line with the basic medical insurance drug catalog, diagnostic and therapeutic items, standards of medical service facilities, as well as emergency, salvage medical expenses, in accordance with state regulations from the basic medical insurance fund.