Rural Cooperative Medical Insurance Reimbursement Ratio in Yichang City, Hubei Province:
Outpatient Reimbursement:
Village Health Office and Village Center Health Office visits are reimbursed 60%, with a limit of 10 yuan for each visit and 50 yuan for prescription drug fees for temporary rehydration of the prescription drug fees for the health center doctor.
Township health centers will be reimbursed 40% of the cost of each visit, with a limit of 50 yuan for each examination and surgery, and a limit of 100 yuan for prescription drugs.
Second-level hospitals are reimbursed 30% of the cost, with a limit of 50 yuan per visit for examinations and surgeries, and 200 yuan for prescription drugs.
Tertiary hospitals will reimburse 20% of the fees, with a limit of 50 yuan for each examination and operation and 200 yuan for prescription drugs.
Chinese medicine invoices accompanied by a prescription are limited to $1 per sticker.
Township-level cooperative medical outpatient compensation is limited to 5,000 yuan per year.
Hospitalization Compensation:
Reimbursement Scope:
A. Pharmaceutical Fees: Auxiliary Examinations: Electrocardiogram, X-ray Fluoroscopy, Films, Laboratory Tests, Physiotherapy, Acupuncture, CT, Nuclear Magnetic *** vibration and other examination fees, limit of 200 yuan; Surgical Fees (with reference to the national standard, reimbursement of more than 1,000 yuan is made in accordance with the amount of 1,000 yuan).
B. For elderly people over 60 years old hospitalized in health centers, treatment and nursing fees are reimbursed 10 yuan per day, with a limit of 200 yuan.
Reimbursement rates: town health centers reimburse 60 percent; secondary hospitals reimburse 40 percent; tertiary hospitals reimburse 30 percent.
Compensation for major illnesses:
Town risk fund compensation: all hospitalized patients who participate in cooperative medical care are compensated in segments where the one-time or yearly cumulative reportable medical expenses exceed 5,000 yuan, i.e., 65% for 5,001-10,000 yuan and 70% for 10,001-18,000 yuan.
The annual limit of compensation for town-level cooperative medical care inpatient and uremia outpatient hemodialysis, oncology outpatient radiotherapy and chemotherapy is 11,000 yuan.
The new rural cooperative medical fund reimbursement to pay for special diseases are: malignant tumors chemotherapy, radiotherapy; severe uremia blood and abdominal dialysis; tissue or organ transplantation after the anti-rejection reaction treatment; schizophrenia with mental decline; systemic lupus erythematosus (one of the cardiac, pulmonary, renal, hepatic, and neurological complications); aplastic anemia; cardiac surgery, anticoagulation therapy. The rest of the reimbursable special diseases are subject to specific local policies.
Specific outpatient treatment for special diseases includes supportive therapy and symptomatic treatment of systemic and local reactions that are necessary during the treatment period, and general adjuvant treatment is not included in the reimbursement scope.
New rural cooperative reimbursement procedures:
Participants discharged from the hospital, will be signed or stamped by the patient's own hospitalization invoices, discharge records, cost lists, referral certificates and a copy of my ID card or proof of domicile paid to the local township co-management office, after review and centralized and unified to send to the municipal agricultural insurance business management center.
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