How much can the hospitalization of rural cooperative medical care be reimbursed?

The proportion of reimbursement for hospitalization of the new rural cooperative medical system is generally 85% in first-class hospitals, and the deductible line is 200 yuan; The proportion of reimbursement for hospitalization in secondary hospitals is 70%, and the deductible line is 500 yuan; The reimbursement rate of tertiary hospitals is 55%, and the deductible line is 700 yuan; Others. The specific reimbursement rate varies from place to place, so you can ask the local people's government.

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.

The following circumstances are not included in the reimbursement scope of the new rural cooperative medical system:

1, outpatient medical expenses of non-designated hospitals in the region (except outpatient treatment expenses for special diseases), expenses incurred from not seeking medical treatment according to regulations and purchasing medicines by oneself;

2, the cost of family planning measures, medical expenses in violation of family planning policy;

3. Dental implants, orthodontics, optometry and glasses, hearing AIDS, artificial organs, beauty treatment, cosmetic surgery, rehabilitation (such as Qigong, massage, physical therapy, magnetic therapy, etc. ), as well as various accompanying expenses, medical transportation expenses, home visits and other miscellaneous expenses during hospitalization;

4. If a third party is responsible, the medical expenses caused by personal injury, such as traffic accidents, medical accidents and work-related injuries, shall be borne by the third party responsible according to law.

5. Medical expenses for injuries caused by illegal acts such as suicide, self-mutilation, taking poison, taking drugs, fighting and other intentional acts of their families;

6. Medical expenses incurred during going abroad or in Hong Kong, Macao and Taiwan;

7, the medical insurance system for urban workers will not be reimbursed drugs and articles;

8. Other expenses determined by the District Medical Management Committee that will not be reimbursed.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 23

Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.