Neijiang medical insurance reimbursement policy

The scope and proportion of reimbursement for rural medical insurance in Neijiang City, outpatient compensation: (1) 60% of village clinics and village center clinics see a doctor, and the prescription drug fee limit for each visit 10 yuan, and the prescription drug fee limit for temporary rehydration for doctors in health centers is 50 yuan. (2) Reimbursement for medical treatment in town health centers is 40%. The limit of examination fee and operation fee for each visit is 50 yuan, and the limit of prescription drug fee is 100 yuan. (3) The reimbursement for medical treatment in secondary hospitals is 30%, and the limit of each examination fee and operation fee is 50 yuan, and the limit of prescription drug fee is 200 yuan. (4) 20% reimbursement for medical treatment in tertiary hospitals, with the limit of each examination fee and operation fee in 50 yuan and the limit of prescription drug fee in 200 yuan. (5) The prescription attached to the invoice of traditional Chinese medicine is limited to 1 yuan. (6) The annual compensation limit for rural cooperative medical clinics is 5,000 yuan.

First, Neijiang medical insurance reimbursement conditions

1. The applicant has gone through the insurance formalities and paid the medical insurance premium in full.

2, cooperative medical designated medical institutions for medical treatment;

3, the insured medical expenses incurred in medical institutions, pay cash in advance, and save the relevant single box and information.

Second, Neijiang medical insurance reimbursement process

1. The agent submits the reimbursement documents and other materials to the Dark Grey Insurance Fund Administration for acceptance;

2. After receiving the application materials, the accepting department will complete the examination, settlement and payment on the same day;

3, the social insurance fund management bureau to review the materials and approve the application, the applicant to receive the "social medical insurance medical expenses reimbursement form", be reimbursed.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

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.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.