The new rural cooperative medical system it is organized by the government, guidance, support, voluntary participation of farmers, individuals, collectives and the government of multi-party financing, to the main medical co-ordination of farmers' medical mutual **** relief system, is an important part of the social security system.
Second, why establish a rural cooperative medical system?
Because most places in rural medical expenses rely entirely on personal payment, the burden on farmers is heavy, 20-30% of farm households poor due to illness.
Many cases show that illness is an important cause of poverty among farmers, and poverty makes it difficult to treat illness. So the most worrying problem for farmers is illness. Because most of the rural economic development level is not yet high, do not yet have the conditions of the farmers medical
security into the social health insurance system, the government or collective economy also do not have the ability to the farmers medical security package, at present the majority of the farmers' medical security problems can only be solved through the implementation of a new type of rural cooperative medical care
resolved.
Three, what are the benefits of participating in rural cooperative medical care for farmers?
"There is an old Chinese saying that "there is a time and a place for every day's calamity". It's hard to avoid getting sick. If you are not sick this year, you may be sick next year, and if one person in a family gets sick, it may drag the whole family down and affect their production and life. When farmers participate in cooperative medical care, the first thing they do is to benefit individually. In terms of the minimum standard, a person who pays 10 yuan a year can receive a maximum compensation of up to 10,000 yuan in the event of illness, which is 1,000 times the amount of the individual's contribution. If there is still a big difficulty, if there is a balance in the fund at the end of the year, according to the policy, one can also apply for "medical aid for serious illnesses" for re-compensation. Secondly, the new rural cooperative medical care has government support, all levels of finance to give each person per year *** counting supporting 40 yuan, four times the individual contributions, in addition to outpatient 15 yuan per person, the rest for hospitalization compensation for serious illnesses, up to 10,000 yuan in compensation. If farmers do not participate, they will not be able to enjoy the compensation policy of the New Rural Cooperative. Once again, even if you do not get sick for a while, it is the same as helping your folks; doing a good deed, and in the future, if you have a serious illness, you will have a chance to get compensation under the policy.
Four, how to participate in the new rural cooperative medical care?
The object of participation is for residents with rural household registration in Kaixian County. Participate in the cooperative medical care farmers must first go to the local township government, the street office of the designated fee point to pay personal funds, 10 yuan per person per year. The whole family must participate in the cooperative medical care on a household basis, and each household is entitled to one copy of the Cooperative Medical Care Certificate, which is to be used continuously and kept in a safe place. If lost, must promptly report to the county, townships and streets co-management office. 2008 to participate in the new rural cooperative medical care farmers must be in November 2007 before the end of the payment of personal funds.
V. Why is the financing of rural cooperative medical care is not an increase in the burden on farmers?
Answer: cooperative medical care is a farmer's mutual ****ji medical insurance, farmers voluntarily pay 10 yuan per person to pay the cooperative medical fee is in order to ward off the risk of disease and fulfill the obligation to pay the fee, is a farmer's personal consumer spending, is not a farmer's burden of the project, these funds are fully used for farmers' medical care, but also the government and the collective to give more money to help will greatly reduce the farmer's hospitalization of the sick! The burden.
Sixth, our county cooperative medical reimbursement standard is how to stipulate?
(A) outpatient account of 15 yuan per person, the whole family can be pulled through the transfer of the use of each outpatient costs at the rate of 40% of the total amount of reimbursement until the whole family runs out. After the family account is used up, those who are sick and hospitalized can still enjoy the hospitalization compensation policy. (ii) For hospitalization, the starting line for township (central) health centers is 50 yuan, with a reimbursement rate of 45%; the starting line for county hospitals is 300 yuan, with a reimbursement rate of 30%; and the starting line for hospitals above the county level is 1,000 yuan, with a reimbursement rate of 20%. The maximum amount of reimbursement for an individual is 10,000 yuan for the whole year. (c) For hospitalized deliveries within the family planning system without other complications, in addition to the 200 yuan subsidy under the "Reduction and Elimination" program, the New Farmers' Cooperative will reimburse a fixed amount of 100 yuan. For inpatient deliveries with other complications, they are treated as inpatient deliveries, and the New Farmers' Cooperative will compensate for the difference after subtracting the amount of the subsidy under the "Reduction and Elimination" program from the amount of the reimbursement. In the case of inpatient cesarean section, the patient is treated as an inpatient, and the difference will be compensated by the New Farmers' Cooperative after subtracting the amount of subsidy under the "Reduction and Elimination" program from the amount of the reimbursement.
VII. What documents and requirements do participating farmers need to bring to outpatient clinics, hospitalization, and referrals?
(1) Participating farmers are required to bring their Medical Card for outpatient treatment;
(2) Participating farmers are required to bring their Medical Card, ID card or original household register when they are hospitalized;
(3) Traumatized patients are required to bring their Medical Card, ID card or original household register, and proof of traumatic injuries when they are hospitalized;
(4) For those who are transferred to a higher level of hospital for treatment, a certificate of transfer is required from the transferring hospital. the transfer certificate of the hospital.
VIII. How do participating farmers report their accounts? What are the procedures required?
(1) Outpatient medical fees incurred by participating farmers at designated medical units will be waived on the spot by the designated medical units and registered and signed.
(2) Participating farmers' inpatient medical fees incurred at designated medical units will be examined by the hospitals where they reside when they are discharged from the hospitals, and the fees will be waived on the spot and registered with their signatures. Trauma hospitalization must have the village committee, witnesses, and townships and streets of the co-management office audit opinion
Nine, the participating farmers referral outside the county and go out to work how to report the accounts? What are the procedures required?
(1) If you are referred to a designated hospital outside of the county for hospitalization, the patient will first pay for the expenses in advance, and then settle the bill at the local health center within one month after being discharged from the hospital after the preliminary examination by the township and street cooperative management office and the final examination by the county cooperative management office.
(2) migrant workers hospitalized in public hospitals in the place where they work, the patient will first pay the medical expenses in advance when they are discharged from the hospital, and then report all the information to the co-management office in the place where they are domiciled for examination and approval by the county co-management office and settle the bill with the townships and streets of the place where they are domiciled for final examination and approval by the county co-management office before the next year's March. The hospitalization of migrant workers must be reported to the household registration office within three days after hospitalization, and no reimbursement will be made beyond the stipulated time.
(3) When applying for reimbursement, patients referred for hospitalization must hold valid computer invoices, one-day lists, hospital diagnostic certificates, transfer certificates, discharge certificates, cooperative medical certificates, household registration books (ID cards) and other supporting materials.
(4) Workers hospitalized outside the county should also have: a valid computer invoice, a one-day list, a hospital diagnosis certificate, a certificate of discharge, a cooperative medical certificate, a hukou book (ID card), a certificate of the work unit, and a certificate of approval from the township and street cooperative management office. By the party entrusted to handle compensation, there should be the party's power of attorney; the appointee must hold the original of his identity card.
X. What are the designated medical institutions for hospitalization outside the county?
There are 9 designated hospitals*** determined by our county for hospitalization outside the county, namely: Southwest Hospital, Xinqiao Hospital, Daping Hospital, First Hospital of Heavy Medicine, Second Hospital of Heavy Medicine, Children's Hospital of Heavy Medicine, Chongqing Tumor Hospital, Chongqing Mental Health Center, and Wanzhou Three Gorges Central Hospital. In addition to the above nine hospitals, referrals from hospitals within the county to other hospitals outside the county and the city will not be compensated by the New Agricultural Cooperative Fund.
Xi. What are the types of chronic diseases and how are they identified?
Our county stipulates that the types of chronic diseases are: coronary heart disease, chronic bronchitis (pulmonary heart disease), hypertension, diabetes, chronic wind heart disease, cerebrovascular accident rehabilitation, malignant tumors in the late treatment of severe schizophrenia eight chronic diseases.
Where the need for chronic disease identification of participating farmers should carefully read the chronic disease identification criteria (will be issued to the village committee, village health office, and posted), in the prescribed time with the "medical card" original and photocopies, ID card (or household registration) original and photocopies and recent one-inch bareheaded photo (3) to the designated designated identification hospital to fill out the "Chronic Disease Identification Application Form". By the county to send a group of experts for centralized time and place inspection and identification, out of date will not be processed.
Twelve, why charge registration fees, consultation fees?
According to the Chongqing Municipal Price Bureau, Chongqing Municipal Health Bureau on the issuance of the "Chongqing Municipal Medical Service Price (Trial)" of the spirit of the notice, the village health clinic charges 1.5 yuan, is a normal charge, is in line with the policy, but also the value of the doctor's labor reflected.
Thirteen, which is not part of the new rural cooperative medical compensation?
A
Non-compensable scope
(1) service category:
(1) registration fee, expert registration fee, consultation fee, in-hospital and out-of-hospital consultation fee, pre-hospital treatment surcharge, ambulance fee.
(2) Expedited examination and treatment fees (start-up fees), named surgery fees, quality and premium fees, special medical service fees such as self-requested special care.
(3) Labor cost of medical records, all kinds of medical record files and account forms.
(2) Non-disease treatment items:
(1) All kinds of cosmetic, fitness and non-functional cosmetic and orthopedic surgeries, such as health care massages, ear piercing, breast augmentation, teeth cleaning, porcelain, treatment of gray hair, hair transplantation, hirsutism and other costs, all costs of using orthopedic and fitness appliances.
(2) All kinds of weight loss, fat gain, height and correction of physiological defects (with the exception of organic lesions) of the examination, treatment, surgery, medicine and other costs. Such as the treatment of armpit odor, cut multiple fingers (toes), open double eyelids and other costs.
(3) The cost of various health checkups.
(4) Various preventive health care treatment programs.
(5) Various medical consultations, such as: computerized health consultations, clinical microcomputer consultations, eugenics computerized consultations, and computerized diagnosis by Chinese medicine experts.
(6) medical appraisal, judicial appraisal fees, work-related injuries, disability labor and other medical appraisal costs.
(3) therapeutic equipment and medical materials category:
(1) the application of positron emission tomography device (PET), nuclear magnetic **** vibration, electron beam (CT, ophthalmology excimer laser therapy instrument and other large-scale medical equipment for the examination, treatment projects), stereotactic radiation device (γ - knife,
χ -knife).
(2) a variety of corrective, health care appliances, such as eyeglasses, prosthetic eyes, teeth and jaw cushions, dentures, prosthetics, hearing aids, brain fitness, leather (steel) undershirt, waist turn, steel head and neck, stomach support, kidney support, uterine support, crutches, prosthetics, wheelchairs, pillows, pads and other rehabilitative appliances.
(3) All kinds of self-use health care, massage, examination and treatment instruments.
(4) the use of medical instruments, equipment and medical materials without the approval of the state or municipal management of medical instruments, equipment and medical materials qualified medical instruments, equipment and medical materials for diagnosis and treatment programs.
(5) the city price department, health department regulations can not be charged separately for disposable medical materials.
(6) the application of X-ray computed tomography device (CT), cardiac and angiography X-ray machine (including digital subtraction equipment), magnetic **** vibration imaging device (MRI), single-photon emission computerized scanning device (SPECT), color Doppler, medical linear gas pedal, and other large-scale medical equipment, inspection, treatment Project.
(7) pacemakers, artificial joints, artificial crystals, vascular stents and other artificial organs replaced in the body, the body to put materials.
(4) Category of therapeutic items:
(1) Organ source or tissue source for all types of organ or tissue transplantation.
(2) Kidney, heart valve, cornea, skin, blood vessel, bone, bone marrow transplants and other organ or tissue transplants.
(3) Various complementary therapies, such as qigong, music, suggestion, hypnotherapy, magnetic therapy, and psychotherapy.
(4) Various treatment programs for infertility and sexual dysfunction.
(5) All expenses for various teaching, research and clinical verification.
(6) Hemodialysis and peritoneal dialysis.
(7) Cardiac bypass surgery, cardiac catheterization balloon dilatation, cardiac radiofrequency ablation, cardiac laser perforation.
(8) Anti-tumor cellular immunotherapy, fast neutron therapy program.
(9) Various kinds of microwave, spectrum, far-infrared ray therapy and other auxiliary treatment programs.
(10) Sexually transmitted diseases (except for those who are not entitled to free national treatment for AIDS)
(11) Tuberculosis (except for free medicines for tuberculosis)
(12) Blood transfusion and blood products.
(13) Other diagnostic and treatment items not included in the price policy management.
(5) Costs of living service items and service facilities that are not compensated
(1) Transportation fee for consultation, TV fee, telephone fee, toilet paper fee, food warmer fee, electric stove fee, bottle fee, refrigerator and compensation fee for damage to public property, electricity consumption fee for own electrical appliances, living goods and personal care fee for hospitalized participants.
(2) Recreational activities and special living services.
(3) Fees for medical services and facilities raised by medical institutions or self-imposed charges.
(4) Fees for over-standard beds. When a designated medical institution must place a participant in an over-standard ward due to bed constraints or other reasons, it shall first obtain the consent of the participant or his family members
(6) Others
(1) Expenses incurred in fights, brawls, alcoholism, self-infliction of injuries, suicides, delinquency, drug addiction treatment, traffic accidents, and increased medical expenses due to medical malpractice, as well as those triggered by other liable accidents. of the diagnosis and treatment program.
(2) Overseas medical expenses incurred when traveling abroad on official or private business and to Hong Kong, Macao and Taiwan.
(3) The use of non-basic medicines and non-provided diagnostic and therapeutic items catalog costs.
(4) Other items stipulated in the "Implementation Measures of Kaixian New Rural Cooperative Medical Care (Trial Implementation)".
(7) Medical expenses incurred for the following acts of medical treatment
(1) All expenses for the stay-at-home beds.
(2) Medical expenses resulting from premarital and extramarital sexual behavior.
(3) Medical expenses for family planning surgery and work-related injuries.
(4) Medical expenses that are the responsibility of others to bear (such as traffic accidents, medical malpractice and after-effects).
(5) Medical expenses incurred while serving a prison sentence.
(6) Medical expenses incurred before enrollment.
(7) Medical expenses incurred by a participant who was hospitalized outside the county without a list of hospitalization expenses and without going through the procedures of referral to another hospital.
(8) Medical expenses incurred for the rescue and treatment of a wide range of critical and serious illnesses caused by sudden epidemic diseases and natural disasters and other irresistible factors.
(9) When a participant is hospitalized due to visiting relatives, friends or workers (except for emergency rescue), he or she fails to report to the cooperation management office of the township where he or she is domiciled within 48 hours from the date of admission to the hospital for the record.
(10) food poisoning outside the family feast, canine injuries.
Fourteenth, the county's new rural cooperative medical care drug prices how to limit the?
In order to effectively reduce the price of medicines, reduce the burden of medical costs of participating farmers, we have implemented the county, townships and villages of the same price of medicines policy, will be commonly used medicines *** 300 kinds of the implementation of the maximum price limit system, and in the townships of the basic medical insurance for workers on the basis of the limit of the price of an average of 15% -20% reduction. The retail price of 300 types of traditional Chinese medicine was increased by 25% on the basis of the actual purchase price. At the same time, it is stipulated that those higher than the maximum price must be implemented at the maximum price, and those lower than the maximum price must be implemented at the original price, with no price increase.
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