Go directly to the reimbursement, and they will look at the invoice and hospitalization list one by one. After applying, I will give you a list, invoices and medical records. Bring all your original materials and this list. If you have commercial insurance, you can go to commercial insurance to see if there is anything you can insure.
Outpatient reimbursement ratio
(1) village clinics and village center clinics are reimbursed 60%, 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.
Proportion and amount of hospitalization reimbursement for new rural insurance:
First-class hospital: 300 yuan, deductible line, no compensation expense segmentation, reimbursement rate of 65%.
Secondary hospitals: 400 yuan, the deductible line of county secondary hospitals, the reimbursement rate of compensation expenses below 6,000 yuan is 65%, and the reimbursement rate of compensation expenses above 6,000 yuan is 80%.
Third-level hospitals: 600 yuan, the deductible line of county-level third-level hospitals, the reimbursement rate of compensation expenses is less than 6,000 yuan, and the reimbursement rate of more than 6,000 yuan is 80%.
Reimbursement process of new rural cooperative medical system;
Information required for reimbursement:
Outpatient reimbursement materials: outpatient invoice, cooperative medical certificate calendar (or medical record).
Materials for hospitalization reimbursement: hospitalization invoice, cooperative medical certificate calendar (or medical record), detailed list of expenses, discharge summary and other relevant certificates.
Outpatient reimbursement materials for special diseases: outpatient invoices and calendar of cooperative medical certificate for special diseases.
Materials for handling special diseases: outpatient treatment proposal for special diseases, calendar of cooperative medical certificate, medical records, relevant laboratory reports and photos.
Reimbursement process:
Insured households submit the required materials for reimbursement to the village (community) cooperative medical liaison, and report to the town cooperative medical liaison after the audit of the village (community) cooperative medical liaison, and the town cooperative medical liaison will send it to the district agricultural office for reimbursement. Guide to reimbursement of new rural cooperative medical care.
Direct reimbursement for hospitalization: When going through the hospitalization formalities due to illness, you will go to the hospital to directly participate in reimbursement with the certificate of the new rural cooperative medical system.