Reimbursement scope and proportion:
1, outpatient reimbursement:
(1) 60% reimbursement for village health clinics and village center health clinics, with a limit of 10 yuan of prescription drug costs per visit, and a limit of 50 yuan of prescription drug costs for temporary rehydration of doctors at health centers.
(2) Township health centers will be reimbursed 40% of the cost for each visit, with a limit of 50 yuan for each examination and surgery, and a limit of 100 yuan for prescription drugs.
(3) Secondary hospitals are reimbursed 30% of the cost, with a limit of 50 yuan for each examination and operation and 200 yuan for prescription drugs.
(4) 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.
(5) Chinese medicine invoices with prescription attached are limited to RMB 1 yuan per sticker.
(6) The annual limit of outpatient compensation for township-level cooperative medical care is 5,000 yuan.
2. Hospitalization Compensation:
(1) Reimbursement Scope:
A. Pharmaceutical Fees: Auxiliary Examinations: Limit of 200 RMB for each examination fee such as EKG, X-ray fluoroscopy, radiography, laboratory tests, physical therapy, acupuncture, CT, MR*** vibration, etc.; Surgical Fees (with reference to the national standard, reimbursement for fees in excess of 1,000 RMB will be made in accordance with the limit of 1,000 RMB).
B. For the elderly over 60 years old who are hospitalized in Xingta Township Health Center, the treatment fee and nursing fee are compensated 10 yuan per day with a limit of 200 yuan.
(2) Reimbursement rate: town health center reimbursement 60%; secondary hospital reimbursement 40%; tertiary hospital reimbursement 30%.
3. Compensation for major diseases:
(1) Compensation from the town's risk fund: Any hospitalized patient who participates in the rural cooperative medical insurance will be compensated for the one-time or yearly cumulative reportable medical expenses exceeding 5,000 yuan in segments, i.e., 65% for 5,001-10,000 yuan, and 70% for 10,001-18,000 yuan.
(2) The annual limit of 11,000 yuan for compensation for township-level cooperative medical care inpatient and outpatient blood dialysis for uremia, and outpatient radiotherapy and chemotherapy for oncology is 11,000 yuan.