Rural cooperative medical insurance, is the government organization, guidance, support, farmers voluntarily participate in the individual, collective and government financing, to the main medical co-ordination of the major illnesses of the farmers' medical mutual **** relief system, which in the protection of farmers access to basic health services, alleviate the farmers due to poverty and return to poverty due to illness plays an important role.
I, rural medical insurance reimbursement process is as follows:
1, declaration, registration: flexible employment with their original identity card and a copy of the municipal health insurance bureau for the early declaration, registration procedures;
2, approved contributions: municipal health insurance bureau according to the declaration of the flexible employment, registration, according to the provisions of the approved, fill in the "payment approval form"; and so on
2, the basic health insurance system is the most important role in protecting the farmers access to basic health services to alleviate poverty and poverty alleviation. p>
Two, the basic medical insurance does not pay the cost of medical treatment
Service category:
1, registration fees, out-of-hospital consultation fees, medical records, such as the cost of books;
2, consultation fees, examination and treatment of expedited fees, surcharges on the name of the surgical surcharges, high-quality and premium rates, self-employed special nurses and other special medical services.
Non-disease treatment programs, a variety of beauty, fitness programs and non-functional cosmetic and orthopedic surgery;
3, a variety of health checkups;
4, a variety of preventive, health care treatment programs;
5, a variety of medical consultations, medical appraisal.
Diagnostic and therapeutic equipment and medical materials
1, the application of positron emission tomography device (PET);
2, electron beam cT;
3, ophthalmology excimer laser treatment instrument and other large-scale medical equipment for the examination and treatment program.
3, the following cases are not included in the reimbursement of the new rural cooperative medical care:
(a) outpatient medical expenses of non-district designated hospitals (except for outpatient treatment costs of special diseases), not in accordance with the provisions of the medical treatment, and the costs incurred by purchasing their own medicines;
(b) the costs of the family planning measures required, and the medical costs of violating the policy of family planning;
(iii (iii) Dentures, orthodontics, optometry, hearing aids, artificial organs, cosmetic treatments, plastic and orthopedic surgeries, rehabilitative medical treatments (e.g., qigong, massages, tui-na, physiotherapy, magnetic therapy, etc.), as well as various types of companion fees, transportation fees for medical consultations, consultation fees, and other miscellaneous expenses during hospitalization;
(iv) In cases where there is third-party liability, the medical expenses arising from the occurrence of bodily injuries shall be borne by the third responsible party, such as traffic accidents, medical malpractice, work-related injuries, etc.;
(e) Medical expenses incurred as a result of injuries caused by suicides, self-inflicted injuries, drug use, drug addiction, fights and brawls and other unlawful acts, as well as intentional acts of the family members of such injuries;
(f) Medical expenses incurred when going abroad or during the period of stay in Hong Kong, Macao and Taiwan;
(g) Drugs and items that are not reimbursed by the urban workers' medical insurance system;
(h) Medicines and items for which reimbursements will not be made; and (viii) Other non-reimbursable expenses as determined by the District Medical Management Committee.
Four, does not belong to the scope of reimbursement
1, self-medication (not designated hospitals for medical treatment or do not apply for referral orders), self-purchase of medicines, public medical provisions can not be reimbursed for medicines and do not comply with the family planning of medical expenses;
2, outpatient treatment costs, clinic fees, hospitalization costs, meals, accompanied by a guest, nutrition, blood transfusion (except for those who have a family blood bank, according to the relevant provisions of the reimbursement), cold and warmth. regulations), heating and cooling costs, ambulance fees, special care fees and other expenses;
3. Medical expenses for car accidents, fights, suicides, alcoholism, workplace accidents and medical malpractice;
4. Orthopedics, plastic surgery, dental implants, prosthetics, organ transplants, naming surgical fees, consultation fees, etc.
5. Reimbursement of expenses within the scope of reimbursement, but outside the limit.
Legal basis
The People's Republic of China*** and the State Law on the Protection of the Rights and Interests of the Elderly
Article 29 The State guarantees the basic medical needs of the elderly through the basic medical insurance system. Older persons enjoying the minimum subsistence guarantee and eligible older persons from low-income families shall be subsidized by the Government for the portion of their individual contributions required to participate in the new type of rural cooperative medical care and basic medical insurance for urban residents.
The relevant departments shall take care of the elderly in formulating medical insurance schemes.
The Social Insurance Law of the People's Republic of China
Article 24 The State establishes and improves the new type of rural cooperative medical care system.
Methods for administering the new type of rural cooperative medical care shall be prescribed by the State Council.
Article 26 The standards of treatment for basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with the provisions of the State.
The Law of the People's Republic of China on Basic Medical Care and Health Promotion
Article 82 The costs of basic medical services shall be paid mainly by the basic medical insurance fund and by individuals. The State shall, in accordance with the law, mobilize the basic medical insurance fund through multiple channels, and gradually improve the mechanism for sustainable financing of basic medical insurance and adjustment of the level of protection.
Citizens have the right and duty to participate in basic medical insurance in accordance with the law. Employers and employees pay the employees' basic medical insurance premiums in accordance with state regulations. Urban and rural residents in accordance with the provisions of the basic medical insurance premiums for urban and rural residents.