New rural cooperative reimbursement scope breakdown 2021

Outpatient reimbursement: 60% for visits to village health centers and village center health centers, 40% for visits to township health centers, 30% for visits to secondary hospitals, and 20% for visits to tertiary hospitals. Reimbursement for hospitalization: 60% for township health centers, 40% for secondary hospitals, and 30% for tertiary hospitals. Hospitalization reimbursement reimbursement scope: medicine: auxiliary examination: EKG, x-ray fluoroscopy, filming, laboratory tests, physical therapy, acupuncture, ct, nuclear magnetic **** vibration and other examination fees limit of 200 yuan; surgical fees (with reference to the national standard, more than 1,000 yuan reimbursement of 1,000 yuan). 60 years of age or older hospitalized in the town health center in Xingtar, the treatment costs and nursing care costs of compensation of 10 yuan per day, limit of 200 yuan. Reimbursement rate: town health center reimbursement 60%; secondary hospital reimbursement 40%; tertiary hospital reimbursement 30%.

Town risk fund reimbursement: Any hospitalized patient who participates in cooperative medical care will be reimbursed for the one-time or yearly accumulated reportable medical expenses over 5,000 yuan in segments, i.e., 5,001-10,000 yuan will be reimbursed at 65%, and 10,001-18,000 yuan will be reimbursed at 70%.

The new rural cooperative medical care refers to the government organization, guidance, support, farmers voluntarily participate in, individual, collective and government financing, with the main medical co-ordination of farmers' medical mutual **** relief system. It is financed by individual contributions, collective support and government funding. The aim is to narrow the gap between urban and rural areas and to solve the problem of farmers' difficulties in accessing medical care. The reimbursement for hospitalization includes reimbursement for medicines and reimbursement for treatment costs. For reimbursement of medicines, you need to refer to the drug reimbursement catalog of the province; treatment costs, medicines, laboratory tests, examination costs, operation costs and hospitalization costs during the period of hospitalization belong to the reimbursable medical costs. Outpatient reimbursement scope: outpatient reimbursement includes reimbursement of drugs and examination fees, drugs reimbursement if they are prescribed; examination fees include ultrasound, electrocardiogram, laboratory fees, treatment fees, infusion fees. If you are hospitalized in a designated medical institution outside of the city, you will be reimbursed directly by credit card when you are discharged from the hospital. If the insured patient is hospitalized in a public medical institution of the second level or above outside the city, he/she shall, within three months after discharge from the hospital, be reimbursed by the insured person or his/her family members with the original invoice of the medical expenses (photocopies are invalid), the summarized itemized list of the medical expenses for the hospitalization, the summary of the hospitalization summary and the medical records of the outpatient clinics, the patient's ID card, medical card, household registration booklet, and the ID card of the person who manages the case to the window of the New Farmers' Cooperative Program on the 1st floor of the District Administrative Service Center, No. 14 and No. 15 Medical expenses. Outpatient reimbursement for special diseases can be made with the medical records issued by the designated medical institutions of the second level and above, and relevant information such as relevant examination and laboratory reports and certificates of medical institutions, as well as the "Approval Form for Outpatient Treatment of Special Diseases in New Rural Cooperative Medical Care of Huangyan District", and then the outpatient medical expenses (excluding medical expenses for supportive therapies, auxiliary therapies, or treatments for other diseases) can be included in the medical expenses of New Farmer's Cooperative Medical Care after being examined and approved by the District New Farmer's Cooperative Medical Care Office. The outpatient medical expenses (excluding medical expenses for supportive therapy or treatment of other diseases) can be included in the reimbursement scope of the New Farmers' Cooperative Fund and reimbursed on an annual basis according to the reimbursement standard for hospitalization.

Legal basis:

The Law of the People's Republic of China on Social Insurance

Article 2: The State establishes a social insurance system for basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance, maternity insurance, etc., and guarantees the right of citizens to receive material assistance from the State and society in accordance with the law in the event of old age, sickness, industrial injury, unemployment and childbirth.