At present, the payment of the new rural cooperative medical system is coming to an end. Everyone has to pay 320 yuan this year, so what is the specific reimbursement rate?
How to calculate the reimbursement ratio of rural cooperative medical care?
1, the reimbursement rate of hospitalization at township level (first-class hospital) is 85%, and the deductible line is 200 yuan;
2. The reimbursement rate for hospitalization in county-level (secondary hospitals) is 70%, and the deductible line is 500 yuan;
3 municipal (tertiary hospitals) hospitalization reimbursement rate is 55%, and the deductible line is 700 yuan;
4. The reimbursement rate of provincial hospitals (tertiary hospitals) is 50%, and the deductible line is 1000.
Medical insurance deductible refers to the basic medical insurance deductible standard! The medical expenses below the deductible line shall be borne by the patient himself; If the medical expenses reach the deductible line, they shall be reimbursed according to the prescribed reimbursement ratio.
Reimbursement amount of rural cooperative medical care
The reimbursement scope of rural cooperative medical care includes outpatient reimbursement, hospitalization reimbursement and serious illness reimbursement. 1. Outpatient reimbursement: 60% for outpatient reimbursement in village clinics and village center clinics, 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 in 50 yuan.
40% reimbursement for medical treatment in the town health center, with the limit of examination fee and operation fee for each visit, and the limit of prescription drug fee 100 yuan.
The reimbursement for medical treatment in secondary hospitals is 30%, with the limit of each examination fee and operation fee in 50 yuan and the limit of prescription drug fee in 200 yuan.
Third-level hospitals will be reimbursed 20% for each visit. The examination fee and operation fee are limited to 50 yuan, and the prescription drug fee is limited to 200 yuan.
Second, Chinese medicine granules, is the new rural cooperative medical system reimbursed?
Existing reimbursement process of the new rural cooperative medical system: materials required for reimbursement:
1. Outpatient reimbursement information: outpatient invoice, cooperative medical certificate calendar (or medical record).
2. Hospitalization reimbursement materials: hospitalization invoice, cooperative medical certificate (or medical record) calendar, detailed list of expenses, discharge summary and other relevant certificates.
3. Special disease outpatient reimbursement: invoices and calendars for special disease cooperative medical certificate outpatient service.
4. Information for handling special diseases: outpatient treatment proposal for special diseases, calendar of cooperative medical certificate, medical records, relevant laboratory reports and photos. Reimbursement process:? 1. The insured households prepare the required materials for reimbursement and submit them to the village (community) cooperative medical liaison, which will report them to the town cooperative medical liaison after review, and the town cooperative medical liaison will send them to the district agricultural medical office for reimbursement. Guide to reimbursement of new rural cooperative medical care.
2. Direct reimbursement by the hospital: When going through hospitalization procedures due to illness, you will issue a certificate of the new rural cooperative medical system to the hospital and directly participate in reimbursement.
Third, Anhui new rural cooperative medical system 202 1 reimbursement?
The premise of reimbursement of Anhui new rural cooperative medical system is that you have to pay 280 yuan/person, and then take the medical bill, ID card, discharge summary, social security card and other materials to the medical insurance window of the county administrative service center where the household registration is located, or directly reimburse in the hospital.
4. What is the reimbursement ratio of cooperative medical care in TCM hospitals?
The reimbursement of cooperative medical insurance is carried out in proportion, generally fluctuating around 20-85%.
The proportion and amount of reimbursement are related to their own examination and medication, medical level and other factors.
For example, it is clear that Class A drugs can enjoy full coverage, Class C drugs need to bear all the costs, and Class B drugs will report 80% and bear 20% of the costs.
Someone spent a total of 9000 yuan on medical expenses, and the reimbursement formula is as follows: (9000-500 "deductible"-self-paid medicine) *70%. If self-funded drugs account for a large proportion, there is not much amount to be reimbursed.
In addition, it is also important to go to designated medical institutions for medical treatment.
The state pays two thirds and the individual pays one third.