1, what is the new rural cooperative medical care system?
The new rural cooperative medical system is organized, guided and supported by the government, farmers voluntarily participate in the individual, collective and government financing, with the main focus on the coordination of major diseases of the farmers' medical mutual **** relief system.
2, the new rural cooperative medical "new" in what way?
(a) there is government financial assistance and support, the government subsidizes 40 yuan per person per year (county by county according to the number of participants), the individual to pay 10 yuan per year, the individual does not pay, the government does not subsidize. (b) The government set up a specialized agency for management, funds earmarked for special purposes, the management of the account does not see the money, the management of the money does not see the account, the management of the use of separate, closed operation, to ensure the safety of the funds. (C) hospitalization medical expenses can be reimbursed proportionally, and the establishment of family outpatient account, taking into account the outpatient medical expenses reimbursement (8 yuan per person).
3, the significance of the establishment of a new rural cooperative medical system?
The new rural cooperative medical care is an important part of China's rural social security system, government funding, is a social welfare, mainly for farmers to establish a long-term, effective medical insurance system, so that farmers from the new rural cooperative medical care to get benefits, reduce the economic burden of farmers sick, improve the health of farmers.
4, the new rural cooperative medical care can run for a long time?
The establishment of a new rural cooperative medical care is to establish and improve a long-term, effective adaptation to the rural farmers of the medical security system, is the government for the farmers to do a practical, good thing, the government not only to persist in the long term, but also to continue to summarize, improve, expand, and comprehensively promote, so that the farmers to get a practical medical protection.
5, who can participate in the new rural cooperative medical care?
All rural residents in the county with an agricultural household registration can participate in the new rural cooperative medical care, including migrant workers, business people and workers in the county enterprises, county, township agencies, institutions in the temporary workers and private teachers in the agricultural household registration. In the spirit of "village can miss the household, the household does not miss the person" principle, the implementation of a household a certificate system.
6, to participate in the new rural cooperative medical care why to the household as a unit, all members of the family all participate?
As the cooperative medical care has the nature of mutual assistance ****, relying on everyone's money to help a small number of sick people, therefore, farmers are required to participate in the cooperative medical care on a household basis, the purpose is to avoid choosing to pay the fees of the personnel who are prone to illness, and the healthy people do not pay the fees of the situation.
7. What are the benefits of participating in the new rural cooperative medical care?
"The sky has unpredictable wind and clouds, and people have every day to get sick", this is an old Chinese saying. It is inevitable that people will not be sick. If one person in a family gets a serious illness, it may drag the whole family down and have an impact on production and life. When farmers participate in cooperative medical care, the first thing they do is to benefit personally. From the minimum standard, pay 10 yuan a year, if once you get sick, the maximum compensation can reach 20,000 yuan, which is 2,000 times of the personal payment. Secondly, the new rural cooperative medical care is supported by the government, which supports more than the farmers' individual contributions; if the farmers do not participate, the government will not subsidize them. Furthermore, even if they do not get sick, it is also equal to help the townspeople, do a good deed, in the future, they have a disease, there is still a chance to compensate, if you do not get sick within two years can also enjoy a free medical examination.
8. Why do farmers have to fund their participation in rural cooperative medical care?
This is the nature of the cooperative medical care ****jianzhi decision. To enjoy the cooperative medical protection to bear the corresponding obligations, the farmers themselves must participate. Only bear the corresponding obligations, in order to enjoy the right to receive government funding. In fact, the new rural cooperative medical care has embodied the government and collective financial support, but the government and collective funds are limited, only to let the majority of people to participate in, in order to expand the cooperative medical fund-raising capacity, give full play to the role of mutual assistance ****ji.
9, why pay once a year? And to pay within the stipulated time?
The new rural cooperative medical care to a period of one year, in the charging period did not participate in the cooperative medical care of farmers, only in the next year to participate. The purpose of this provision: is to timely and accurate statistics on the number of participants, to facilitate the accurate accounting of cooperative medical funds. Because the normal operation of the cooperative medical care is based on scientific calculations, to keep expenditure within the limits of revenues, to be able to absorb how much money, to determine how much compensation standards, annual break-even.
10, the county's new rural cooperative medical care how to fund? Government financial assistance funds can be guaranteed in place? Will the funds be misappropriated?
Farmers voluntarily pay 10.00 yuan per person per year, national, provincial, municipal and county financial subsidies of 40 yuan per person per year for participating farmers (the central 20 yuan, the provincial 15 yuan, the city of 2 yuan, the county of 3 yuan), *** counted 50.00 yuan per person per year, all of which are deposited into the county cooperative medical fund account, the formation of the county as a unit of the overall fund dedicated to the participants of the hospitalization fee subsidies and outpatient The government is also responsible for the payment of hospitalization and outpatient medical fee subsidies for the participants.
The government subsidies are disbursed on schedule after the number of enrollees is reported and verified, and the fund is not misappropriated.
11. What preferential policies does the government have for the Five Guaranteed Households and Special Hardship Households to participate in the New Rural Cooperative Medical Scheme?
The five guaranteed households, the disabled, the two female sterilization households in the poor households, military martyrs, the elderly over 80 years old and other vulnerable groups and the inclusion of the minimum subsistence guarantee line within the scope of the special hardship case, to participate in the new rural cooperative medical care of the individual part of the contribution funded by the County Civil Affairs Bureau.
12, school students have participated in the insurance, to participate in the new rural cooperative medical care?
Rural schoolchildren, including all schoolchildren, kindergarten children have participated in the insurance, but also with the household to participate in the new rural cooperative medical care, both benefit. The students of universities and colleges who have moved out of their hukou and are studying abroad are exempted from the program.
13. Why do I have to go to a designated medical institution to get reimbursed for the medical fee subsidy?
(1) To ensure the quality of medical services, to ensure the rights and interests of participants. Must have certain conditions of the medical unit as a designated medical institutions, (2) to facilitate the management, to prevent people from impostor, take false bills reimbursement, set off the cooperative medical fund.
14. Can medical expenses be reimbursed across years?
No, because the validity of the cooperative medical certificate is limited to the year, the expiration of the farmers to continue to pay the cooperative medical co-ordination fund to continue to be effective. The so-called inter-annual is based on the date of issuance of medical bills. If you have been hospitalized for more than one year, you will have to pay the cooperative medical insurance premiums before the expiration of the certificate.
15. Is the office expenditure from the farmers' contribution?
No. The new rural cooperation agency office expenses included in the county budget, will not withdraw a penny from the cooperative medical fund, the farmers pay money and government funding money and interest are all to be used in the reimbursement of sick farmers.
16, how to participate in cooperative medicine? The time limit for paying the medical cooperative fund?
Farmers voluntarily participate in cooperative medicine as a family unit, before November 30 each year, according to the standard of 10 yuan per person per year, to pay the next year's participation fee for the household as a unit, there are townships and townships to collect, register and fill in the Office of the cooperative management.
17, participating farmers to enjoy the cooperative medical subsidies time?
From January 1 to December 31 of the next year after the payment of fees for a period of time, the participating farmers can enjoy the new rural cooperative medical treatment under the medical fee compensation treatment. For example, after paying the participation fee in 2007, the period of enjoying the cooperative medical care subsidy is from January 1, 2008 to December 31, 2008.
18. What is the purpose of the cooperative medical fund paid by the farmers themselves?
Participating farmers pay per person per year cooperative medical co-ordination fund, of which 8 yuan to set up a family fund account for the family unit, the remaining 2 yuan with the central and local government subsidies at all levels together *** with the composition of the county's rural cooperative medical co-ordination fund for the farmers to reimburse the integrated reimbursement of major illnesses.
19. How is the family account fund used?
The family account fund (8 yuan per person) is mainly used for reimbursement of family members' outpatient medical expenses, with the principal and interest belonging to them, and the balance being carried over to the next year for cumulative use, but cannot be withdrawn in cash, and shall not be offset against the next year's personal participation fee payable.
20. How is the family account fund reimbursed?
Participating farmers in the designated medical institutions (county hospitals, township health centers, village health centers) outpatient medical expenses, the patient first temporary payment, after the consultation with the "cooperative medical card", ID card (household register), the New Rural Cooperative special prescriptions and medical invoices to the township health centers to reimbursement, but also a number of cumulative reimbursement.
21. How is the cooperative medical fund used?
The integrated fund is divided into a fund for major diseases, a risk reserve fund and a health checkup fund.
The risk reserve fund is set at 12% of the pooled fund and is used to prevent overdraft of the cooperative medical fund or to meet contingencies in case of major accidents.
The health checkup fund is extracted at the rate of 2 yuan per capita, and is used for the health checkups of participating farmers who have not incurred any outpatient or hospitalization expenses within two consecutive years.
The Major Disease Coordination Fund is the remaining portion of the fund in addition to the Risk Reserve Fund and the Health Examination Fund, which is mainly used for the compensation of hospitalized medical expenses of participating farmers.
22. What are the designated medical institutions in the county?
1) County People's Hospital, County Hospital of Traditional Chinese Medicine, County Maternal and Child Health Care Station, and health centers in each township.
2) Participating farmers in the village of the designated health center (outpatient treatment only).
23. What are the reimbursement standards for fixed-point medical institutions at all levels?
The starting line at the township level is 80 yuan, with a reimbursement rate of 60% and a ceiling of 3,000 yuan; the starting line at the county level is 200 yuan, with a reimbursement rate of 50% and a ceiling of 8,000 yuan;
The starting line at the municipal level is 800 yuan, with a reimbursement rate of 35% and a ceiling of 10,000 yuan;
The starting line at the municipal level or above is 1,000 yuan, with a reimbursement rate of 30% and a ceiling of 20,000 yuan. The cap line is 20,000 yuan.
If a participating farmer is hospitalized several times in a year, the total reimbursement of medical expenses shall not exceed RMB 20,000 yuan.
24. What kind of medical fee subsidies are available for hospitalization of participating farmers?
The scope of the subsidy is: bed fee, treatment fee, medicine fee, operation fee, laboratory fee, electrocardiogram, x-ray, ultrasound and other necessary examination fees.
25. How do I get the medical fee subsidy if I give birth under the program?
Participating farmers who are hospitalized for normal delivery within the plan will be reimbursed a fixed amount of RMB 150 per case for medical expenses. If you choose to have a cesarean section because of a difficult birth, you will be reimbursed for the medical expenses according to the standard reimbursement rate of the General Disease Coordination Fund. (If you are hospitalized for delivery, you should bring along a valid birth certificate)
26. What are the non-reimbursable medical fees under the New Rural Cooperative?
The hospitalization subsidy fund is mainly used to subsidize the medical expenses incurred by participating farmers who are hospitalized due to illnesses, not all medical expenses belong to the scope of reimbursement, the new rural cooperative in our county will not be reimbursed for the medical expenses are mainly:
(1) the medical expenses of the people who do not participate in the cooperative medical care;
(2) the cost of self-acquired medicines, heating costs, utilities, out-of-hospital consultation fees, naming surgery surcharge, washing fee, meal fee, ambulance fee;
(3) assembly of prosthetic limbs, prosthetic teeth, prosthetic eyes, hearing aids, organ transplants, flap replacements and pacemakers, physical therapy equipment, cosmetic surgery fee and its sequelae of the medical fee, infertility, sexually transmitted diseases and sexual dysfunction and abortion, induced abortion fee;
(4) due to the fights and brawls caused by injuries, disabilities, and drug addiction, alcoholism, suicide, other murder, Self-injury, traffic accidents, medical accidents, medical appraisal, and industrial injuries and occupational diseases caused by labor export;
(5) Medical expenses incurred for convalescence, rehabilitation, hospitalization in a non-designated medical institution, and transferring to other hospitals for treatment without prior consent (except for emergency and first-aid);
(6) Medical expenses incurred in unplanned hospital births;
(7) Medical expenses incurred during treatment that are not related to the disease;
(8) Medical expenses incurred for the treatment of a disease that is not related to the disease; and (7) During the treatment period, any medical expenses not related to the disease, medicine expenses in the prescription not belonging to the diagnosis, examination expenses in excess of the scope, medicine expenses without medical prescription, false medicine expenses, and medicines outside the catalog of New Rural Cooperative in Gansu Province;
(8) blood transfusion, albumin and nutritional tonic drugs.
(9) Other medical expenses, living service items and service facilities expenses that are not reimbursed by the cooperative medical care as stipulated by the county cooperative management office.
27, participating farmers in violation of which provisions will not be reimbursed or must be returned to the subsidized medical fees?
1) lending one's Cooperative Medical Card to others;
2) falsely altering the Cooperative Medical Card, medical receipts and medical records, prescriptions and other false claims;
3) unreasonably making a fuss over the fact that one's failure to comply with the provisions of the Cooperative Medical System results in the failure to make reimbursement or affecting the reimbursement;
4) violating the provisions of the Cooperative Medical Management System.
7) other violations of the cooperative medical management regulations.
28. What are the precautions for enrolled farmers to be hospitalized in the county?
Participating farmers who need medical consultation and hospitalization due to illness, with their own "cooperative medical card", ID card or hukou book at the designated hospital to see a doctor or hospitalization procedures, (《Cooperative Medical Card》on the incomplete photo or did not post the photo should be submitted to the patient's recent registration photo, in order to determine the identity of the patient). Hospitalized in the county hospital, hospitalization on the day or within three days with their "cooperative medical card", household registration (ID card), hospitalization diagnosis to the county co-management office to issue a notice of consultation; hospitalized in the township health hospitals, in order to facilitate the participation of farmers, by the township health hospitals co-management section staff on behalf of.
29, how to reimburse the medical expenses of hospitalized patients?
Participating farmers hospitalized in designated medical institutions due to illness, first pay a deposit for hospitalization procedures. During the hospitalization period, the "cooperative medical card" by the designated medical institutions for temporary custody, the patient to pay the hospital fees after discharge, with the "cooperative medical card", ID card (hukou book), discharge certificate, copy of the prescription, the detailed list of charges, the cost of settlement of the list of documents (due to farm work due to accidental injuries to the village committee must be issued with a letter of introduction from the township administration of the Office of the examination and approval of the official seal), in the designated medical institutions to reimburse the cooperative management section The hospitalization subsidy costs.
30. How to calculate the reimbursement method?
(1) Reduce the starting line. (2) Subtract the cost of drugs outside the catalog. (3) Multiply the reimbursement rate. (4) Above the ceiling line is paid according to the ceiling line.
Calculation method = (total cost - non-reimbursable costs - starting line) × reimbursement rate of the attending medical institution%
31, how to transfer to other medical institutions?
Cooperative medical patients whose conditions require hospitalization in a designated medical institution at or above the county level, should be certified by the Cooperative Medical Card, ID card or household booklet by the county designated medical institution treating physician to fill in the requirements of the "referral to the hospital approval form", reported to the county co-management office for approval before being transferred out of the hospital for treatment. Special circumstances, such as the need to refer critically ill patients to the hospital in time for the formalities, you can first telephone (4428615) reported to the county co-management office, and then make up for the relevant procedures.
32, the transfer of foreign patients must bring what information when discharged?
Diagnostic certificate of the attending hospital, discharge summary, copy of inpatient medical record (stamped with the official seal of the attending hospital), billing list, detailed list of charges, and approval form for referral to other hospitals.
33. What are the rules for transferring to a foreign hospital?
1) Zhangye City designated hospitals: Zhangye City People's Hospital, Zhangye City Hospital of Traditional Chinese Medicine, Zhangye City Maternal and Child Health Station, Zhangye City Red Cross Psychiatric Hospital;
2) Provincial-level and provincial-level hospitals must be non-profit hospitals.
34. How to reimburse the medical expenses for patients who are transferred out of China?
The patients transferred out of the hospital with relevant information to the county co-management office registration, fill out the transfer registration form, notice of consultation to the township hospital or transfer out of the designated medical institutions co-management section settlement reimbursement. Without the approval and registration of the county co-management office, directly hospitalized outside the county, its medical fees will not be reimbursed in principle.
35, hospitalized in the directory of drugs is how to provide?
The fixed-point medical institutions in the use of cooperative medicine outside the basic medication directory drugs, township fixed-point medical institutions to use the proportion shall not exceed 10% of the total cost of drugs, county-level fixed-point medical institutions shall not exceed 15%. When the use of drugs outside the catalog is required due to medical conditions, the consent of the participating patients must be obtained.
36, the county's rural cooperative medical fund how to manage?
The county's rural cooperative medical fund to implement the financial, cooperative medical office, the bank tripartite joint management system, financial management account, the joint management office management, bank management money, mutual constraints, the separation of money account, closed operation, to ensure that the cooperative medical fund for the reimbursement of medical expenses of farmers.
37, the county's rural cooperative medical fund how to monitor?
The county set up by the county people's Congress, the Chinese People's Political Consultative Conference, the Discipline Inspection Commission, supervision, pricing, auditing and other departments and participate in the cooperative medical supervision committee composed of representatives of farmers, every six months on the use of the cooperative medical fund and the management of the inspection and supervision; the county office of the new rural cooperative medical care will be regularly reimbursement of the fund for the public, to accept the supervision of the community; the auditing department of the regular use of the fund to carry out special audits.
The use and management of the fund is monitored.
38, what are the requirements for filling out the new cooperative medical certificate
"New Rural Cooperative Medical Certificate" should be stamped with a unified seal, fill in the content to be informative, unified and standardized number (10-digit), the photo posted complete and consistent with the name of my ID card, and shall not be altered.
39, "new rural cooperative medical card" lost how to replace the card?
In the use of the process, the "cooperative medical card" shall not be transferred to the wrong, if lost or damaged, by my application, the executive village committee introduced by the township co-management office audit, transferred to the county co-management office to replace.
40, migrant workers how to participate in cooperative medicine?
Outside workers to participate in the cooperative medical care in the place of domicile, hospitalized due to illness must be reported by phone, fax or letter to the county co-management office for the record, discharged with a certificate of discharge, a copy of medical records (stamped with the official seal of the hospital), hospital invoices, detailed list of costs and proof of employment, to the county co-management office after review, the transfer of domicile of the local hospital for reimbursement of subsidies, if special circumstances If you can't return, you can have a close relative bring the relevant information to do it on your behalf.
41 、Can I get reimbursement in time? How much time can I get the reimbursement?
Yes, as long as the procedures are complete, generally the same day can be completed, completed to get reimbursement. If there are special circumstances that prevent you from being reimbursed on the same day, the staff member will explain.
42, the face of the new rural cooperative medical care we farmers how to do?
"The weight of life is heavier than a thousand pieces of gold", human life is only once. All people pick up the wood and the flame is high. Farmers friends, let us *** with action, under the correct leadership of the new central government, the same boat **** help, help each other, *** with the risk of resisting major illnesses, in the government's hand of assistance under the pull, with the majority of farmers' hands of mutual help and friendship *** with the paving of the road to health and happiness.
43, participate in the new rural cooperative medical system publicity song
The sun shines on the earth, the policy benefits all families. The new rural cooperative medical system is a good way to protect your health.
The new rural cooperative medical system is a great way for people to get the most out of the new rural cooperative medical system.
The new rural cooperative, the doctor has subsidies, the burden on the family is light, the health is guaranteed.
Listen to the same village, look at the money, calculate the economic account, how to be cost-effective,
Early participation in the early benefit, do not participate in can not make up for the policy is really good, everyone to participate in the insurance.
44, the new rural cooperative financing propaganda song
Every day to spend three points, to participate in the health insurance, personal payment of ten yuan, the government to make up forty.
Ten dollars to get eight dollars, the family account deposit, the remaining two dollars, the big disease co-ordination fund.
The government's policy is to provide a comprehensive health care system for all people, including those who are sick.
45, cooperative medical fund management propaganda song
Cooperative medical funds, health protection money, individuals do not pay money, the government does not give compensation.
The fund is set up as a special account, and its management and utilization are separated.
Please rest assured that the money will be used exclusively for the purpose, the use of which will be publicized and monitored by everyone.
46, the participating farmers hospitalization publicity song
See a selected point, bring all the documents, identity card, can not be missing.
The doctor will make a diagnosis, come to the Farmers' Cooperative Office, fill in the notification form, pay a deposit at the hospital,
Hospitalization to cure the disease, the prescription should be rewritten, the patient should sign, the cure is discharged,
The payment of money to end the account, the settlement should be a list of hospitals to the cooperative management section, the reimbursement procedures to be done.
47, the participating farmers hospitalization reimbursement rate publicity song
Township hospitals, the proportion of 60, threshold fee 80, the highest reported 3,000.
County hospitals, the proportion is fifty, threshold fee of two hundred, the highest reported eight thousand.
Municipal hospitals live, the proportion of thirty-five, the threshold fee of eight hundred, the highest reported ten thousand.
Provincial hospitals live, the proportion is thirty, the threshold fee of one thousand, the highest reported twenty thousand.
How the reimbursement is calculated, the cost minus the threshold, and then minus the non-reported, multiplied by the reimbursement ratio.
48, the participating farmers referral to the hospital publicity song
If the big disease is transferred to the hospital, you need to be transferred to the next level, the referral approval form, the county hospital to fill out.
The first time I came to the Farmer's Cooperative Office, I was able to complete the approval procedures, and then I was transferred to the designated hospital for treatment.
When you are discharged from the hospital, you have to bring five documents, a certificate of diagnosis, and an invoice for settlement.
The hospitalization summary is filled in, the cost list is complete, the medical record is copied, and the official seal of the hospital is stamped.
When you come to bring all, then go to the Farmers' Cooperative Office, fill out the notice, the health center reimbursement.
49, the use of cooperative medical card management publicity song
Cooperative medical card, stamped with a unified seal, the photo posted full, name filled out.
The words are the same as the ID card, don't change them, each family has a number, a **** ten digits.
After the reimbursement of the doctor, the certificate has a record.
If you lose your documents, go to the village committee,
issue a letter of introduction, the township audit, and then transferred to the Office of the Joint Management, to replace the documents.