Shanghai New Rural Cooperative Medical Insurance Problems with Medical Treatment in Other Places

Can New Rural Cooperative Medical Insurance be reimbursed in another place? How to reimburse for new rural cooperative medical insurance in another place? Now that the entire province is connected to the Internet, reimbursement can be made in other places. If you need to go through relevant procedures for medical treatment in other places, the expenses for medical treatment in other places can only be reimbursed according to regulations after approval by the local rural cooperative medical management center. Set up a settlement center for off-site medical expenses in the health administrative departments of districts and cities, and coordinate the settlement of hospitalization expenses for participating farmers on a county-by-county basis to achieve immediate reimbursement for medical treatment by farmers.

How to reimburse for new rural cooperative medical insurance in another place?

Relying on the province's medical insurance network and equipment platform, a new rural cooperative medical information operation platform will be established in each district and city, and an off-site medical expense settlement center will be established in the health administration department of the district and city to coordinate the process on a county-by-county basis. Participate in the settlement of farmers' hospitalization expenses to achieve immediate reimbursement for farmers' medical treatment. Establish the province's new rural cooperative medical data backup center and off-site medical data exchange center in the province.

However, it is worth noting that reimbursement is only available for hospitalization, but not for outpatient services. When you need to go back to your hometown (place of insurance participation) for reimbursement, the procedures that may be required are:

1. Hospitalization record

2. Expense list

3. Hospitalization invoice

4. Disease diagnosis certificate

5. Discharge summary

6. ID card, household registration book

7. Cooperative Medical Care Book (or Certificate, card)

8. Transfer procedures or certificates (certificate of work in the unit or emergency certificate)

Not included in the scope of reimbursement of the New Rural Cooperative Medical System:

(1) Outpatient medical expenses in non-designated hospitals in the region (except for outpatient treatment expenses for special diseases), expenses incurred by not seeking medical treatment in accordance with regulations, and self-purchased drugs;

(2) Expenses required for family planning measures, violations of Medical expenses under the family planning policy;

(3) Dentures, orthodontics, optometry, hearing aids, artificial organs, beauty treatments, plastic surgery and orthopedic surgeries, and rehabilitative medical treatments (such as qigong, massage, massage , physical therapy, magnetic therapy, etc.) as well as various accompanying expenses, medical transportation expenses, consultation fees, other miscellaneous expenses during hospitalization, etc.;

(4) In the case of third-party liability, personal injury occurs The medical expenses of the patient shall be borne by the third responsible party in accordance with the law, such as traffic accidents, medical accidents, work injuries, etc.;

(5) Due to suicide, self-mutilation, poisoning, drug abuse, fights and other illegal activities, as well as the intentional actions of their family members Medical expenses incurred due to injuries caused by behavior;

(6) Medical expenses incurred while abroad or in Hong Kong, Macao and Taiwan;

(7) Urban employee medical insurance system regulations Drugs and items that are not reimbursable;

(8) Other expenses that are not reimbursable as determined by the District Medical Management Committee.

Reference:

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