Category A drugs can enjoy full reimbursement, category C will need to pay all the out-of-pocket expenses, while category B reimbursement of 80%, the proportion of 20% out-of-pocket.
1, outpatient reimbursement:
(1) 60% reimbursement for visits to village health centers and village central health centers, with a limit of 10 yuan for prescription medication per visit, and a limit of 50 yuan for temporary rehydration prescription medication by a doctor at the health center.
(2) Township health centers will be reimbursed 40% of the cost for each visit, with a limit of 50 yuan for each examination and surgery, and a limit of 100 yuan for prescription drugs.
(3) Secondary hospitals are reimbursed 30% of the cost, with a limit of 50 yuan for each examination and operation and 200 yuan for prescription drugs.
(4) Tertiary hospitals will reimburse 20% of the fees, with a limit of 50 yuan for each examination and operation and 200 yuan for prescription drugs.
(5) Chinese medicine invoices with prescription attached are limited to RMB 1 yuan per sticker.
(6) The annual limit of outpatient compensation for township-level cooperative medical care is 5,000 yuan.
2. Hospitalization Compensation
(1) Reimbursement Scope:
A. Pharmaceutical Fees: Auxiliary Examinations: Electrocardiograms, X-ray Fluoroscopy, Films, Laboratory Tests, Physiotherapy, Acupuncture and Moxibustion, CT, Nuclear Magnetic *** Vibration and other examinations
Checking Fees Limit of 200 RMB; Surgical Fees (with reference to the national standard, reimbursement for fees in excess of 1,000 RMB will be made in accordance with the limit of 1,000 RMB).
B. For the elderly over 60 years old who are hospitalized in Xingta Township Health Center, the treatment fee and nursing fee are compensated 10 yuan per day with a limit of 200 yuan.
(2) Reimbursement rate: town health center reimbursement 60%; secondary hospital reimbursement 40%; tertiary hospital reimbursement 30%.
3. Compensation for major illnesses
(1) Compensation from the town risk fund: Any hospitalized patient who participates in the rural cooperative medical insurance shall be compensated for the one-time or yearly cumulative reportable medical expenses exceeding
5000 yuan or more in segments, i.e., 65% for 5001-10,000 yuan, and 70% for 10,001-18,000 yuan.
(2) The annual limit of 11,000 yuan for compensation for town-level cooperative medical care inpatient hospitalization and outpatient blood dialysis for uremia, and outpatient radiotherapy and chemotherapy for oncology is 11,000 yuan.
Extended information:
Not covered by the Rural Cooperative Medical Insurance reimbursement:
1, self-medical treatment (without designated hospitals for medical treatment or without a referral order), self-purchased medicines, medicines that cannot be reimbursed under the provisions of public medical care and medical expenses that do not meet the requirements of family planning;
2, outpatient treatment, consultation fees, hospitalization, meals, companion fees, nutritional fees, blood transfusion fees (except for those with family blood reserves, which are reimbursed in accordance with the relevant regulations), heating and cooling, ambulance fees, and special nursing care fees Other expenses;
3. Medical expenses for car accidents, fights, suicides, alcoholism, workplace accidents and medical malpractice;
4. Orthopedics, plastic surgery, dentures, prosthetics, organ transplants, named surgery fees, consultation fees, etc.
5. Reimbursement of expenses within the scope of reimbursement, part of the limit outside the scope.
Baidu Encyclopedia-Medicare Reimbursement Scope