The hospital where there is a new rural cooperative medical office, at that time you can be reimbursed directly in the hospital, if it is a different place or there is no office, after discharge from the hospital, bring invoices and handbook IDs! to the local cooperative medical office for reimbursement!
Rural cooperative medical insurance reimbursement scope and standards
1, outpatient compensation:
(1) 60% reimbursement for village health clinic and village center health clinic visits, with a limit of 10 yuan of prescription drug costs per visit, and a limit of 50 yuan of prescription drug costs for temporary rehydration of doctors 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: Limit of 200 RMB for each examination fee such as EKG, X-ray fluoroscopy, radiographs, laboratory tests, physical therapy, acupuncture, CT, MR*** vibration, etc.; 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: all hospitalized patients who participate in cooperative medicine are compensated for one-time or yearly cumulative reportable medical expenses exceeding 5,000 yuan in segments, i.e., 65% for 5,001-10,000 yuan and 70% for 10,001-18,000 yuan.
The annual limit of compensation for town-level cooperative medical care inpatient and uremia outpatient hemodialysis, oncology outpatient radiotherapy and chemotherapy is 11,000 yuan.
Excluded from the reimbursement scope of rural cooperative medical insurance
1, self-medical treatment (without designated hospitals for medical treatment or without referral orders), self-purchased medicines, medicines not reimbursable under the provisions of the public medical care and medical expenses not in line with family planning;
2, outpatient treatment fees, consultation fees, hospitalization fees, meals, accompanying guests, nutritional costs, blood transfusion costs (those with family blood storage) Except for those who have family blood storage, they will be reimbursed according to the relevant regulations), heating and cooling costs, ambulance fees, special care fees and other expenses;
3. Medical expenses for car accidents, fights, suicides, alcoholism, workplace accidents, and medical malpractice;
4. Orthopedics, cosmetic surgery, dental implants, prosthetics, organ transplants, named surgery fees, and consulting fees;
5. Reimbursement of expenses within the scope of reimbursement, but outside of the limit
Specifically, the difference between each place is different, but not too big, and can be very fast to get the money, the requirements are not very strict, and sometimes self-paid drugs are also reimbursed.