(A) the proportion of outpatient reimbursement
1, the reimbursement rate of village clinics and health clinics is 60%;
2. The reimbursement rate of urban hospitals is 40%;
3. The proportion of stroke in secondary hospitals is 30%;
4. The reimbursement rate of tertiary hospitals is 20%;
5. The reimbursement limit for township-level cooperative medical clinics is 5,000 yuan/year.
(2) Proportion of hospitalization reimbursement
1, new EEG, X-ray fluoroscopy, radiography, laboratory tests, physiotherapy, acupuncture, CT, MRI and other auxiliary examination items will be reimbursed to 200 yuan;
2, the operation fee deductible line 1000 yuan according to national standards, more than 1000 yuan according to 1000 yuan;
3. The hospitalization expenses and nursing expenses of the elderly over 60 years old can be reimbursed every day 10 yuan, with the limit of 200 yuan;
4. The reimbursement ratio of hospitals at all levels is: town hospitals reimburse 60%; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%.
(3) Proportion of reimbursement for serious illness
1, the proportion of overall subsidies for township and village clinics increased to 65% and 75% respectively.
2, a medical institution hospitalization expenses below 400 yuan, no deductible;
3, secondary medical institutions to increase the proportion of subsidies to 75% ~ 80%;
4, the proportion of tertiary medical institutions to increase subsidies to 55%~60%.
5, the proportion of provincial tertiary medical institutions subsidies increased to 55%.
6. Eight kinds of serious diseases such as congenital heart disease in children, 70% of the new rural cooperative medical subsidy diseases, and 12 kinds of serious diseases such as lung cancer, and strive to reach 70% of the new rural cooperative medical subsidy diseases.
Second, the reimbursement scope of the new rural cooperative medical system.
The reimbursement scope of the new rural cooperative medical system is: medical expenses, examination expenses, laboratory expenses, operation expenses, treatment expenses and nursing expenses incurred by the insured in designated hospitals due to illness during the overall planning period, which meet the reimbursement scope of medical insurance for urban employees (i.e. effective medical expenses).