Treatment of ankylosing spondylitis in other provinces and cities is generally reimbursed locally. At this time, the expenses in this hospital need to be paid at your own expense, and then you will be reimbursed locally with relevant reimbursement procedures. It also depends on the treatment you choose, such as the scope and standard of compensation for factors such as drugs used and hospitals you choose.
1, outpatient compensation:
(1) village clinics and village center clinics are reimbursed 60%, and the prescription drug fee limit for each visit 10 yuan, and the prescription drug fee limit for temporary rehydration for doctors in health centers is 50 yuan.
(2) Reimbursement for medical treatment in town health centers is 40%. The limit of examination fee and operation fee for each visit is 50 yuan, and the limit of prescription drug fee is 100 yuan.
(3) The reimbursement for medical treatment in secondary hospitals is 30%, and the limit of each examination fee and operation fee is 50 yuan, and the limit of prescription drug fee is 200 yuan.
(4) 20% reimbursement for medical treatment in tertiary hospitals, with the limit of each examination fee and operation fee in 50 yuan and the limit of prescription drug fee in 200 yuan.
(5) The prescription attached to the invoice of traditional Chinese medicine is limited to 1 yuan.
(6) The annual compensation limit for rural cooperative medical clinics is 5,000 yuan.
2, hospitalization compensation
(1) Reimbursement scope:
A. Drug expenses: auxiliary examination: the expenses for ECG, X-ray fluoroscopy, radiography, laboratory tests, physical therapy, acupuncture, CT and nuclear magnetic resonance are limited to 200 yuan; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan).
B, the elderly over 60 years old are hospitalized in Xingta Town Health Center, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan.
(2) Reimbursement ratio: town hospitals reimburse 60%; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%.
3. Compensation for serious illness
(1) town risk fund compensation: all inpatients who participate in the cooperative medical system whose medical expenses exceed 5,000 yuan at one time or for the whole year shall be compensated by stages, that is, 500 1- 10000 yuan is 65%,10001-/.
The annual compensation limit of town-level cooperative medical system hospitalization, uremia outpatient hemodialysis and tumor outpatient radiotherapy and chemotherapy is 1. 1 ten thousand yuan. Six, does not belong to the scope of reimbursement.
1. Medical treatment at one's own expense (no designated hospital or referral form), drugs purchased at one's own expense, drugs that cannot be reimbursed according to the regulations of public medical care and medical expenses that do not meet the requirements of family planning;
2, outpatient treatment fees, visits, hospitalization fees, meals, escort fees, nutrition fees, blood transfusion fees (except for family blood storage, according to the relevant provisions of reimbursement), heating and cooling fees, ambulance fees, allowances and other expenses;
3. Medical expenses for car accidents, fights, suicides, alcoholism, industrial accidents and medical accidents;
4. Orthopedics, cosmetic surgery, dental implants, artificial limbs, organ transplantation, roll call surgery fees, consulting fees, etc. ;
5, within the scope of reimbursement, beyond the limit. According to the Interim Measures of Wendeng Rural Cooperative Medical System, since 2007, the medical expenses of outpatients who participated in the cooperative medical system in line with the Interim Provisions of Wendeng New Rural Cooperative Medical System on the Management of Overall Compensation for Special Diseases in Outpatients have been included in the scope of payment of the outpatient overall compensation fund. Have the following 1 1 special diseases: 1. Outpatient radiotherapy and chemotherapy for malignant tumors; 2, uremia outpatient dialysis; 3. Anti-rejection treatment after approved tissue transplantation and organ transplantation; 4. Systemic lupus erythematosus; 5. Treatment of cerebral hemorrhage and cerebral infarction in recovery period; 6. Hypertension (Grade II and III); 7. Chronic pulmonary heart disease; 8. Femoral head necrosis; 9. Mental illness; 10, diabetes; 1 1, tuberculosis. The diabetes you mentioned belongs to the scope of outpatient co-ordination compensation, but coronary heart disease does not.
Patients suffering from these diseases should go to the designated medical institutions in the participating areas for special disease identification, and then go to the designated medical institutions for treatment after approval. Make an overall compensation once a year. At the end of the year, patients whose medical expenses exceed the deductible line shall submit documents to the local cooperative medical workstation and be compensated according to regulations. Each person's annual medical expenses deductible line 1000 yuan, reimbursement ceiling line 4000 yuan.
There is a limit to the reimbursement of cooperative medical care, and the salary is generally tens of thousands of yuan according to the local society.
Rural cooperative medical insurance is purchased in the same year and takes effect the following year. The reimbursement of cooperative medical insurance needs to go to the medical insurance checkout window of the local cooperative medical management institution or designated medical institution for reimbursement.
Procedures include: my ID card, medical insurance card, original invoice, medication list, medical records and other materials. The reimbursement of cooperative medical insurance is carried out in proportion, generally fluctuating around 20-85%. The proportion and amount of reimbursement are related to their own examination and medication, medical level and other factors. For example, it is clear that Class A drugs can enjoy full coverage, Class C drugs need to bear all the costs, and Class B drugs will report 80% and bear 20% of the costs. Someone spent a total of 19000 yuan on medical expenses, and the reimbursement formula is as follows: (19000-500 "deductible"-self-paid medicine) *70%. If self-funded drugs account for a large proportion, there is not much amount to be reimbursed. In addition, it is also important to go to designated medical institutions for medical treatment.