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Conditions and standards for the second reimbursement of rural cooperatives

The conditions and standards for the second reimbursement of the new rural cooperative medical system (NCMS) are as follows:

1. Insurance conditions: farmers who must participate in the NCMS.

2. Reimbursement conditions: After normal reimbursement, if the remaining personal out-of-pocket expenses exceed the annual per capita net level of rural residents in the whole city in the previous year, you can apply for a second reimbursement procedure for the excess amount.

3. Location of medical treatment: For those who seek medical treatment in the local second-class hospital or designated hospital due to serious illness, the insured persons of the new rural cooperative medical system can directly pay the compensation funds for serious illness insurance at the hospital charging window, and they will be reimbursed automatically according to the regulations on serious illness insurance of the new rural cooperative medical system when they leave the hospital, without additional reimbursement procedures.

4. compensation principle: the second compensation of the new rural cooperative medical system refers to the re-compensation of the participating farmers who have obtained the overall compensation for serious illness by using the balance of the overall fund of the new rural cooperative medical system. It is a temporary control measure taken before adjusting and perfecting the overall compensation plan, and is not used as a conventional compensation model. Not in the beginning of the new rural cooperative medical fund allocation withholding, in the balance of the overall fund over the years more than 25% of the overall fund, can be a second compensation.

payment methods of the new rural cooperative medical care fee:

1. centralized collection at the door of township and village cadres.

2. Payment method of village collective economy.

3. Farmers take the initiative to pay in the rural new rural cooperative medical system.

to sum up, the conditions for second reimbursement may be different in different places, so the specific reimbursement standards and procedures should be based on the local new rural cooperative medical system policy.

legal basis:

social insurance law of the people's Republic of China

article 25

the state establishes and improves the basic medical insurance system for urban residents. The basic medical insurance for urban residents combines individual contributions with government subsidies. Those who enjoy the minimum living guarantee, the disabled who have lost the ability to work, the elderly and minors who are over 6 years old in low-income families, etc., are subsidized by the government.

article 28

medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations.