1. Rural residents who are first diagnosed or mainly diagnosed as childhood leukemia (0- 14 years old), congenital heart disease (0- 14 years old), end-stage renal disease, breast cancer, cervical cancer, severe mental illness, multidrug-resistant tuberculosis, AIDS opportunistic infection, lung cancer, esophageal cancer, gastric cancer, colon cancer, etc. For 22 major diseases such as type I diabetes, hyperthyroidism, cleft lip and palate, BH4 deficiency and critical pregnant women, after reimbursement by the new rural cooperative medical system, the personal expenses within the reimbursement policy of the new rural cooperative medical system accumulated more than 3,000 yuan (including 3,000 yuan) and those outside the policy (including 30,000 yuan) accumulated more than 3,000 yuan (including 30,000 yuan).
2. In addition to the above-mentioned 22 major diseases, the annual hospitalization and serious illness outpatient medical expenses of rural residents, after reimbursement by the new rural cooperative medical system, the annual accumulated personal expenses within the reimbursement policy of the new rural cooperative medical system are more than 20,000 yuan (including 20,000 yuan), and the annual accumulated personal expenses outside the policy are more than 40,000 yuan (including 40,000 yuan).
3. The expenses outside the reimbursement policy of the new rural cooperative medical system are set as the upper limit of the total medical expenses, and the expenses outside the designated medical institutions of the first-level new rural cooperative medical system are 10% (including 10%, the same below), the designated medical institutions of the second-level new rural cooperative medical system are 20%, and the designated medical institutions of the municipal new rural cooperative medical system and the designated medical institutions outside the city are 30%.
(two) one of the following circumstances, not included in the scope of medical assistance for serious illness in rural areas:
1. Going to a medical institution outside the city or at a non-designated place without approval;
2 medical expenses within the scope of public health services (such as vaccination, pre-marital medical examination, preventive health care, health education, etc.). ) special funds are arranged by the government;
3 beauty, weight loss, escort and other non-disease diagnosis and treatment costs;
4. Self-injury caused by industrial accidents, medical accidents, traffic accidents, fights and other obvious responsible parties, drunk driving, driving without a license, theft and robbery, self-injury, suicide, drug abuse and so on. ;
5. Expenses incurred by abortion, abortion and other family planning measures.
(3) Medical assistance standard for serious illness in rural areas.
1. Rural residents suffering from 22 major diseases are included in the reimbursement policy of the new rural cooperative medical system. If the accumulated personal expenses exceed 3,000 yuan per year, they will be given assistance according to the proportion of 60%; The annual expenses exceeding the reimbursement policy of the new rural cooperative medical system exceed 3,000 yuan, and assistance is given according to the proportion of 20%.
2. In addition to suffering from 22 major diseases, rural residents' hospitalization and serious illness clinics are included in the annual self-funded part of the reimbursement policy of the new rural cooperative medical system, and 60% of them are given assistance; The annual accumulated expenses exceeding the reimbursement policy of the new rural cooperative medical system are more than 40,000 yuan, and assistance is given at 20%.
3. The cumulative time of medical assistance expenses and assistance amount for serious illness in rural areas is calculated according to the natural year, and the annual assistance amount is capped at 65,438+10,000 yuan.
(four) the implementation time of medical assistance for serious illness in rural areas.
Medical assistance for serious illness in rural areas has been implemented since July 1, 20 12, the medical expenses that fall within the scope of medical assistance for serious illness from July 1, 20 12 until the implementation of this opinion, and the medical expenses that continue to be hospitalized until July 1 2.
skill
The above answer is only for the current information combined with my understanding of the law, please refer carefully!
If you still have questions about this issue, I suggest you sort out relevant information and communicate with professionals in detail.