The rural cooperative medical system implemented in Shenzhen is a policy of "advance the hospitalization expenses in different places and reimburse them after returning to the household registration", that is, the insured persons of rural cooperative medical system who are hospitalized in Shenzhen need to pay their own medical expenses first and then reimburse them at the local rural cooperative medical management center after returning to the household registration. The specific reimbursement ratio is subject to local policies and regulations. The policies of rural cooperative medical care in different regions may be slightly different, and the local policies shall prevail.

Reimbursement provisions for cooperative medical care are as follows:

1. Reimbursement scope: The cooperative medical system can reimburse medical expenses that meet the requirements, including hospitalization expenses, outpatient expenses, medicine expenses, examination fees, etc.

2. Reimbursement ratio: The reimbursement ratio of cooperative medical care depends on local regulations. Generally, the reimbursement rate of hospitalization expenses is between 50% and 80%, and the reimbursement rate of outpatient expenses is between 20% and 60%;

3. Reimbursement limit: the reimbursement limit of cooperative medical care is determined according to local regulations. Under normal circumstances, the reimbursement limit for hospitalization expenses is between 1000-30000 yuan per year, and the reimbursement limit for outpatient expenses is between 200-800 yuan per year;

4. Reimbursement process: it is necessary to apply to the local cooperative medical service agency within the specified time after the treatment, generally within half a year after the treatment. Need to provide related medical expenses invoices, medical records, diagnosis certificates and other materials. After the audit of the cooperative medical service agency, the eligible expenses will be reimbursed to individuals or medical institutions.

To sum up, there may be differences in reimbursement regulations of cooperative medical care in different regions, and the specific situation should be handled according to local regulations. In addition, cooperative medical care does not include some special medical items and drugs, such as cosmetic surgery and health care products. , and does not include medical expenses caused by illegal acts.

legal ground

Article 30 of People's Republic of China (PRC) Social Insurance Law

The following medical expenses are not included in the payment scope of the basic medical insurance fund:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.