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Neijiang Medical Insurance Reimbursement Policy

Neijiang City's rural medical insurance reimbursement scope and proportion, outpatient compensation: (1) Village clinics and village central clinics are reimbursed 60%, with a limit of 10 yuan for prescription drugs per visit, and a limit of 50 yuan for prescription drugs for temporary rehydration by doctors at the health center.

(2) The town health center will reimburse 40% of the fees for each visit, with a limit of 50 yuan for examination fees and surgical fees, and a limit of 100 yuan for prescription drugs.

(3) 30% reimbursement for visits to secondary hospitals, with a limit of 50 yuan for examination fees and surgical fees for each visit, and a limit of 200 yuan for prescription drugs.

(4) 20% reimbursement for visits to tertiary hospitals, with a limit of 50 yuan for examination fees and surgical fees for each visit, and a limit of 200 yuan for prescription drugs.

(5) There is a limit of 1 yuan per prescription attached to the traditional Chinese medicine invoice.

(6) The annual compensation limit for town-level cooperative medical outpatient clinics is 5,000 yuan.

1. Conditions for reimbursement of Neijiang medical insurance: 1. The applicant has gone through the insurance procedures and paid the medical insurance premium in full; 2. Seeked medical treatment in a medical institution designated by the cooperative medical system; 3. The insured person incurred hospitalization medical expenses while seeking medical treatment in a registered medical institution, and the insured person shall be paid first

Pay cash, and keep relevant documents and information. 2. Neijiang Medical Insurance Reimbursement Process 1. The handler submits reimbursement documents and other materials to the Shenhui Insurance Fund Management Bureau for acceptance; 2. The acceptance department will complete the review on the same day after receiving the application materials.

, settlement and payment work; 3. The Social Security Fund Management Bureau reviews the materials and approves the application. The applicant will be reimbursed after receiving the "Social Medical Insurance Medical Expense Reimbursement Form".

Legal basis: Article 26 of the "Social Insurance Law of the People's Republic of China" The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with national regulations.

Article 28 Medical expenses that comply with the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue expenses shall be paid from the basic medical insurance fund in accordance with national regulations.

Article 29 The part of the medical expenses of the insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance agency and the medical institution and pharmaceutical business unit.

The social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in other places to facilitate insured persons to enjoy basic medical insurance benefits.