Reimbursement scope and proportion of rural medical insurance in Yunnan Province 1. Outpatient compensation: (1) 60% reimbursement for village clinics and village central clinics, 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 health centers.

(2) The town health center reimburses 40% of the fees for each visit, with a limit of 50 yuan for various 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 RMB 50 for examination fees and surgical fees for each visit, and a limit of RMB 200 for prescription drugs.

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

2. Hospitalization compensation (1) Scope of reimbursement: A. Medication expenses: Auxiliary examinations: ECG, X-ray, film, laboratory tests, physical therapy, acupuncture, CT, MRI and other examination fees are limited to 200 yuan

;Surgery fee (refer to national standards, if it exceeds 1,000 yuan, it will be reimbursed at 1,000 yuan).

B. For elderly people over 60 years old who are hospitalized in Xingta Town Health Center, treatment and nursing fees will be compensated 10 yuan per day, with a limit of 200 yuan.

(2) Reimbursement ratio: Town health center reimburses 60%; second-level hospitals reimburse 40%; third-level hospitals reimburse 30%.

Medical insurance reimbursement ratio in Yunnan Province in 2017 3. Serious illness compensation (1) Town risk fund compensation: All inpatients participating in rural cooperative medical insurance whose one-time or annual cumulative medical expenses reimbursed exceed 5,000 yuan will be compensated in stages, that is, 5,001-10,000

The compensation is 65% for RMB 10,001-18,000 Yuan, and the compensation is 70% for RMB 10,001-18,000.

(2) The annual limit of compensation for town-level cooperative medical inpatient and uremia outpatient hemodialysis, cancer outpatient radiotherapy and chemotherapy is 11,000 yuan.

Questions and Answers on Rural Medical Insurance in Yunnan Province: My parents now live in rural Anhui and have participated in the new rural medical insurance. Is there a cap on the reimbursement amount of this insurance? What is the maximum amount that can be reimbursed?

In addition, I now want to buy another critical illness medical insurance for them. Will there be any conflict in the reimbursement of this insurance in the future?

If I see a doctor in a hospital in this province, can the reimbursement ratio reach 50%? In addition, there is only one medical bill. If I apply for rural medical insurance, is there any way to apply for serious illness medical insurance from the insurance company?

Answer: The maximum cap of the New Rural Cooperative Medical System is 40,000 yuan per year, and the reimbursement ratio is 80% for town-level hospitals after the deductible, followed by 60% at the county level and 45% at the provincial level. It does not conflict with other commercial insurances.

Please keep copies of all documents and ask the NCMS office that received your documents to stamp their official seal for reimbursement from commercial insurance.

Warm reminders about rural medical insurance in Yunnan Province. Compared with the launch of the system in 2007, the new version of the "Drug Catalog for Basic Medical Insurance, Work Injury Insurance and Maternity Insurance in Anhui Province" released in 2010 has 2,422 categories of Class A and B drugs.

The last edition of the Drug Catalog added more than 300 drugs.

At the same time, the scope of payment of medical insurance funds has gradually expanded, and the scope of prescribed outpatient diseases for serious diseases and chronic diseases has continued to increase.

In addition, Yunnan Province focuses on resolving the transfer and continuation of rural medical insurance relationships in Anhui Province that move between urban and rural areas by providing good medical insurance relationship transfer and continuation and off-site medical settlement services, thereby achieving smooth transfer and continuation of medical insurance relationships between different systems and different regions.

.

By coordinating medical insurance management and handling services with the "Yangtze River Delta" region, we will continue to improve the settlement methods for medical treatment in other places, so that insured persons in our province can better enjoy medical insurance benefits in other places.

In 2015, Yunnan Province continued to implement the basic medical insurance system for urban residents, a livelihood project, and increased the reimbursement benefits of medical insurance.

In order to help the majority of insured residents further understand the residents’ medical insurance policy, master how to participate in insurance, seek medical treatment, reimbursement and other related procedures, so as to better enjoy the government’s policies to benefit the people, the Yunnan Provincial Human Resources and Social Security Bureau recently announced the residents’ medical insurance 2015-2016

Annual benefits and reimbursement policies.