The new rural cooperative medical system needs to buy prescription drugs in designated village clinics or public hospitals at or above the township level, and can be reimbursed within the limit. The general reimbursement rate does not exceed 20%.

The coverage of serious illness insurance should be connected with urban residents' medical insurance and the new rural cooperative medical system. The medical insurance for urban residents and the new rural cooperative medical system should provide basic medical security according to the policy. On this basis, the major illness insurance mainly guarantees the eligible medical expenses of urban residents compensated by medical insurance and the new rural cooperative medical system when the insured (co-insured) is seriously ill and the medical expenses are high.

High medical expenses can be judged by the fact that the accumulated annual compliance medical expenses of individuals exceed the annual per capita disposable income of urban residents and the annual per capita net income of rural residents announced by local statistical departments, and the specific amount is determined by local governments.

Compliance medical expenses refer to the actual and reasonable medical expenses (which can be stipulated not to be paid), which are determined by the local government. All localities can also start to carry out serious illness insurance from diseases with heavy personal burden.

Expand data and strive to avoid catastrophic medical expenses for urban and rural residents, reasonably determine the compensation policy for serious illness insurance, and the actual payment ratio is not less than 50%; The proportion of payment is determined according to the level of medical expenses. In principle, the higher the medical expenses, the higher the payment ratio. With the continuous improvement of financing, management and security, the proportion of reimbursement for serious illness will be gradually increased, and the burden of personal medical expenses will be reduced to the greatest extent.

Do a good job in connecting basic medical insurance, serious illness insurance and medical assistance for serious and serious diseases, establish a serious illness information notification system, timely grasp the medical insurance payment of seriously ill patients, strengthen policy convergence, and effectively avoid the problems of poverty caused by illness and returning to poverty due to illness. The designated medical institutions, medication and diagnosis and treatment scope of urban and rural medical assistance shall be implemented with reference to the relevant policies and regulations of basic medical insurance and serious illness insurance respectively.

References:

Baidu encyclopedia-new rural cooperative medical care