First, outpatient reimbursement standards

1. Village clinics and village center clinics will be reimbursed 60%, and the cost limit of prescription drugs for each visit 10 yuan, and the cost limit of prescription drugs for temporary rehydration by doctors in health centers is 50 yuan.

2. Reimbursement of 40% for medical treatment in town health centers, with the limit of examination fee and operation fee for each visit, and the limit of prescription fee 100 yuan.

3. Reimbursement for medical treatment in a secondary hospital is 30%, with the examination fee and operation fee limited to 50 yuan and prescription drug fee limited to 200 yuan.

4. Reimbursement for medical treatment in tertiary hospitals is 20%, with examination fees and operation fees limited to 50 yuan and prescription drug fees limited to 200 yuan.

5. Chinese medicine invoice with prescription, the limit is 1 yuan.

6. The annual compensation limit for township-level cooperative medical clinics is 5000 yuan.

Second, the hospitalization reimbursement standard

1. Medical expenses: supplementary examination: examination expenses such as electrocardiogram, X-ray fluoroscopy, photography, laboratory tests, physiotherapy, acupuncture, CT and nuclear magnetic resonance, etc. 200 yuan; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan).

2. The elderly over 60 years old are hospitalized in Xingta Town Health Center, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan.

Proportion of hospitalization reimbursement: town hospital reimbursement 60%; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%.

Third, the reimbursement standard for serious illness

Compensation from town risk fund: if the medical expenses of inpatients participating in cooperative medical care exceed 5,000 yuan at one time or for the whole year, they should be compensated by stages, that is, 5001-kloc-0/0000 yuan is 65%, and10001-kloc-0/8000 yuan is 75%. The annual compensation limit of town-level cooperative medical system hospitalization, uremia outpatient hemodialysis and tumor outpatient radiotherapy and chemotherapy is 1. 1 ten thousand yuan.

Shanxi rural medical insurance will not be reimbursed.

1. Medical treatment at one's own expense (no designated hospital or referral form), drugs purchased at one's own expense, drugs that cannot be reimbursed according to the regulations of public medical care and medical expenses that do not meet the requirements of family planning;

2, outpatient treatment fees, visits, hospitalization fees, meals, escort fees, nutrition fees, blood transfusion fees (except for family blood storage, according to the relevant provisions of reimbursement), heating and cooling fees, ambulance fees, allowances and other expenses;

3. Medical expenses for car accidents, fights, suicides, alcoholism, industrial accidents and medical accidents;

4. Orthopedics, cosmetic surgery, dental implants, artificial limbs, organ transplantation, roll call surgery fees, consulting fees, etc. ;

5, within the scope of reimbursement, beyond the limit.