First, rural medical insurance reimbursement?
1. outpatient compensation:
(1) village clinics and village center clinics are reimbursed 60%, and the prescription drug fee limit for each visit 10 yuan, and the prescription drug fee limit for temporary rehydration for doctors in health centers is 50 yuan.
(2) Reimbursement for medical treatment in town health centers is 40%. The limit of examination fee and operation fee for each visit is 50 yuan, and the limit of prescription drug fee is 100 yuan.
(3) The reimbursement for medical treatment in secondary hospitals is 30%, and the limit of each examination fee and operation fee is 50 yuan, and the limit of prescription drug fee is 200 yuan.
(4) 20% reimbursement for medical treatment in tertiary hospitals, with the limit of each examination fee and operation fee in 50 yuan and the limit of prescription drug fee in 200 yuan.
(5) The prescription attached to the invoice of traditional Chinese medicine is limited to 1 yuan.
(6) The annual compensation limit for rural cooperative medical clinics is 5,000 yuan.
2. Hospitalization compensation:
(1) Reimbursement scope:
A medical expenses: auxiliary examination: the examination expenses of electrocardiogram, X-ray fluoroscopy, radiography, laboratory tests, physiotherapy, acupuncture, CT and nuclear magnetic resonance are limited to 200 yuan; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan).
B the elderly over B.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.
(2) Reimbursement ratio: town hospitals reimburse 60%; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%.
3. Compensation for serious illness:
(1) town risk fund compensation: where the medical expenses of inpatients participating in rural cooperative medical insurance exceed 5,000 yuan at one time or throughout the year, they should be compensated by stages, that is, 5001-kloc-0/0000 yuan will be compensated by 65%,10001-.
(2) The annual compensation limit for hemodialysis, radiotherapy and chemotherapy in the town-level cooperative medical system inpatient and uremia clinic is1.65,438+0.000 yuan.
The following are not included in the scope of reimbursement of rural cooperative medical insurance:
1. See a doctor at one's own expense (there is no designated hospital or referral form), buy medicines at one's own expense, medicines that cannot be reimbursed according to the regulations of public medical care, and medical expenses that do not conform to family planning.
2. Outpatient treatment fee, visiting fee, hospitalization fee, food fee, escort fee, nutrition fee, blood transfusion fee (except for family blood donors, reimbursed according to relevant regulations), cooling and heating fee, ambulance fee, special nursing fee, etc.
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.
Many farmers have purchased some commercial medical insurance after purchasing the "new rural cooperative medical system". If you buy commercial medical insurance, you should first reimburse the expenses of the "New Rural Cooperative Medical System" and then find an insurance company to reimburse the remaining expenses.