1. All inpatients participating in cooperative medical care whose one-time or annual cumulative medical expenses exceed 5,000 yuan will be compensated in stages, that is, 65% will be compensated for 5,001-10,000 yuan, and 70% will be compensated for 10,001-18,000 yuan.
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.
Extended information: Settlement procedures: 1. Settlement procedures for hospitalization and outpatient treatment of special diseases. Designated medical institutions shall submit the cost settlement form, hospitalization settlement form and relevant information of patients discharged last month to the medical insurance agency before the 10th of each month.
, after review by the medical insurance agency, it will be used as the basis for monthly pre-allocation and year-end final accounts.
The medical insurance agency pre-allocates the overall cost of hospitalization and outpatient treatment for special diseases in the previous month every month.
2. Emergency settlement procedure. The insured person is hospitalized in a non-designated medical institution or a remote medical institution in the city due to emergency rescue. The medical expenses incurred will be paid in advance by the individual or unit. After the emergency rescue is completed, the insured person will be paid based on the hospital’s emergency medical records and examination.
, laboratory reports, invoices, and detailed medical fee lists until the medical insurance agency handles the reimbursement procedures in accordance with regulations.
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