In 20 12, the financial subsidy standard of the new rural cooperative medical system in the county is higher, the reimbursement ratio is larger, the scope of protection is wider, and the degree of benefit is more. Welcome farmers to participate in the new rural cooperative medical system!
I. Financing methods
1, pay back the amount owed by 20 1 1 year per person 10 yuan.
In order not to affect the reimbursement of the new rural cooperative medical system in 20 1 1 year, the fund-raising for 201year was carried out in advance in February, 20 10. At that time, the relevant documents of the city's fund-raising standards had not yet been issued, and our county continued to levy according to the standard of 40 yuan per capita in 201year. In May of 20 1 1 year, our city issued the Guiding Opinions on the Adjustment of the Compensation Scheme of the New Rural Cooperative Medical System in 20 1 1 year, requiring that the individual financing standard be adjusted from 40 yuan to 50 yuan, and the financial subsidy standard be adjusted from 120 yuan to 200 yuan. Due to the timely replenishment of financial subsidy funds, the reimbursement ratio of the new rural cooperative medical system in 20 1 1 year is implemented according to the standard of 50 yuan. Each participating farmer owes 10 yuan, which is overdue and is not included in the reimbursement base of 20 12.
2.20 12, each to 60 yuan.
According to the Notice of the Provincial Health Department on Doing a Good Job in Personal Financing and Payment of the New Rural Cooperative Medical System in 20 12, the financing standard of the new rural cooperative medical system in 20 12 was raised from 50 yuan to 60 yuan, and the financial subsidy standards at all levels were raised from 200 yuan to 240 yuan. The reimbursement rate of 20 12 is based on the standard that each person pays 60 yuan and gives financial assistance to 240 yuan.
Total * * * should be paid to 70 yuan. Participating farmers should participate continuously. Those who did not participate in 20 12 and apply for re-participation in the new rural cooperative medical system in the future will pay the annual participation funds (individual contributions and financial subsidies at all levels).
Second, the reimbursement ratio.
1, continue to increase the proportion of outpatient expenses reimbursement. The proportion of reimbursement for outpatient medical expenses of participating farmers in town health centers and designated village clinics in this region has increased from 30% of 20 1 1 to 40%, and the maximum amount of reimbursement for accumulated outpatient medical expenses per person per year is 200 yuan.
2, outpatient chronic diseases and special diseases to implement compensation. According to the requirements of provincial and municipal documents, 10 chronic diseases and five special diseases will be gradually included in the reimbursement and compensation scope of the new rural cooperative medical system outpatient service.
3. Continue to increase the proportion of hospitalization reimbursement. The reimbursement rate of hospitalization expenses (within the scope of reimbursement) in town-level designated medical institutions has increased from 75% of 20 1 1 to 80%. The hospitalization expenses of county-level designated medical institutions shall be reimbursed by stages: 60% of the hospitalization expenses of 50,000 yuan or less; Hospitalization expenses exceeding 50,000 yuan shall be reimbursed at 70%. The reimbursement rate of hospitalization expenses in hospitals above the municipal level has increased from 40% of 20 1 1 to 50%. The top line of reimbursement for hospitalization in that year was 6.5438+0.5 million yuan.
4. Further improve the level of protection for major diseases. For children with congenital heart disease, acute leukemia, cleft lip and palate included in medical insurance coverage, quota management should be implemented, and the quota standard should be raised appropriately. We will carry out fixed-point diagnosis and treatment for severe mental illness, breast cancer, cervical cancer, end-stage renal disease, hemophilia and other diseases, and actively implement price limit increase and quota compensation for single diseases. Traumatic patients are included in the price limit range of single disease, and the top line of reimbursement for hospitalization in that year is 10000 yuan.
Third, the reimbursement instructions.
1. registration place: register at the village Committee where the household registration is located.
2. Materials to be provided: new participants need to provide household registration books; Participants provided the household registration book and the new rural cooperative medical certificate.
3. Designated medical institutions in the city choose to seek medical treatment independently and cancel the referral in the city. To the designated medical institutions outside the city for medical treatment, it is necessary to go through the referral procedures with the "New Rural Cooperative Medical Certificate" and the hospital's diagnosis certificate to the county new rural cooperative medical service agency. Critically ill patients who have no time to go through the referral procedures shall be handled within seven days.
4. Participating farmers are hospitalized due to trauma, poisoning and other special circumstances, and they need to go through the examination and approval procedures at the county cooperative medical office with the new rural cooperative medical certificate, ID card and Huantai county new rural cooperative medical system trauma hospitalization audit form; If you are hospitalized outside the county, you need to go through the examination and approval procedures at the county cooperative medical office with the new rural cooperative medical ID card and outpatient medical records (or a copy of hospitalization medical records). Hospitalization expenses due to alcoholism, traffic accidents, illegal crimes, medical accidents, work-related injuries, fights, self-injuries, plastic surgery, organ transplantation, blood transfusion, etc. Will not be reimbursed.
County New Rural Cooperative Medical Management Office Tel: 8227345 82 18906
Address: East of the first floor of the ward building of Huantai County People's Hospital.
Huantai county new rural cooperation medical treatment management Committee office
February 20 12