1. Rural Cooperative Medical Care Reimbursement Ratio for the Elderly

(1). Township (town) Health Center Medical Expenses Reimbursement Ratio

1. If the amount is less than 300 yuan, 30% reimbursement;

2. If the cost is more than 300 yuan (exclusive) and less than 2,000 yuan, 70% will be reimbursed;

3. If the cost is more than 2,000 yuan (exclusive), 50% will be reimbursed .

(2) Reimbursement ratio of medical expenses in designated medical institutions at the county level

1. If the amount is less than 500 yuan, 25% will be reimbursed;

2. 500 yuan ( If the cost is more than 10,000 yuan (excluding), 65% will be reimbursed;

3. If the cost is more than 10,000 yuan (excluding), 50% will be reimbursed.

(3) Reimbursement ratio of medical expenses in secondary hospitals

1. If the amount is less than 500 yuan, 25% will be reimbursed;

2. 500 yuan (excluding ) and above 10,000 yuan, 55% will be reimbursed;

3. If the cost is above 10,000 yuan (exclusive), 50% will be reimbursed.

(4) Reimbursement ratio of medical expenses in tertiary hospitals

1. If the amount is less than 1,000 yuan, 20% will be reimbursed;

2. 1,000 yuan (excluding ) and above 10,000 yuan, 45% will be reimbursed;

3. If the cost is above 10,000 yuan (exclusive), 40% will be reimbursed.

2. Outpatient reimbursement standards

1. Village clinics and village center clinics are reimbursed 60% for medical expenses, with a limit of RMB 10 for prescription drugs per visit, and temporary rehydration prescription drugs for doctors at the health center. The limit is 50 yuan.

2. The town health center reimburses 40% of the fees for each visit, with a limit of 50 yuan for examination fees and surgical fees, and a limit of 100 yuan for prescription drugs.

3. 30% reimbursement for visits to secondary hospitals, with a limit of 50 yuan for examination fees and surgical fees for each visit, and a limit of 200 yuan for prescription drugs.

4. 20% reimbursement for visits to tertiary hospitals, with a limit of 50 yuan for examination fees and surgical fees for each visit, and a limit of 200 yuan for prescription drugs.

5. There is a limit of 1 yuan per prescription attached to the traditional Chinese medicine invoice.

6. The annual compensation limit for town-level cooperative medical outpatient clinics is 5,000 yuan.

1. Reimbursement ratio of hospitalization expenses for 70-year-olds

If you participate in medical insurance, the reimbursement ratio is the same, but the ratios of different hospitals are slightly different. About 75~85% of seniors over 70 years old have threshold fee discounts. The threshold fee for the first hospitalization within a year is halved, and the second hospitalization fee ranges from 100 to 300 yuan depending on the hospital level. According to the Provincial Department of Human Resources and Social Security, in order to reduce the burden of medical expenses on the elderly, the province has adjusted the medical insurance benefits for elderly people over 70 years old (including 70 years old) who participate in the urban employee basic medical insurance. Specific adjustment standards include: deductibles for inpatient and outpatient chronic diseases and special diseases will be halved according to the current policy; the proportion of personal self-pay for Class B drugs and special examinations and treatments will be cancelled; within the scope of the policy, the reimbursement rate for hospitalization expenses will reach 80%. If it is less than 80%, the medical insurance pooling fund will make up the difference.

II. How to participate in urban residents’ medical insurance

1. If registered urban residents pay on a household basis and have gone through the withholding and payment insurance procedures, they must ensure that the withholding and payment fees are deposited in a passbook The balance is sufficient; if the insurance registration has not been completed, the original and photocopy of the household registration book, ID card, bank card (passbook) should be taken to the human resources and social security service center of the town (street) where the household registration is located to handle the insurance registration and bank withholding and payment procedures.

2. Rural registered residents: Each village (community) committee organizes the registration and collection of medical insurance for urban and rural residents, and each town (street) human resources and social security service office is responsible for handling relevant insurance, Change procedures.

3. School students: They can participate in the insurance together with their families and pay premiums, or they can participate in the insurance uniformly on the basis of the school.

There is no deductible for general outpatient services and all insured residents enjoy general outpatient treatment. Within one year of medical insurance, there is no deductible for general outpatient services, and 60% of the medical expenses paid by the outpatient pooling fund will be reimbursed. The annual maximum individual payment limit of the overall fund is 400 yuan.

Legal basis:

Article 28 of the "Social Insurance Law"

Comply with the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency, The medical expenses for rescue shall be paid from the basic medical insurance fund in accordance with national regulations.

Article 29

The part of the medical expenses of the insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance agency and the medical institution and pharmaceutical business unit . The social insurance administrative department and the health administrative department should establish a medical expense settlement system for medical treatment in other places to facilitate insured persons to enjoy basic medical insurance benefits.