(2) The rural cooperative medical insurance refers to the medical mutual aid system organized, guided and supported by the government, in which farmers voluntarily participate and individuals, collectives and the government jointly raise funds, which is mainly used to co-ordinate farmers' serious illness. Take individual contributions, collective support and government funding to raise funds. Rural cooperative medical care is a medical security system created by farmers themselves in China, which has played an important role in ensuring farmers' access to basic health services and alleviating poverty caused by illness and returning to poverty due to illness.
(3) The hospitalization insurance of the new rural cooperative medical system can be reimbursed. The new rural cooperative medical system, referred to as the "new rural cooperative medical system", refers to the farmers' medical mutual assistance and economic assistance system organized, guided and supported by the government, in which farmers voluntarily participate and individuals, collectives and the government jointly raise funds. Take individual contributions, collective support and government funding to raise funds.
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1. The reimbursement scope of the new rural cooperative medical system is: medical expenses, examination expenses, laboratory expenses, operation expenses, treatment expenses and nursing expenses incurred by the insured in designated hospitals due to illness during the overall planning period, which meet the reimbursement scope of medical insurance for urban workers (i.e. effective medical expenses).
Second, hospitalization compensation, reimbursement scope:
(1) Medical expenses: auxiliary examinations: expenses for electrocardiogram, X-ray fluoroscopy, photography, laboratory tests, physiotherapy, acupuncture, CT, nuclear magnetic resonance, etc. , limited to 200 yuan; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan).
(two) the elderly over 60 years old in the town hospital, daily treatment and nursing fee compensation 10 yuan, the limit of 200 yuan. Reimbursement ratio: town health centers reimburse 60%; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%.
Three, the following circumstances are not included in the scope of reimbursement of the new rural cooperative medical system:
(1) Outpatient medical expenses of designated hospitals outside the district (except for outpatient treatment expenses for special diseases), expenses incurred by not seeking medical treatment according to regulations, and expenses incurred by purchasing medicines by oneself;
(two) the expenses necessary for the implementation of family planning measures and the medical expenses in violation of the family planning policy;
(3) tooth restoration, orthodontics, optometry and glasses, hearing AIDS, artificial organs, beauty treatment, cosmetic surgery, rehabilitation (such as qigong, massage, physical therapy, magnetic therapy, etc.). ) and various auxiliary fees, transportation fees, outpatient fees and other miscellaneous expenses during hospitalization;
(4) If the responsibility is borne by a third party, the medical expenses incurred due to personal injuries such as traffic accidents, medical accidents and work-related injuries shall be borne by the third party according to law;
(five) medical expenses caused by suicide, self-mutilation, drug abuse, fighting and other illegal acts and intentional acts of family members.
(six) medical expenses incurred overseas or in Hongkong, Macao and Taiwan Province Province;
(seven) drugs and articles that are not reimbursed in accordance with the medical insurance system for urban workers; (eight) other expenses determined by the District Medical Management Committee not to be reimbursed.