Settlement procedures for inpatient and outpatient treatment of special diseases:

1, before each month 10, the designated medical institutions shall submit the expense statement, hospitalization statement and related materials discharged from the hospital last month to the medical insurance agency, which will serve as the basis for monthly pre-allocation and year-end final accounts after review;

2, medical insurance agencies monthly pre-allocated last month's hospitalization and outpatient special disease co-ordination fees;

3. Insured persons who have been identified as suffering from special diseases shall go to the designated medical institutions designated by the labor and social security department for medical treatment and medicine purchase, and the medical expenses incurred shall be directly accounted for and settled immediately.

4. Emergency settlement procedure: the medical expenses incurred by the insured in emergency rescue to non-designated medical institutions in the city and medical institutions in different places shall be paid in advance by individuals or units. After the emergency rescue, the medical insurance agency shall go through the reimbursement procedures according to the regulations with emergency medical records, inspection, laboratory sheets, invoices and detailed list of medical expenses.

Extended data:

The following are not included in the scope of reimbursement of rural cooperative medical insurance:

1. Medical treatment at one's own expense (no designated hospital or referral form), drugs purchased at one's own expense, drugs that cannot be reimbursed according to the regulations of public medical care and medical expenses that do not meet the requirements of family planning;

2, outpatient treatment fees, visits, hospitalization fees, meals, escort fees, nutrition fees, blood transfusion fees (except for family blood storage, according to the relevant provisions of reimbursement), heating and cooling fees, ambulance fees, allowances and other expenses;

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 bought some commercial medical insurance after purchasing the new rural cooperative medical system. If you buy commercial medical insurance, you must first reimburse the expenses of the new rural cooperative medical system, and then find an insurance company to reimburse the remaining expenses.

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