My father is in Anyang Cancer Hospital, and he is the insured of the new rural cooperative medical system. When I left the hospital, I was reimbursed 50% (excluding 8000 inspection fees), but I checked.
Hehe, I'm also from Anyang, Henan. As soon as you said it, I knew where the symptoms appeared. The reimbursement ratio of the new rural cooperative medical system refers to reasonable expenses, not total expenses. The first is the deductible line. Anyang Cancer Hospital is a third-class first-class hospital in the city. From June 1, the deductible line 1500 yuan; The second is self-funded medicine. According to the policy of the new rural cooperative medical system in Henan province, according to the needs of diseases, provincial and municipal medical institutions are allowed to have 15% drugs at their own expense, but this part is not reported; Third, according to the diagnosis and treatment catalogue of the new rural cooperative medical system in Henan Province, most of the inspection expenses are included in the reasonable expenses according to 85%; Fourth, most of the material expenses are included in the reasonable expenses according to 80% (70% for individuals), and the outside part and the part exceeding 20,000 yuan are paid by themselves. So you calculate again, MINUS these four unreported parts, how much is your medical expenses left? So there is a gap between the theoretical compensation ratio and the actual compensation ratio. This phenomenon is more obvious in provincial medical institutions. The deductible line of provincial medical institutions alone reaches 3000 yuan, and the actual reimbursement may be as high as 40%.
When you mentioned the referral certificate, I thought of a question. Since May 1, Henan has re-standardized the referral system. The participating patients must be referred step by step, that is, the township level can only be transferred to the county level, and the county level can only be transferred to the provincial and municipal levels. After referral from county-level medical institutions, they must go to the county new rural cooperative medical system office for examination and approval in time, and then go to the corresponding medical institutions for hospitalization. Except for emergency and mental illness, the reimbursement rate will be reduced for patients who do not need paper referral. Hospitalization before referral must be within three days, which also reduces 10%. If you work or live in a hospital outside the province, you must call and register in time!