1. Overtime is not reimbursed. According to the regulations of the new rural cooperative medical system, only the medical expenses incurred in this year can be reimbursed. If overtime is required, individuals will have to bear the medical expenses, and the new rural cooperative medical system will not be reimbursed. For farmers who seek medical treatment in different places, the reimbursement time limit is shorter, and it needs to be completed within three months. In special circumstances, it can be extended to six months. Once the reimbursement time limit has passed, farmers can only bear these medical expenses themselves. 2. Not all hospitals can be reimbursed for not seeing a doctor in a designated hospital. If the designated medical institution has limited conditions and needs to be transferred to other hospitals, it is necessary to issue transfer procedures. Under normal circumstances, the proportion of reporting in township hospitals is relatively high. 3. Transfer to a hospital privately If the medical level of the current hospital is not enough, you need to go to a hospital with better medical conditions for treatment. At this time, you must get the approval of the current hospital and go through the transfer procedures. The new rural cooperative medical system will be reimbursed. 4, special accident medical hospitalization caused by their own or others, the new rural cooperative medical system can not be reimbursed. For example, drunk driving, plastic surgery, alcoholism, fighting, drug abuse, flu and other injuries will not be reimbursed. There are also traffic accidents caused by themselves or others, which are generally borne by the responsible party or unit, and the new rural cooperative medical system will not be reimbursed. 5. Less than the prescribed reimbursement amount According to the new regulations, hospitals at all levels will set a starting amount, and those below the reimbursement amount will not be reimbursed. The specific standard is that the starting standard of township hospitals is 1 yuan, county-level hospitals are graded, the starting standard of second-class hospitals is 5 yuan, and the starting standard of third-class hospitals is 2 yuan. For details of the specific reimbursement ratio of the new rural cooperative medical system, please poke the reimbursement ratio of the new rural cooperative medical system in 218. 6. Health care drugs are not reimbursed. Drugs outside the new rural cooperative medical system drug list are not reimbursed, such as health care drugs and nutrition products.
The medical expenses for outpatient and inpatient services can be reimbursed according to the prescribed compensation ratio for those who participate in the new rural cooperative medical system. The ways to enjoy compensation are as follows: (1) Outpatient service: There is no deductible line for outpatient service, and the reimbursement rate for outpatient service is not higher than 25%. Set the capping line as 15 yuan. (2) Hospitalization: A deductible line is set for hospitalization. The deductible line of township hospitals is not lower than that of 1 yuan, and the reimbursement ratio is not less than 5%; The deductible line of county-level designated medical institutions is not less than that of 2 yuan, and the reimbursement ratio is not less than 4%; The deductible line of designated medical institutions at or above the county level is not less than that of 4 yuan, and the reimbursement ratio is not less than 3%. The deductible line is the individual pays part. For example, when you are hospitalized in a township health center, * * * pays 16 yuan for medical expenses. After deducting the self-paid part of 1 yuan, you will be reimbursed according to the reimbursement ratio of 5%, at least 75 yuan can be reimbursed. The capping line is not higher than 7 yuan, which means that the total amount of personal reimbursement for the whole year does not exceed the capping line. Who participated in the new rural cooperative medical system, the annual hospitalization medical expenses can be reimbursed according to the prescribed compensation ratio. The proportion of hospitalization can be reimbursed, and the proportion of reimbursement in township hospitals is 7%; The reimbursement rate of county-level designated medical institutions is not less than 4%.