All designated medical institutions should publicize the contents of the Catalogue of Diagnosis and Treatment Projects of New Rural Cooperative Medical System in Chengdu and the Catalogue of Essential Medicines of New Rural Cooperative Medical System in Chengdu, enhance the transparency between doctors and patients, and let farmers understand money and eat medicines with confidence.
Article 23 The "new rural cooperative medical system" in our city should establish a strict reimbursement system for medical expenses. The expenses incurred by farmers participating in the new rural cooperative medical system in township (town) hospitals and municipal medical institutions in our city shall be paid by farmers themselves, and the reimbursement expenses shall be reviewed and reimbursed by the medical institutions at the time of discharge. Approved referral to provincial, Chengdu municipal hospitals and migrant workers hospitalization expenses, the implementation of individual farmers to advance, after the approval of the city's "new rural cooperative medical system" and signed, back to the account where the township (town) hospitals in proportion to reimbursement, reimbursement funds by the township (town) hospitals in advance. The city's "Xinhe" will settle the outpatient and hospitalization expenses with the township (town) hospitals on time every month. The expenses that cannot be reimbursed after the "new joint venture" in the city shall be borne by the township (town) health center.
Twenty-fourth farmers who participate in the new rural cooperative medical system can see a doctor at any designated medical institution in this city. Because of illness need hospitalization and referral to the municipal designated medical institutions in our city, should be approved by the township (town) "Xinhe"; If it is necessary to transfer to a medical institution above the municipal level in our city due to illness, the transferred municipal designated medical institution shall issue a certificate of transfer and report it to the municipal "New Union" for approval, except for emergency.
Twenty-fifth women of childbearing age who participate in the new rural cooperative medical system in this area and are hospitalized in accordance with the family planning policy will be given a subsidy of 100 yuan per case, and the medical expenses incurred in hospitalization are not within the scope of reimbursement of the new rural cooperative medical system fund.
Twenty-sixth rural five guarantees, subsistence allowances, entitled groups of poor households in the enjoyment of the new rural cooperative medical expenses reimbursement, still have difficulties, you can apply for rural medical assistance. In accordance with the "chongzhou city rural medical assistance fund financing, allocation and management pilot scheme" implementation.
Twenty-seventh in any of the following circumstances, no reimbursement:
(a) did not participate in the local new rural cooperative medical care medical expenses.
(two) medical expenses (except emergency) incurred by not seeing a doctor at a designated medical institution or not going through the transfer formalities.
(3) Medical expenses for infectious diseases within the coverage of planned immunization.
(four) the cost of family planning operation and its complications and the cost of hospital delivery.
(five) the diagnosis of unnecessary and unreasonable inspection fees.
(6) Registration fee, decocting fee, hospitalization food fee, heating fee, house call fee, medical travel fee, ambulance fee, electric stove fee, special care fee, escort fee, private room fee, etc.
(seven) medical consultation, organ transplantation, blood transfusion, artificial limbs, artificial eyes, dental implants and various beauty, plastic surgery, correction and other expenses.
(eight) medical expenses caused by alcoholism, suicide, fighting, illegal injuries, traffic accidents and medical accidents.
(nine) medical expenses incurred by enterprises due to work-related injuries.
(ten) the above is not listed in accordance with the relevant provisions of the "Chengdu new rural cooperative medical care project directory" and "Chengdu new rural cooperative medical care essential drugs directory".
Its reimbursement is carried out in proportion, generally floating around 20-70%. The proportion and amount of reimbursement are related to their own examination and medication, medical level and other factors. For example, it is clear that Class A drugs can enjoy full coverage, Class C drugs need to bear all the costs, and Class B drugs will report 80% and bear 20% of the costs.
Someone spent a total of 9000 yuan on medical expenses, and the reimbursement formula is as follows: (9000-500 "deductible"-self-paid medicine) *70%. If self-funded drugs account for a large proportion, there is not much amount to be reimbursed.
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Handling procedures: all residents with rural household registration in our city can join the new rural cooperative medical system in the township (town) where their household registration is located from September to 10 every year and enjoy the hospitalization compensation of the new rural cooperative medical system.
Required materials: 1. Participation: provide household registration book.
2. Reimbursement for hospitalization: provide medical certificate, copy of my ID card or household registration book, admission and discharge disease certificate, hospitalization expense settlement bill and hospitalization expense list.
Charge standard:
Time limit for processing: insurance: September -65438+ 10 every year; Hospitalization reimbursement: chongzhou city for 3 months; 4 months in Chengdu and the province; 1 year outside the province.
Offices: chongzhou city New Rural Cooperative Medical Service Center and designated medical institutions.
Office Address: No.31,North Second Lane, Tang 'an Road, chongzhou city (in the Municipal Health Bureau)
Contact information: Tel: 82279695 Fax: 82273655
Legal basis: Notice of the People's Government of chongzhou city on Printing and Distributing the Work Plan of Promoting the New Rural Cooperative Medical System in chongzhou city (Chongfufa [2005] 16).
Notice of chongzhou city New Rural Cooperative Medical Management Committee on Printing and Distributing the Detailed Rules for the Implementation of New Rural Cooperative Medical System in chongzhou city (Chonghe Committee [2005]1No.)
Notice of the People's Government of chongzhou city on Printing and Distributing the Opinions of chongzhou city on Adjusting the Financing and Compensation Standards of the New Rural Cooperative Medical System (Chongfufa [2007] No.64)
Notice on the Implementation of Chengdu Municipal People's Government's Adjustment of Financing and Compensation Standards for New Rural Cooperative Medical System (No.2 [2008] of Chongqing Cooperation Committee)