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What hospitalization expenses can be reimbursed?
Benefits of the new rural cooperative medical system

Who participated in the new rural cooperative medical system, the annual outpatient and inpatient medical expenses can be reimbursed according to the prescribed compensation ratio. The way to enjoy compensation is 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 to 150 yuan.

(2) Hospitalization: deductible line is set for hospitalization. The deductible line of township hospitals is not less than 100 yuan, and the reimbursement ratio is not less than 50%; The deductible line of county-level designated medical institutions is not less than that of 200 yuan, and the reimbursement ratio is not less than 40%; The deductible line of designated medical institutions at or above the county level is not less than that of 400 yuan, and the reimbursement ratio is not less than 30%. The deductible is the individual pays part. For example, if you are hospitalized in a township hospital, * * * pays 1.600 yuan's medical expenses. After deducting the self-paid part of 1.000 yuan, you will be reimbursed according to the reimbursement rate of 50%, at least you can reimburse 750 yuan. The capping line is not higher than 7000 yuan, that is, the total amount of personal reimbursement for the whole year does not exceed the capping line. For example, if you are hospitalized twice in a year, you will be reimbursed 3500 yuan each time, and you will not be reimbursed for the third hospitalization.

14. How to reimburse the medical expenses?

The implementation of on-site reimbursement of medical expenses, designated medical institutions should be in accordance with the provisions of the fee reduction. The hospital shall announce the relief on a monthly basis and accept the supervision of the masses. Outpatient medical expenses reimbursement is limited to rural two-level designated medical institutions, and outpatient medical expenses of designated medical institutions at or above the county level shall not be reimbursed. The referral system is not implemented in the county where the patient is hospitalized, and it is implemented in the designated medical institutions at or above the county level.

Under what circumstances can medical expenses not be reimbursed?

Under any of the following circumstances, it will not be reimbursed:

(1) Hospitalization accompanying expenses, organ transplantation, self-funded drugs outside the basic drug list of rural cooperative medical care, self-purchased drugs, ambulances and other transportation expenses.

(two) fighting, drinking injury, drug abuse, drug rehabilitation, suicide, sexually transmitted diseases treatment, traffic accidents and other medical expenses.

(3) Medical expenses incurred for assistive devices, plastic surgery, dental implants and glasses.

(4) medical expenses incurred in premarital examination, family planning operation and violation of family planning regulations.

(5) medical expenses incurred by non-illness without approval or hospitalization in non-designated hospitals.

(6) The vibration of nuclear magnetic resonance * * * exceeds the self-funded inspection items specified in the Implementation Plan of New Rural Cooperative Medical System.

(7) Other expenses that will not be reimbursed according to the Measures for the Administration of New Rural Cooperative Medical Care.

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