I paid medical insurance for three years. When I went to see a doctor for reimbursement of medical expenses this year, there was no medical insurance. Where did I ask the village cadres about my medic

I paid medical insurance for three years. When I went to see a doctor for reimbursement of medical expenses this year, there was no medical insurance. Where did I ask the village cadres about my medical condition? Notice of Cangnan County People's Government on Doing a Good Job in Cooperative Medical Insurance for Urban and Rural Residents 20 1 1

All township people's governments and units directly under the county government:

In order to further promote and improve the cooperative medical insurance system for urban and rural residents in our county, and effectively improve the level of medical security for urban and rural residents, according to the spirit of relevant provincial and municipal documents and combined with the actual situation of our county, the relevant matters concerning the work of 201kloc-0/cooperative medical insurance for urban and rural residents are hereby notified as follows:

1. Participants: urban and rural residents whose household registration is not covered by medical insurance for urban workers in our county. The way to participate in insurance is that urban and rural residents must "participate in insurance for the whole family" on a household basis, so as to ensure that all insurance is guaranteed. Residents who have participated in the basic medical insurance for urban workers are not insured in the cooperative medical insurance for urban and rural residents, and cannot enjoy the reimbursement treatment of two insurances repeatedly.

2. Financing standard: 360 yuan/person (excluding the cost of health examination), in which 280 yuan/person is subsidized by all levels of finance and 80 yuan/person is paid by individuals. The individual contributions of five-guarantee households, rural single-female households, two-female households (including only the daughter herself and her parents), rural demobilized soldiers, and urban and rural disabled residents (limited to intellectual, mental and physical disabilities) who have not given birth illegally shall be borne by the county-level finance; Immigrants pay 50% of the county finance; Urban and rural subsistence allowances shall be borne by the county and township (town) governments at 50% each (all the participating funds for the township subsistence allowances subject to "agency reimbursement" shall be borne by the county finance).

Three. Fund raising time: 2010/21to 2011131. All towns and villages should complete the information data entry of participants before the end of February, so as to be accurate and standardized, and report to the county medical office.

Four, the insured object: the participation rate of each township should reach more than 90%.

Verb (abbreviation of verb) acceptance and write-off time: the implementation year of medical expenses compensation and write-off for seriously ill inpatients and special disease outpatients is February 1 to 1, and the deadline for acceptance is in principle the end of February of the following year. If there are special circumstances, it can be extended appropriately. The verification standard is based on the admission time of the current year (according to Cang Zhengban [2065438]

Reimbursement of intransitive verbs: the method of combining hospitalization (including pre-hospitalization medical expenses for special diseases and emergency diseases) with reimbursement of general outpatient medical expenses. On the basis of the original nine special diseases, "severe mental illness" was added to the special outpatient service, and the hospital delivery of women who met the family planning policy was included in the scope of hospitalization reimbursement.

(a) the verification of medical expenses compensation for hospitalization (including special disease outpatient and emergency hospitalization expenses) adopts the method of "zero reporting line, accumulated in the current year". The specific verification criteria are:

1. The reimbursement rate of hospitalization medical expenses in central hospitals in the county is 80%, that in designated hospitals at the county level is 70%, and that in designated hospitals outside the county level is 50%.

2. The maximum compensation limit for each participant's accumulative write-off in that year is 70,000 yuan, and the minimum compensation is 80 yuan. The maximum payment limit for each participant to write off in the current year is 90,000 yuan.

(two) general outpatient medical expenses reimbursement, the implementation of real-time reimbursement system. According to different levels of hospitals, the reimbursement rate of drugs (report part) in general outpatient clinics of county hospitals is 20%, that in general outpatient clinics of central hospitals is 35%, and that in general outpatient clinics of township hospitals is 35%, and the use of drugs listed in the national essential drugs list is further increased by 5% (according to the Administrative Measures for Reimbursement of General Outpatients of Cooperative Medical Insurance for Urban and Rural Residents in Cangnan County).

7. Reimbursement scope: The drug use scope of participants shall be implemented according to the provisions of Zhejiang Basic Medical Insurance Drug Catalogue Guide and National Essential Drugs Catalogue, and the standards of diagnosis and treatment projects and medical service facilities shall be implemented according to the Management Scope of Diagnosis and Treatment Projects of Urban and Rural Cooperative Medical Insurance in Cangnan County.

Eight, two levels of verification: the township medical management office is responsible for the acceptance, review and verification of the hospitalization medical expenses of the participants with valid bills below 25,000 yuan (inclusive); The effective bill amount is more than 25,000 yuan for hospitalization medical expenses and special outpatient medical expenses. After accepting the preliminary examination, the township joint medical office shall submit it to the county joint medical office for verification within the prescribed working days.

9. Time limit for write-off: establish a time limit system for compensation write-off. While accepting the verification materials, the township medical office shall issue a notice of acceptance to the parties and specify the time limit for completion. In line with the "Cangnan County Urban and Rural Cooperative Medical Insurance County and Township Two-level Verification Work Plan" and below the limit of 25,000 yuan, the township will complete the settlement within 20 working days from the date of acceptance and submit it to the county medical office for verification, and the county medical office will complete the audit and compensation fund transfer within 7 working days from the date of acceptance; Above the limit, the township medical office will send the verification materials to the county medical office for review within 7 working days from the date of acceptance, and the county medical office will complete the settlement, review and compensation fund transfer within 20 working days from the date of acceptance; Cangnan Rural Cooperative Bank is responsible for handling some accounts that are not bankbooks or cannot be transferred due to account errors.

X. Payment of reimbursement funds: The parties or agents (immediate family members only) shall not only provide the required verification materials, but also provide their account number (card number), contact telephone number and valid identity certificate in Cangnan Rural Cooperative Bank, and fill in the material confirmation form. County, township (town) medical office handling personnel in accordance with the relevant provisions of the verification of compensation and settlement, the county medical office financial staff to print and seal the list of compensation funds, Cangnan rural cooperative bank unified into the account of the parties or agents, Cangnan rural cooperative bank to inform the parties or agents by SMS or telephone.

XI。 Fund management: the fund can only be used for the compensation and verification of the hospitalization medical expenses of the insured and the expenditure of the general outpatient co-ordination fund, so as to be earmarked for special purposes. Take 10% of the total fund as the risk fund, and set up the general outpatient co-ordination fund according to 10% of the total fund. Villages and towns may not temporarily deposit the raised funds into private accounts, and the staff responsible for collecting the participating funds must deposit the funds into the county financial account or the township government accounting account within three days, and the villages and towns will eventually remit them into the county financial account to ensure the safety of the funds.

Twelve, supervision and management: the establishment of work supervision mechanism, the agencies should be clear about their responsibilities, implement their responsibilities, people-oriented services, and do a good job in the work of cooperative medical insurance for urban and rural residents. The health department should strengthen the supervision of the service quality of designated medical institutions, establish and improve the access and exit mechanism of designated medical institutions, and implement dynamic management through agreements; The county government supervision office, the county office for rectifying the situation and the the State Council office for rectifying the situation should regularly or irregularly supervise the designated medical units of the cooperative medical insurance for urban and rural residents at all levels.

Thirteen, reward and punishment assessment: the establishment of a work assessment mechanism, the county government every year to assess the township government's annual work target responsibility system for urban and rural residents cooperative medical insurance, according to the assessment results to give rewards and punishments.

Fourteen Related requirements

(1) All towns and villages should strengthen leadership, improve institutions, strengthen responsibilities and organize meticulously according to the unified arrangements of the county government. To timely convene a mobilization meeting, general party membership meeting, village committees and villagers' congresses, make full use of radio, television, banners, brochures, typical cases and other forms, carry out in-depth publicity activities and fund-raising mobilization for urban and rural residents' medical insurance, and decompose the insured tasks into films, villages and villages.

(two) to further implement the annual target responsibility system of cooperative medical insurance for urban and rural residents, and strengthen the accountability. The "top leaders" of the township party and government take overall responsibility for the cooperative medical insurance for urban and rural residents, and it is necessary to clarify the specific responsible person and incorporate the fund-raising work into the performance appraisal of township cadres in villages.

(3) All towns and villages should fully understand the importance of cooperative medical insurance for urban and rural residents, do a good job in raising funds, and ensure that the participation task is completed on time. County-level health administrative departments should play a functional role, be good government staff, strengthen business guidance and policy propaganda, improve service quality, and effectively facilitate the masses to seek medical treatment. County-level news organizations should open up a column of cooperative medical insurance for urban and rural residents and actively do a good job in publicity and reporting.

15. This notice shall be implemented as of 2011. If the original Detailed Rules for the Implementation of the Cooperative Medical Insurance System for Urban and Rural Residents in Cangnan County (Cangnan [2008] No.211) is inconsistent with this notice, this notice shall prevail.

Sixteen, the specific provisions of this notice shall be interpreted by the county medical office.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.