Reimbursement ratio of new rural cooperative medical care in Huantai County, Zibo, Shandong Province in 2012

Huantai County launched the new rural cooperative medical care in 2012 and implemented cooperative medical care to benefit thousands of households and ensure the health of farmers. Author: Unknown Date: 2012-2-23 9:05:55 Source: Huantai Government Affairs Network Visits : 314 participating farmers:

In 2012, the county’s new rural cooperative medical care had higher financial subsidy standards, greater reimbursement ratios, wider coverage, and greater benefits. Farmers are welcome to participate in the new rural cooperative medical care!

1. Financing methods

1. Pay back the 10 yuan per person owed in 2011

In order not to affect the reimbursement of the New Rural Cooperative Medical Care System in 2011, the 2011 The fund-raising work for 2010 was carried out in advance in December 2010. At that time, the city's relevant financing standard documents had not yet been issued. Our county continued to use the 2010 standard of 40 yuan per person for collection, and the financial supporting subsidy was 120 yuan per person. The fund-raising work was It will be completed by the end of January 2011, and the financial subsidy of 120 yuan per person will be fully received. In May 2011, the city issued the "Guiding Opinions on the Adjustment of the New Rural Cooperative Medical System Compensation Plan in 2011", requiring the individual financing standard to be adjusted from 40 yuan per person to 50 yuan per person, and the financial subsidy standard to be adjusted from 120 yuan per person. to 200 yuan per person. Due to the timely replenishment of financial subsidy funds, the reimbursement ratio of the New Rural Cooperative Medical System in 2011 will be based on the standard of 50 yuan per person. Each participating farmer owes 10 yuan. This 10 yuan is a back payment and will not be included in the 2012 reimbursement base.

2. Each person should pay 60 yuan in 2012

According to the Provincial Department of Health’s “Notice on Carrying Out Individual Financing and Payment of the New Rural Cooperative Medical Care System in 2012”, the New Rural Cooperative Medical Care System in 2012 The financing standard has been increased from 50 yuan per person to 60 yuan per person, and the financial subsidy standard at all levels has been increased from 200 yuan per person to 240 yuan per person. The reimbursement ratio in 2012 is based on the standard of 60 yuan per person and 240 yuan in financial subsidies.

The total ***should be paid is 70 yuan. Participating farmers should continue to participate. Those who did not participate in 2012 and apply to re-join the New Rural Cooperative Medical System in the future must pay additional participation funds (individual contributions and financial subsidies at all levels) for the year of interruption.

2. Reimbursement ratio

1. Continue to increase the reimbursement ratio for outpatient expenses. The proportion of outpatient medical expense reimbursement for participating farmers at town hospitals and designated village clinics in their respective jurisdictions has increased from 30% in 2011 to 40%, and the maximum annual cumulative outpatient medical expense reimbursement per person is 200 yuan.

2. Implement compensation for outpatient chronic diseases and special diseases. In accordance with the requirements of provincial and municipal documents, 10 chronic diseases and 5 special diseases will be gradually included in the new rural cooperative medical outpatient reimbursement and compensation scope.

3. Continue to increase the hospitalization reimbursement ratio. The reimbursement ratio for hospitalization expenses (within the scope of reimbursement) in designated medical institutions at the town level increased from 75% in 2011 to 80%. Inpatient expenses in designated medical institutions at the county level are reimbursed in stages: hospitalization expenses of 50,000 yuan and below are reimbursed at a rate of 60%; hospitalization expenses above 50,000 yuan are reimbursed at a rate of 70%. The reimbursement ratio for hospitalization expenses in hospitals at the municipal level and above has increased from 40% in 2011 to 50%. The cap line for hospitalization reimbursement is RMB 150,000 in cumulative reimbursement for the year.

4. Further improve the level of major disease protection. Implement limit management for children with congenital heart disease, acute leukemia, and children with cleft lip and palate that are included in the medical insurance for major diseases, and increase the limit standards appropriately. Implement designated diagnosis and treatment for serious mental illness, breast cancer, cervical cancer, end-stage renal disease, hemophilia and other diseases, and actively implement price limits for individual diseases to increase fixed compensation. Trauma patients are included in the price limit for single diseases, and the cap line for hospitalization reimbursement is a cumulative reimbursement of 10,000 yuan for the year.

3. Instructions for reimbursement

1. Registration location for participation: On a household basis, go to the village committee where the household registration is located to register for participation.

2. Materials required: New participants should provide their household registration book; existing participants should provide their household registration book and "New Rural Cooperative Medical Care Certificate".

3. Choose your own medical treatment at designated medical institutions in the city and cancel referrals within the city. To seek medical treatment at designated medical institutions outside the city, you need to go to the county New Rural Cooperative Medical Care Office with the "New Rural Cooperative Medical Care Certificate" and the diagnosis certificate from the hospital to go through the referral procedures. For urgent and critical patients, if it is too late to go through the transfer procedures, they will have to go through the procedures within seven days.

4. Participating farmers who are hospitalized due to trauma, poisoning and other special circumstances must hold the "New Rural Cooperative Medical Care Certificate", ID card and "Huantai County New Rural Cooperative Medical Care Trauma Hospitalization Review Form" if they are hospitalized in the county. 》Go to the county cooperative medical office to go through the approval procedures; those who are hospitalized outside the county must go to the county cooperative medical office to go to the county cooperative medical office to go to the county cooperative medical office to go to the county cooperative medical office with their ID card and outpatient medical record (or a copy of the inpatient medical record). Hospitalization expenses due to alcoholism, traffic accidents, crimes, medical accidents, employment injuries, fights, self-inflicted injuries, cosmetic surgery, organ transplants, blood transfusions, etc. will not be reimbursed.

County New Rural Cooperative Medical Care Management Office consultation hotline: 8227345 8218906

Address: East side of the first floor of the ward building of the new hospital of Huantai County People's Hospital

Huantai County New Rural Cooperative Medical Care Management Committee Office

February 2012