Can the new rural cooperative medical system be directly reimbursed for medical treatment in different places in the province?

Yes Medical insurance reimbursement process in different places: the applicant pays the relevant medical expenses in advance, and then carries the above information to the social security institution or medical institution for reimbursement. Upon examination, those who meet the requirements will be reimbursed for related medical expenses. It should be noted that some provinces have opened the settlement system for medical treatment in different places in the province, and the insured can directly leave the hospital for settlement. Cross-provincial medical treatment is being piloted.

Steps for reimbursement of medical insurance in different places:

1. First, you need the referral certificate from the hospital at or above the county level. Take the medical insurance in a small town as an example. If you want to go to a different place for medical treatment, you must first go to a hospital at or above the county level. There are usually county-level hospitals in the town, where doctors can issue referral certificates.

2. Stamp the social security window of the hospital. The social security window of the hospital is generally located at the toll gate. Take the referral certificate to the window, and the staff there will naturally know how to help you.

3. Go to the local social security bureau or social security office to register for out-patient treatment. Generally, there are social security offices in towns. Because it is a branch, it may be in an inconspicuous place.

4. After going out for treatment, get it back to the county-level social security bureau for reimbursement. After completing the above three steps, you can go to a hospital in a big city. When you are cured, you can take the invoice, medical record book, social security card and household registration book to your superior social security bureau for reimbursement.

Reimbursement ratio:

Outpatient reimbursement:

1, the reimbursement rate for general outpatient service is 50%, and the reimbursement for each person is capped in 80 yuan every year;

2. Outpatient observation can be reimbursed for 30 yuan at a maximum of 1 10,000 yuan per day;

3. The reimbursement rate for serious and serious diseases in outpatient department is 50%, and patients with liver cirrhosis, cerebral thrombosis and sequelae of cerebral hemorrhage, rheumatoid arthritis (active stage), femoral head necrosis, hypertension with complications, diabetes, pulmonary heart disease, systemic lupus erythematosus, aplastic anemia, organ or tissue transplantation anti-rejection therapy, leukemia, severe mental illness, congenital adrenal hyperplasia and congenital hypothyroidism are reimbursed 654.38 million yuan per person per year; Patients with malignant tumor, uremia and hemophilia are reimbursed 30,000 yuan per person per year.

Hospitalization reimbursement:

1, 200 yuan, town-level (first-class) hospitalization reimbursement deductible line, with reimbursement ratio of 85%.

2, county-level (secondary) designated medical institutions hospitalization reimbursement deductible line 500 yuan, reimbursement rate of 70%.

3, municipal (level 3) designated medical institutions hospitalization reimbursement deductible line 700 yuan, reimbursement rate of 55%.

4, provincial (level 3) designated medical institutions hospitalization reimbursement deductible line 1000 yuan, the reimbursement ratio is 50%. )

5, with the consent of the county-level new rural cooperative medical management institutions, referral for the record, and in addition to the municipal and provincial designated medical institutions in counties and districts, unified reimbursement deductible 1000 yuan, the reimbursement ratio is 40%, and the guaranteed reimbursement ratio is 20%.

6. The reimbursement rate of drugs, Chinese herbal pieces and non-drug non-surgical therapies such as acupuncture, massage, cupping and scrapping in the list of essential drugs will be increased by 10% on the basis of the original reimbursement rate. The deductible lines of Dezhou City, county-level Chinese medicine hospitals and maternal and child health hospitals were reduced by 200 yuan, and the compensation ratio was increased by 5% on the basis of the original reimbursement ratio.

7. The reimbursement rate of 20 major diseases such as childhood leukemia, congenital heart disease in children, end-stage renal disease, breast cancer, cervical cancer, severe mental illness, AIDS opportunistic infection, multidrug-resistant tuberculosis, hemophilia, chronic myeloid leukemia, cleft lip and palate, lung cancer, esophageal cancer, gastric cancer, type I diabetes, hyperthyroidism, acute myocardial infarction, cerebral infarction, colon cancer and rectal cancer reached 70% in designated medical institutions at the municipal and provincial levels.

8. Accidental injuries caused by their own reasons, except the case that the Catalogue of New Rural Cooperative Medical Treatment Projects in Shandong Province is not reimbursed, the unified hospitalization reimbursement deductible line is 1 000 yuan, and the reimbursement ratio is segmented. If the age of the insured is between 16 years old (including 16 years old) and 60 years old, the reimbursement ratio is 20%; /kloc-those under 0/6 years old and over 60 years old (including 60 years old) will be reimbursed at the rate of 30%.

9 to participate in the hospital natural childbirth and cesarean section of pregnant women, unified compensation. 500 yuan was compensated for natural childbirth, and the compensation for cesarean section was 1 1,000 yuan.

10. If the insured is hospitalized for many times in the same insurance period and the same medical institution, the deductible will be deducted for the first time, and 50% of the deductible will be deducted for the second hospitalization.

The total amount of reimbursement for outpatient and inpatient services per farmer per year is 200,000 yuan.

Reimbursement for critical illness:

After the reimbursement of medical expenses for 20 major diseases such as childhood leukemia, congenital heart disease, end-stage renal disease, breast cancer, cervical cancer, severe mental illness, AIDS opportunistic infection, multidrug-resistant tuberculosis, hemophilia, chronic myeloid leukemia, cleft lip and palate, lung cancer, esophageal cancer, gastric cancer, type I diabetes, hyperthyroidism, acute myocardial infarction, cerebral infarction, colon cancer and rectal cancer, the remaining compliance expenses are 8,000 yuan.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Twenty-seventh individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with state regulations; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.