In 2022, the hospitalization expenses of the third-floor households in Lintao, Dingxi, Gansu Province are 60,000. How much does chemotherapy cost?

According to the principle of "insurance first, then assistance", low-income groups can be reimbursed according to the types of medical insurance they participate in, and the rest can apply for medical assistance, that is, 60% reimbursement, making the total reimbursement ratio reach more than 80%.

First, the new rural cooperative medical reimbursement

The policies in each region are the same, and the proportion of reimbursement for rural subsistence allowances is also different.

(1) hospitalization reimbursement scope:

A. Medical expenses: auxiliary examination: examination expenses such as electrocardiogram, X-ray fluoroscopy, radiography, laboratory tests, physical therapy, acupuncture, CT and nuclear magnetic resonance. Average 200 yuan; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan).

B, the elderly over 60 years old are hospitalized in the town health center, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan.

(2) Reimbursement ratio: town hospitals reimburse 60%; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%.

(3) Compensation for serious illness

Compensation from town risk fund: if the medical expenses of inpatients participating in cooperative medical care exceed 5,000 yuan at one time or for the whole year, they should be compensated by stages, that is, 5001-kloc-0/0000 yuan is 65%, and10001-8000 yuan is 75%.

The annual compensation limit of town-level cooperative medical system hospitalization, uremia outpatient hemodialysis and tumor outpatient radiotherapy and chemotherapy is 1. 1 ten thousand yuan.

The special diseases reimbursed by the new rural cooperative medical fund are: chemotherapy and radiotherapy for malignant tumors; Hemodialysis and peritoneal dialysis for severe uremia; Anti-rejection therapy after tissue or organ transplantation; Schizophrenia with mental retardation; Systemic lupus erythematosus (one of the complications of heart, lung, kidney, liver and nervous system); Aplastic anemia; Anticoagulation therapy after cardiac surgery. Other special diseases that can be reimbursed shall be subject to local specific policies.

(4) reimbursement procedures

After the insured is discharged from the hospital, the hospitalization invoice, discharge record, expense list, referral certificate, a copy of my ID card or the household registration certificate signed or sealed by the patient shall be handed over to the township joint management office, and sent to the municipal agricultural insurance business management center after examination.

Second, low-income assistance.

Explain to the staff of the new rural cooperative medical system that you want to go to the subsistence allowance reimbursement, and the staff will give you a reimbursement form, which will tell you how much is left at your own expense, and then you can go to the subsistence allowance department (or social assistance department) of the Civil Affairs Bureau for medical assistance reimbursement. The main process is:

(1) Application: Eligible low-income residents take their families as a unit, and the head of the household applies to the community neighborhood committee (or village committee) where the household registration is located to enjoy relevant assistance, and issues household registration books, income certificates and other materials.

(2) Audit: the handling personnel of the community and neighborhood (village) committees assist in the preliminary examination, evaluation and publicity of the applicant's qualifications; Street, township social security office is responsible for the applicant's household survey, qualification review and other work. ;

(3) Examination and approval: The district and county civil affairs bureaus shall complete the examination and approval procedures for families meeting the conditions of temporary assistance within 30 days after receiving the examination and approval materials; Do not meet the conditions, it shall notify the applicant in writing within 30 days, and explain the reasons.

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The reimbursement scope of the new rural cooperative medical system is: medical expenses, examination expenses, laboratory expenses, operation expenses, treatment expenses and nursing expenses incurred by the insured in designated hospitals due to illness during the overall planning period, which meet the reimbursement scope of medical insurance for urban employees (i.e. effective medical expenses).

The new rural cooperative medical fund payment set up Qifubiaozhun and maximum payment limit. The hospitalization expenses below the annual deductible line of the hospital shall be paid by the individual. If the Qifubiaozhun is reached in the same overall period, the hospitalization expenses incurred by two or more hospitalizations can be reimbursed cumulatively. The hospitalization expenses exceeding Qifubiaozhun shall be calculated in sections and reimbursed cumulatively, and there is a maximum amount of accumulative reimbursement per person per year.