How much is the reimbursement for the new rural cooperative medical system?

The reimbursement of medical expenses for children born in the new rural cooperative medical system should be considered in two situations:

1, Caesarean section: the starting point for reimbursement is 2,000 yuan, 45% of medical expenses above 2,000 yuan but less than or equal to 7,000 yuan, and 65% of medical expenses above 7,000 yuan can be reimbursed;

2. Natural childbirth: township-level designated medical institutions subsidize 300 yuan, and county-level and above designated medical institutions subsidize 450 yuan.

Reimbursement process:

Insured households submit the required materials for reimbursement to the village (community) cooperative medical liaison, and report to the town cooperative medical liaison after the audit of the village (community) cooperative medical liaison, and the town cooperative medical liaison will send it to the district agricultural office for reimbursement. Guide to reimbursement of new rural cooperative medical care.

Hospital direct reimbursement:

When you go through the hospitalization formalities due to illness, you can directly participate in reimbursement with the new rural cooperative medical certificate issued by the hospital.

1. What is the reimbursement ratio of the new rural cooperative medical system?

Reimbursement proportion of new rural cooperative medical system

(a) in principle, the maximum annual compensation standard for participating farmers does not exceed 6000 yuan. Participating farmers suffered from serious illness, and the amount of medical expenses in that year was particularly huge, and secondary compensation was implemented. The maximum amount of secondary compensation shall not exceed 6000 yuan. That is to say, the participating farmers were hospitalized with serious illness that year, and they could enjoy the maximum compensation of 12000 yuan that year. The plans formulated by a few counties and cities are slightly higher than this standard.

(2) The reimbursement rate of hospitalization expenses within the scope of the new rural cooperative medical system policy has also increased from 60% to 70%, and the maximum payment limit has increased from 30,000 yuan to not less than 50,000 yuan. At the same time, all localities will also generally carry out the overall planning of the new rural cooperative medical clinic, and farmers' outpatient medical treatment can also be reimbursed in proportion. This reimbursement rate is based on the hospital level, not the city and county level. In addition, according to the local economic level, there will be a difference of 5% among provinces: outpatient reimbursement will be increased to 30%, hospitalization reimbursement will be no less than 75% in first-class hospitals, 55% in second-class hospitals and 45% in third-class hospitals, and the actual reimbursement rate for hospitalization within the policy scope will reach 70%, with the highest ceiling line 10. The proportion of reimbursement for basic drugs, Chinese herbal pieces (including in-hospital Chinese herbal preparations) and suitable Chinese medicine techniques such as acupuncture, massage, cupping and scrapping will increase 10%.

Second, how much is the maternity reimbursement?

(1) Maternity allowance: Maternity allowance is the salary of female employees during maternity leave. If the maternity allowance is lower than my salary standard, the difference will be made up by the enterprise. Maternity allowance is calculated according to the payment base of the month when female employees give birth divided by 30 and multiplied by the number of days of maternity leave.

(two) employees who have participated in maternity insurance for a total of one year are still insured when they give birth (abortion) and enjoy maternity insurance benefits according to relevant regulations.

(III) Maternity insurance benefits The payment standard of maternity allowance is calculated and paid based on the average monthly salary of employees in the previous year of the employer where employees work. Maternity insurance = maternity allowance+Medicaid.

3. How long does it take for maternity insurance reimbursement to arrive?

According to the maternity insurance policy, maternity allowance must be applied by the employer. Enterprises must go to the local social security agency to handle the required information after deducting money from the financial department of the social security center from the 20th to 25th of the month following the birth of female employees. Generally, in the second half of the application, the maternity allowance will be paid to the unit account, and then the unit will pay it to the individual. To put it simply, after completing the application procedures for maternity allowance, maternity allowance can be reported in the middle and late next month and can be collected. The reimbursement of the new rural cooperative medical system is different from place to place, and should be judged according to local living standards and other standards.

legal ground

"Population and Family Planning Law of the People's Republic of China" Article 18 The state encourages a couple to have two children. Those who meet the requirements stipulated by laws and regulations may ask for another child. Specific measures shall be formulated by the people's congresses of provinces, autonomous regions and municipalities directly under the Central Government or their standing committees. Ethnic minorities should also practice family planning, and the specific measures shall be formulated by the people's congresses of provinces, autonomous regions and municipalities directly under the Central Government or their standing committees. If the provinces, autonomous regions and municipalities directly under the Central Government where the husband and wife are registered are inconsistent, the principle of benefiting the parties shall apply.

The Decision of the State Council, the Central Committee of the Communist Party of China on Optimizing the Birth Policy and Promoting the Long-term Balanced Development of the Population implements the policy that a couple can have three children, cancels restrictive measures such as social support fees, cleans up and abolishes relevant punishment provisions, and implements positive birth support measures.

legal ground

"Population and Family Planning Law of the People's Republic of China" Article 18 The state encourages a couple to have two children. Those who meet the requirements stipulated by laws and regulations may ask for another child. Specific measures shall be formulated by the people's congresses of provinces, autonomous regions and municipalities directly under the Central Government or their standing committees. Ethnic minorities should also practice family planning, and the specific measures shall be formulated by the people's congresses of provinces, autonomous regions and municipalities directly under the Central Government or their standing committees. If the provinces, autonomous regions and municipalities directly under the Central Government where the husband and wife are registered are inconsistent, the principle of benefiting the parties shall apply.

The Decision of the State Council, the Central Committee of the Communist Party of China on Optimizing the Birth Policy and Promoting the Long-term Balanced Development of the Population implements the policy that a couple can have three children, cancels restrictive measures such as social support fees, cleans up and abolishes relevant punishment provisions, and implements positive birth support measures.