Hanjiang social security bureau

Children born under the new rural cooperative medical system have different reimbursement standards in different places, so it is recommended to consult the local rural cooperative medical institutions.

1. What materials do the participants of the new rural cooperative medical system need to bring for the compensation subsidy for hospitalization delivery?

Those who give birth in hospitals outside Fenghua can bring cooperative medical card, ID card, pre-marital medical examination certificate, reproductive health service certificate, discharge record, hospitalization invoice and their bank card (passbook) to the municipal medical insurance center for compensation; Enjoy rural pregnant women in hospital delivery subsidies, need to bring residence booklet, maternal health booklet, reproductive health service certificate, hospitalization invoice to the city medical insurance service hall to apply for subsidies; In Fenghua, hospital delivery is directly reimbursed in the hospital with pre-marital medical examination certificate, reproductive health service certificate and household registration book. Fixed compensation to 500 yuan; Fixed subsidy to 600 yuan.

2. How much is the reimbursement for children of rural cooperative medical care in Chongqing?

According to the Notice of Chongqing Municipal Bureau of Human Resources and Social Security on Several Issues Concerning the Cooperative Medical Insurance for Urban and Rural Residents in Chongqing (No.267 [2013]), during the normal insured period, 400 yuan will be given a fixed subsidy; Cesarean section and its complications are reimbursed according to the general hospitalization policy of cooperative medical care for urban and rural residents, which is lower than that of 400 yuan in 400 yuan.

The reimbursement of general hospitalization policy is as follows: (1) deductible line, and the insured person needs to pay the deductible line when he is hospitalized. The standard is a first-class medical institution 100 yuan/time, a second-class medical institution in 300 yuan and a third-class medical institution in 800 yuan; (2) the capping line, the amount of hospitalization reimbursement for insured persons, the standard is 80,000 yuan/person/year for the first file and 0.2 million yuan/person/year for the second file; (III) Reimbursement ratio: medical expenses incurred by the insured in hospitalization within the policy scope shall be reimbursed by 80% by the first-level medical institutions, 60% by the second-level medical institutions, 40% by the third-level medical institutions, and 5 percentage points by the second-level medical institutions on the basis of the first-level medical institutions.

3, rural cooperative medical reimbursement and admission, discharge related issues.

In order to encourage pregnant women to give birth in hospital, the new rural cooperative fund will give appropriate compensation to pregnant women who participate in planned hospital delivery and cooperate with the "Rural Maternal Hospital Delivery Assistance Project".

-Participating pregnant women are hospitalized for vaginal delivery, and the price standard is strictly enforced. In the township (town) hospitals (or community health service centers organized by the government), 200 yuan is given a fixed subsidy, and in the designated medical institutions at the county level, 300 yuan is given a fixed subsidy.

-To participate in the pathological obstetrics of obstetric hospital delivery, strictly implement the price standard, first implement the subsidy policy stipulated in the "rural obstetric hospital delivery subsidy project", and the rest will be compensated by the new rural cooperative medical fund in accordance with the relevant regulations, and the total compensation will not exceed the actual expenditure.

4. Hospital delivery of rural pregnant women has also been included in the new rural cooperative medical system. Can you elaborate on how pregnant women participate in the new rural cooperative medical system?

It is one of the important measures taken by the government to ensure the life safety of rural pregnant women and newborns, further improve the quality of rural population and promote social harmony and progress.

(1) Be hospitalized in designated medical institutions in the county, and pregnant women who give birth normally are hospitalized in designated medical institutions at the township level for free delivery (Licheng District, Xiuyu District and Xianyou County are limited to 800 yuan, Chengxiang District, Hanjiang District, the north shore of Meizhou Bay and Meizhou Island are limited to 900 yuan); In the designated medical institutions at the county level, compensation will be made according to 80% of the price limit standard. (The price limit of Licheng District, Xiuyu District and Xianyou County is 1 100 yuan, and the price limit of Chengxiang District, Hanjiang District, the north shore of Meizhou Bay and Meizhou Island is 1200 yuan).

(2) For those who are hospitalized in the designated medical institutions in this county, the government will give subsidies to pregnant women who have undergone vaginal surgery and cesarean section, and the remaining reimbursable expenses will be compensated according to the provisions of the local new rural cooperative medical system. (Total subsidy compensation amount = 400 yuan+hospitalization reimbursable expenses * compensation ratio)

(3) If the participating pregnant women give birth in hospital in designated medical institutions outside the county (including normal delivery, vaginal delivery and cesarean section), they will be subsidized by the government in 400 yuan, and the remaining reimbursable expenses will be compensated according to the provisions of the local new rural cooperative medical system. (Total subsidy compensation amount = 400 yuan+hospitalization reimbursable expenses * compensation ratio)

(4) Unmarried pregnant women: You can also enjoy the government's policy on rural pregnant women giving birth to 400 yuan. Carrying materials: household registration certificate, discharge summary, hospitalization expense summary, hospitalization expense list and birth certificate.

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