Meizhou rural social security reimbursement limit

Currently, China's new rural cooperative medical care system (known as the "new rural cooperative") has been implemented on a pilot basis throughout the country, and has been implemented at a relatively rapid pace. According to the Ministry of Health on June 30, 2004 statistics, the country has 30 provinces, municipalities directly under the Central Government, autonomous regions in 310 counties (municipalities) to carry out the new rural cooperative medical care pilot, covering an agricultural population of 95.04 million people, the actual participation of 68.99 million rural residents in the cooperative medical insurance reimbursement of the scope and proportion of rural areas are as follows:1, outpatient reimbursement: (1) the village health clinic and the village center of the health clinic clinic reimbursement 60%, with a limit of 10 yuan per visit, and a limit of 50 yuan per visit for temporary rehydration prescriptions from health center doctors. (2) Reimbursement for visits to township health centers is 40%, with a limit of RMB 50 per visit for examinations and surgeries, and a limit of RMB 100 for prescription drugs. (3) 30% reimbursement for visits to secondary hospitals, with a limit of RMB 50 yuan for each examination and operation and RMB 200 yuan for prescription drugs. (4) Tertiary hospitals will reimburse 20% of the fees, with a limit of RMB 50 yuan for each examination and operation and RMB 200 yuan for each prescription. (5) Chinese medicine invoices with prescription are limited to RMB 1 yuan per sticker. (6) Township-level cooperative medical outpatient reimbursement annual limit of 5,000 yuan. 2, hospitalization reimbursement (1) reimbursement scope: A, medicine: auxiliary examination: EKG, X-ray fluoroscopy, filming, laboratory tests, physical therapy, acupuncture, CT, MRI*** vibration and other examination fees limit of 200 yuan; surgical fees (with reference to the national standard, more than 1,000 yuan reimbursement of 1,000 yuan). B, elderly people aged 60 years or older hospitalized in the Xingta Township Health Center for hospitalization, treatment and nursing fees are reimbursed at RMB 10 per day, with a limit of RMB 200. (2) Reimbursement ratio: town health center reimbursement 60%; secondary hospital reimbursement 40%; tertiary hospital reimbursement 30%.3. Compensation for major illnesses (1) town risk fund compensation: all hospitalized patients who participate in the rural cooperative medical insurance for a one-time or yearly cumulative reportable medical expenses exceeding 5,000 yuan or more segmented reimbursement, i.e., 5,001-10,000 yuan reimbursement of 65%, 10,001-18,000 yuan reimbursement of 70%. (2) The annual limit of compensation for township-level cooperative medical care for inpatient hospitalization and outpatient blood dialysis for uremia, and outpatient radiotherapy and chemotherapy for tumors is 11,000 yuan. The following are not covered by the Rural Cooperative Medical Insurance: 1) medical expenses for self-medical treatment (medical treatment in unappointed hospitals or without a referral order), self-purchased medicines, medicines that cannot be reimbursed under the regulations of the public medical care and medical expenses that do not conform to the family planning; 2) other expenses such as outpatient treatment fees, consultation fees, hospitalization fees, meal fees, companion fees, nutritional fees, blood transfusion fees (except for those who have a family blood bank, which are reimbursed according to the relevant regulations), air-conditioning fees, rescue fees, and special care fees. Other expenses, such as car accidents, fights, suicides, alcoholism, workplace accidents and medical malpractice; 4. Orthopedics, cosmetic surgery, dentures, prosthetics, organ transplants, named surgery, consultation fees, etc.; 5. Reimbursement of expenses within the scope of reimbursement, but outside the limit. Many farmers who have purchased the New Rural Cooperative Medical Insurance (NRCM) have also purchased some commercial medical insurance. If you purchase commercial medical insurance, you have to reimburse the NRCM expenses first, and then seek reimbursement from the insurance company for the rest of the expenses. The first thing you need to do is to get the money back from the insurance company, and then get the insurance company to reimburse you for the rest of the cost.