Jiangsu new rural insurance reimbursement ratio for medical treatment in other places

Jiangsu New Rural Insurance reimbursement ratio for foreign medical treatment is as follows:

1, outpatient reimbursement

(1) general outpatient reimbursement rate of 50%, per person per year reimbursement cap of 80 yuan;

(2) outpatient observation of up to 30 yuan per day, a maximum of 1,000 yuan per year;

(3) outpatient reimbursement of 50% of the major diseases, cirrhosis of the liver, Cerebral thrombosis and cerebral hemorrhage sequelae, rheumatoid arthritis, femoral head necrosis, combined complications of hypertension, diabetes mellitus, pulmonary heart disease, systemic lupus erythematosus, aplastic anemia, organ or tissue transplantation anti-rejection treatment, leukemia, severe mental illness, congenital adrenal hyperplasia, congenital hypothyroidism, patients with the reimbursement of the cap line of 10,000 yuan per year per person; malignant tumor, uremia, Hemophilia patients are reimbursed 30,000 yuan per person per year.

2. Reimbursement for hospitalization

(1) The threshold for reimbursement for hospitalization at the township level is RMB 200, and the reimbursement rate is 85%;

(2) The threshold for reimbursement for hospitalization at the county-level designated medical institutions is RMB 500, and the reimbursement rate is 70%;

(3) The threshold for reimbursement for hospitalization at the municipal-level designated medical institutions is RMB 700, and the reimbursement rate is 55%;

( (4) Provincial designated medical institutions hospitalization reimbursement starting line of 1000 yuan, reimbursement rate of 50%;

(5) by the county-level New Farmers' Cooperative management agencies agree to referral for the record, and hospitalization outside the county in addition to municipal and provincial designated medical institutions, the uniform reimbursement of the starting line of 1000 yuan, reimbursement rate of 40%, the guaranteed reimbursement rate of 20%;

(6) drugs in the list of basic medicines (6) The reimbursement rate for drugs in the basic drug list, Chinese medicine tablets and non-drug non-surgical therapies such as acupuncture, tuina, cupping and gua sha is increased by 10% on the basis of the original reimbursement rate. Municipal and county hospitals of traditional Chinese medicine and maternal and child health hospitals in Dezhou City reduced the starting line by 200 yuan, and the compensation ratio increased by 5% on the basis of the original reimbursement ratio;

(7) childhood leukemia, congenital diseases in children, end-stage renal disease, breast cancer, cervical cancer, severe mental illness, AIDS opportunistic infections, multidrug-resistant tuberculosis, hemophilia, chronic granulocytic leukemia, cleft lip and palate, lung cancer, esophageal cancer, Stomach cancer, type I diabetes, hyperthyroidism, acute myocardial infarction, cerebral infarction, colon cancer, rectal cancer and other 20 major diseases in the city, provincial designated medical institutions hospitalization costs of the New Farmers' Cooperative reimbursement ratio of 70%;

(8) their own reasons for accidental injuries, in addition to the provisions of the circumstances of the project not to be reimbursed, uniform hospitalization reimbursement of the starting line of 1,000 yuan, reimbursement rate of the implementation of the principle of segmentation, participants in the 16 to 60 years of age. The reimbursement rate is 20% for those between the ages of 16 and 60, and 30% for those below the age of 16 and above the age of 60.

(9) Participating mothers will be reimbursed for natural births and cesarean sections in hospitals at a flat rate of 500 yuan for natural births and 1,000 yuan for cesarean sections.

(10) If a participant is hospitalized more than once in the same cycle of participation in the same health care institution, the first payment will be deducted from the first payment for multiple hospitalizations in the same period of time. If a participant is hospitalized several times in the same cycle and in the same medical institution, the starting line will be deducted for the first time, and 50% of the starting line will be deducted for the second hospitalization.

The cumulative reimbursement ceiling for outpatient and inpatient hospitalization is 200,000 yuan per participant per year.

3. Reimbursement for Major Diseases

The State has identified 20 categories of major diseases, such as childhood leukemia, congenital diseases of children, end-stage renal disease, breast cancer, cervical cancer, severe mental illness, opportunistic infections of AIDS, multidrug-resistant tuberculosis, hemophilia, chronic granulocytic leukemia, cleft lip and palate, lung cancer, esophageal cancer, gastric cancer, type I diabetes mellitus, hyperthyroidism, acute myocardial infarction, cerebral infarction, colorectal cancer, rectal cancer and so on, which are covered by the new insurance. After the reimbursement of medical expenses for 20 categories of major diseases by the New Rural Cooperative Medical Care, the remaining part of the compliant expenses below 8,000 yuan will be reimbursed at 17%, and the part exceeding 8,000 yuan will be reimbursed at 73%, with the maximum annual compensation limit of 200,000 yuan for an individual.

New rural cooperative medical reimbursement process is as follows:

1, fill in the "basic medical insurance working, living in a different place, the situation of the person declaration form" and stamp;

2, will be filled out "application form" to the social security institutions to audit;

3, after the audit, you can directly by virtue of the medical card in the network of health care institutions, pharmacies, swipe the card settlement.