NCMS reimbursement ratio of Taiyuan 264 Hospital in Qinxian County, Changzhi City

1. According to the document (Jin [2016] No.57), if the party concerned goes through the medical insurance referral procedures and is approved by the local social security department, the reimbursement benefits are as follows:

(1) The urban and rural residents' medical insurance fund is mainly used to pay the inpatient and outpatient medical expenses incurred by the insured, so as to stabilize the level of hospitalization security, and the proportion of hospitalization expenses paid by the overall fund within the policy scope remains at around 75%;

(2) Implement a unified serious illness insurance system for urban and rural residents. Within the scope of the policy, the part of the large medical expenses for hospitalization or outpatient service that the individual pays more than 6.5438+0,000 yuan shall be paid by the urban and rural residents' serious illness insurance, and the payment ratio shall remain above 55%, with the maximum payment limit of 400,000 yuan;

(III) For the poor people, low-income family members, destitute dependents, severely (disabled) patients who have lost the ability to work, and the elderly and minors over 60 years old in low-income families who participate in the basic medical insurance for urban and rural residents, the minimum threshold for urban and rural residents' serious illness insurance can be reduced to 5,000 yuan, and the payment ratio can be appropriately increased.

2. The above Implementation Opinions on Integrating the Basic Medical Insurance System for Urban and Rural Residents (Jin [2016] No.57).