The difference between NCMS and medical insurance, and the difference between NCMS and medical insur

What is the difference between NCMS, rural medical insurance and resident medical insurance?

New Rural Affordable Medical Insurance. NCMS is a new type of rural cooperative medical insurance.

The new type of rural cooperative medical insurance is a medical security system created by farmers (agricultural household registration) in China themselves, which has played an important role in ensuring that farmers have access to basic health services and alleviating the poverty caused by illness and returning to poverty due to illness. The new rural cooperative medical system is a system of mutual medical assistance and mutual aid for farmers that mainly takes into account the settlement of major illnesses and minor diseases.

The two are not the same. The difference between the two is reflected in:

1. The new rural cooperative medical requirement is rural hukou, and the resident medical insurance requirement is urban hukou;

2. The reimbursement list of NCMS is less than that of urban medical insurance, and the reimbursement ratio of NCMS in township hospitals is higher, and the average reimbursement ratio in municipal hospitals is 120% lower than that of urban medical insurance, and the maximum ceiling is also less than that of urban medical insurance.

2. NCMS mainly allows farmers to reimburse more in township health centers, with a low starting line, and relatively less reimbursement in urban hospitals; The starting line of domestic medical insurance is slightly higher than that of NCMS, and the reimbursement ratio in large hospitals is slightly higher, and the payment is also more.

The new type of rural cooperative medical care, referred to as "NCMS", refers to the system of mutual medical assistance and mutual aid for farmers that is organized, guided and supported by the first and the other, with the voluntary participation of farmers, and the financing of individuals, collectives and multiple parties. Funds are raised by means of individual payment, collective support and funding.

Extended reading: [Insurance] How to buy, which one is better, teach you to avoid these insurance"pits"

The difference between rural medical insurance and social security lies in the payment of fees, included items and payment methods. The fees are different: the cost of rural health insurance is much lower in comparison; Included items are different:

In addition to medical insurance, social security also includes endowment, unemployment, work-related injury and maternity insurance; Rural medical insurance is fully covered by the insured, while social insurance is borne by the employee and the company.

The difference between NCMS and medical insurance is:

1. The target group is different.

1) NCMS is a new type of rural cooperative medical care, and you must have a rural hukou to participate in NCMS. The target group is farmers who do not work in cities and towns;

2) Medical insurance is the basic medical insurance for urban employees, which is not limited to household registration, and is composed of individual payment part and overall payment part. The main target group is working workers and flexible workers;

2. Different payment methods.

1) The new farmer pays once a year, and the individual pays;

2) Medical insurance is paid once a month, and some units are responsible for the overall part of the unit, and flexible employment individuals should bear part of the overall payment;

3. Different treatment.

1) NCMS is mainly aimed at farmers, with low payment and low reimbursement amount;

2) Medical insurance is mainly for employees and flexible employees, with high contributions, high treatment and reimbursement ratio;

4. The retirement age is different.

1) NCMS has no retirement policy and needs to pay for life;

2) After reaching the retirement age and meeting the requirements of the local medical insurance retirement period, urban employees can retire by medical insurance and enjoy free medical insurance treatment for life.

5. The included items are different.

1) NCMS only includes medical insurance;

2) The basic medical insurance for urban employees includes medical insurance, endowment insurance, unemployment insurance, work-related injury insurance and maternity insurance.

Legal basisArticle 23 of the Social Insurance Law of the People's Republic of China.

Employees shall participate in the basic medical insurance for employees, and the employer and the employee shall jointly pay the basic medical insurance premiums in accordance with the provisions of the state.

Individually-owned businesses without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other flexibly employed persons may participate in the basic medical insurance for employees, and the individual shall pay the basic medical insurance premiums in accordance with the provisions of the state.

1. The payment subject is different. Medical insurance is paid by urban workers, and rural cooperative medical care is paid by farmers; 2. The cost is different. Medical insurance is compulsory and is charged according to a certain proportion of employees' wages, and rural cooperative medical care is voluntarily participated by farmers, and the cost is generally fixed; 3. Different payment methods.

The medical insurance is paid by the unit and the employee together, and the unit pays most of it, and the employee only pays a small part. Rural cooperative medical care is paid by the farmers themselves.

Questions. The difference between medical insurance and agricultural cooperative medical system is **.

The difference is that the rural cooperative medical insurance pays less, the reimbursement is less, and the restrictions are more, and the medical insurance pays more, the reimbursement is more, and the restrictions are less.

1. The people covered are different.

The medical insurance for urban and rural residents covers residents who do not work and urban minors who do not participate in the medical insurance for urban employees;

The main target of NCMS is rural farmers.

2. The degree of protection is different.

The starting line of medical insurance for urban and rural residents is higher than that of NCMS, and the reimbursement ratio in large hospitals is also higher than that of NCMS. The reimbursement cost of NCMS in township health centers is relatively high;

The payment for medical reimbursement for urban and rural residents is paid every month, with a maximum reimbursement of 70%, and the NCMS is paid once a year, with a maximum reimbursement of 30%.

3. It is the different departments of management.

Medical insurance for urban residents is mainly managed by the human resources and social security departments, and most places in NCMS are managed by the health departments.

4. The focus of the guarantee treatment is different.

The medical insurance for urban residents mainly covers both inpatient and outpatient serious illnesses and ordinary outpatient services, so the treatment of inpatient and outpatient serious illnesses is higher than that of NCMS. The level of outpatient treatment of NCMS is higher than that of urban residents' medical insurance.

Medicare"target="_blank"title="Encyclopedia - Medicare"Encyclopedia - Medicare

A new type of rural cooperative medical care? fromtitle=New Rural Cooperative Medical Insurance-New Rural Cooperative Medical Care"> Encyclopedia - New Rural Cooperative Medical Care.

The difference between NCMS and medical insurance is divided into two categories, which are as follows:

1. Different insurance objects and payment basis: Employee medical insurance does not distinguish the nature of household registration, as long as they are employed or have no employees, individual industrial and commercial households and flexible employees can participate in the insurance, and the average salary of the employer in the previous year is used as the basis for collection; Urban medical insurance is limited to the "non-agricultural household registration" personnel in the jurisdiction, and the implementation is the first subsidy and the insured to pay the remaining part of the payment;

2. The treatment of the two is different: as long as the employee medical insurance reaches a certain number of years before retirement, such as: 25 years, after retirement, the monthly medical insurance card will be paid a certain treatment, and the urban medical insurance is limited to the year of insurance, and there is no retirement treatment; Under the same conditions, the payment base and reimbursement ratio of employee medical insurance are greater than those of urban medical insurance.

The scope of basic medical insurance payment is limited to the medical expenses within the prescribed basic medical insurance drug list, diagnosis and treatment items and medical service facility standards; Implement fixed-point management of medical institutions and pharmacies that provide basic medical insurance services; Social insurance agencies and basic medical insurance service institutions (designated medical institutions and designated retail pharmacies) shall settle expenses in accordance with the settlement methods stipulated in the agreement.

Legal basisArticle 30 of the Social Insurance Law of the People's Republic of China.

The following medical expenses are not covered by basic medical insurance**:

1) It should be paid out of work-related injury insurance**;

2) It shall be borne by a third party;

3) shall be borne by public health;

4) Seeking medical treatment outside the country.

Medical expenses shall be borne by the third party in accordance with the law, and if the third party does not pay or the third party cannot be determined, the basic medical insurance shall pay in advance. After the basic medical insurance** is paid in advance, it has the right to recover from the third hand.

Article 31.

According to the needs of management services, social insurance agencies may sign service agreements with medical institutions and drug business units to standardize medical service behavior.

Medical institutions shall provide reasonable and necessary medical services to insured persons.

The differences between NCMS and medical insurance include different payment methods, different payment times, different fees, different reimbursement ratios, and different included items.

1. The payment method is different

Employee medical insurance needs to be paid monthly, which is a compulsory insurance and is paid by the employer. The new farmer only needs to pay once a year, and does not need to pay every month.

2. The time of payment is different

Employee medical insurance can be paid every month, and if the employee medical insurance is interrupted, it can be paid within three months.

NCMS is paid on an annual basis, and the annual payment time is from the beginning of November to the end of December, and the special payment time will be clearly stipulated.

3. The fees paid are different

The employee medical insurance will refer to the average salary of local employees in the previous year to calculate the rotation, and the payment fee is much higher than that of NCMS.

Fourth, the proportion of reimbursement is different

The proportion of reimbursement for employee medical insurance is relatively high, usually more than 70%. However, the reimbursement rate of NCMS is relatively low, and the maximum reimbursement shall not exceed 50%.

Fifth, the included items are different

NCMS only includes medical insurance. The basic medical insurance for urban workers includes medical insurance, pension insurance, unemployment insurance, work-related injury insurance and maternity insurance.