Does rural cooperative medical care have to be hospitalized to be reimbursed? Why?

With the development of modern society, people's living standards have gradually improved, and the living conditions have been infinitely satisfied, and people can enjoy more and more welfare systems provided by the state and society, which has facilitated people's lives and improved people's happiness index. Especially in the rural areas, more and more systems have been popularized in the rural areas, and a number of systems have been implemented in the rural areas that can reduce the burden on the peasants, and the peasants have shown a sincere smile on their faces. Rural cooperative medical care is an initiative that helps farmers to rest assured that they do not have to worry too much about costs in the process of illness.

First of all, we all know that it is a mutual aid system that is organized by farmers, voluntarily participated, funds were raised by multiple parties, and serious illnesses were the main ones. Because it comes from multiple fundraising, the funds used are limited, and in the case of some minor illnesses that they can afford, they will not be reimbursed, and each family has a certain income**, so small expenses can still be afforded, but a large proportion of the expenses can be reimbursed if the cost is slightly larger。The cost of hospitalization is generally relatively large, and in this regard** policy support can alleviate a large part of the pressure.

Another point is that you must transfer to the hospital. Because the rural cooperative medical policy has not yet passed the private transfer**, if the transfer is not processed, and the private transfer is carried out in order to seek better medical technology, this situation will not be reimbursed.

The state has given us a lot of policy support, which is the welfare given to us, and we must learn more about these policies and enjoy these benefits. At the same time, we should understand the content of these policies more, and in the end, we will still benefit.

I just enrolled in the insurance when I was in school, and I paid 80 yuan at that time and gave us a red notebook similar to a medical insurance card. Now I have chronic appendicitis, and although I was not hospitalized, it cost nearly 1,000 yuan to hang saline and the cost of examination. But I don't know if I'm hospitalized to be reimbursed???

Urgent!!!

Yes, it can be reimbursed, and the way of hospitalization payment will not affect the reimbursement of medical insurance. However, you should keep the voucher of each payment, and when the medical insurance reimbursement, you will need these materials to prove that you have paid the payment by yourself and the payment amount, and then you can provide it according to the requirements of the medical insurance.

Extended Materials. The methods of reimbursement by medical insurance are:

1. Hospitalization reimbursement:

Cardholders can bring their ID cards and social security cards to designated hospitals, use their social security cards to go through hospitalization procedures, and then directly use their social security cards for reimbursement when they are discharged.

2. Reimbursement for buying medicines:

Cardholders can go to designated pharmacies with their ID cards and social security cards, select appropriate medicines, and then insert the card at the settlement office to swipe the card for reimbursement.

One. Copies of inpatient medical records.

It must be stamped with the seal of the hospital, and it is not necessary to provide a doctor's order and a record of the course of the disease.

Among them: Pathology report (biopsy report) must be attached for cancer patients;

Surgical patients must attach anesthesia records and surgical records;

Blood transfusion and use of blood products must be accompanied by blood routine and liver function test reports.

Two. A detailed list of expenses.

It must be stamped with the hospital stamp.

Three. Hospitalization bills.

Use a valid bill supervised by the financial or taxation department, and stamped with the special seal of the medical institution, and the seal is clear, and the content is clear and there is no trace of alteration.

Four. Health insurance card.

Five. Other materials.

1) The "Referral and Transfer Approval Form" must be attached to the referral and transfer hospital.

2) If the insured patient lives or works outside the city of Bijie, he or she must attach a certificate from the unit.

3) A copy of the "Business Trip Approval Form" and the "Business Trip Reimbursement Form" must be attached for emergency hospitalization on business trips, and a certificate from the unit must be attached for emergency medical treatment in other places.

4) When the official name (i.e., "generic name") is not used for the drug, the drug insert must be attached.

And medical insurance has a designated institution! When you are insured, you must remember that your designated hospital is **, and only when you go to the designated hospital to see a doctor and be hospitalized can you be reimbursed; If you go to a non-designated medical institution, there is no way to reimburse the cost, otherwise you can only bear it yourself. Only designated pharmacies with medical insurance can buy drugs with their medical insurance cards, and other pharmacies can only pay out of their own pockets.

Cooperative medical care in rural areas cannot be reimbursed if you are not hospitalized. According to the current reimbursement rules of rural cooperative medical care, in fact, rural cooperative medical care is not reimbursable for many medical matters, and we can actively ask the front desk of the hospital when we seek medical treatment. <>

With the further improvement of the social security system, many rural cooperative medical care is also doing well, and in addition, the rural cooperative medical care is basically the same as the urban medical insurance, so the scope of protection is relatively extensive, and the peasants are also very willing to actively buy it. However, rural cooperative medical care can be used in the first is a problem that everyone is thinking about, in fact, it is generally not reimbursable if it is not hospitalized, whether it can be reimbursed when buying drugs locally, you can further consult the front desk, and do not feel that it can be reimbursed at will.

Cooperative medical care in rural areas: no hospitalization, no reimbursement <>

According to the current regulations, if a person is sick and is not hospitalized, then the corresponding expenses incurred cannot be reimbursed, but this situation is not absolute. If a person sees a doctor in a hospital in the city, generally speaking, the drug can be reimbursed at the time of payment, but the form of reimbursement is mainly discounted, and it will not be reimbursed afterwards, even if it is hospitalized, and it will be directly deducted at the time of settlement.

The reimbursement rules for rural cooperative medical care <>

According to the current reimbursement rules for rural cooperative medical care, medical treatment in other places can only be reimbursed if you are hospitalized and a corresponding order is issued, and the reimbursement agency generally returns to the front desk of the local tertiary hospital. Due to the existence of medical treatment in other places, the reimbursement amount is generally not as large as the reimbursement for hospitalization in a local hospital. It is more important to note that the reimbursement of drugs will not be reimbursed, so we must ask about the specific situation when we go to the local tertiary hospital to see a doctor, if you can't reimburse yourself, you need to consider carefully whether you still want to buy drugs, after all, the rules of reimbursement are based on the variety of drugs and the regulations of the hospital.

If you are not hospitalized, you cannot be reimbursed, because the rural cooperative medical care does not have a personal account, and if you buy medicine or outpatient services, you cannot use the money in your personal account to pay.

It is basically not reimbursable if you are not hospitalized, but there is a situation that can be reimbursed, that is, your outpatient clinic spends more money and reaches the minimum payment line.

Yes, it cannot be reimbursed. The main reason is that the scope of reimbursement for cooperative medical care is relatively narrow, and generally only hospitalization expenses can be reimbursed. The cost of the surgery.

Legal analysis: No, from January 1 to December 31 of the following year of payment, you can enjoy the medical insurance treatment of urban and rural residents.

Legal basis: "Implementation Measures for the Protection of Basic Medical Insurance and Serious Illness Insurance for Urban and Rural Residents in Bengbu City" Article 8 From September to December each year, the basic medical insurance for urban and rural residents is the centralized insurance payment period. Those who register and pay in full during the centralized insurance payment period will enjoy the medical insurance treatment for urban and rural residents from January 1 to December 31 of the following year.

Newly enrolled students who pay the basic medical insurance premiums for urban and rural residents in the following year during the centralized insurance period shall enjoy the medical insurance benefits for urban and rural residents from the date of enrollment.

Rural Cooperative Medical Care (NCMS) is a medical security system in rural China, which aims to solve the basic medical security problems of farmers. Reimbursement will vary depending on the region and hospital, but generally speaking, hospitalization is not required for rural cooperative health care, and the following are some common cases:

1.Outpatient**: The cost of receiving outpatient clinic** in a medical institution covered by rural cooperative medical care can be reimbursed according to a certain percentage. The reimbursement ratio and limit for blind individuals will vary according to the regulations of different regions and hospitals.

2.Hospitalization**: The cost of hospitalization** in medical institutions covered by rural cooperative medical care can be reimbursed according to a certain percentage, and the specific reimbursement ratio and limit will be different according to the regulations of different regions and hospitals.

It should be noted that the reimbursement policy of rural cooperative medical care is formulated by different regions and hospitals themselves, and the specific reimbursement conditions and processes may be different, and it is necessary to understand and consult according to local regulations. At the same time, when reimbursing rural cooperative medical care, it is also necessary to provide relevant medical certificates and expense lists.

Relatives can be reimbursed if they are hospitalized and then paid to rural cooperative medical care. The exact amount of reimbursement depends on the local policy** policy, the hospital fee hall, the medical certificate number issued before admission to the hospital, and other factors. For the medical certificate and inpatient medical record issued before hospitalization, the medical card and a large number of supporting materials related to the one-time reimbursement should be prepared, otherwise the reimbursement amount will be affected.

In addition, other insurance premiums paid during the stay at the Shin Shin Model Hospital are also covered by the reimbursement of rural cooperative medical care, so you can consider purchasing special medical medical insurance to increase the actual reimbursement amount.