In 2019, the NCMS insurance will bear 1.65 million yuan, can it be reimbursed twice? How much can I

After the reimbursement of NCMS, 18,000 yuan can be reported for the second reimbursement of 1,500 yuan, that is, (18,000-15,000)*50%=1,500 yuan.

"Secondary reimbursement" for serious illnesses, once a participating farmer suffers from a serious illness, he can not only enjoy the reimbursement of the NCMS, but also enjoy the second reimbursement given by the commercial insurance, also known as the compensation of the NCMS serious illness insurance.

The reimbursement of NCMS major illnesses can only reimburse "compliance expenses", which are tentatively set as out-of-pocket medical expenses within the scope of the NCMS Essential Medicines List and the Basic Diagnosis and Treatment Items List. The starting line for the second reimbursement is 10,000 yuan, and the reimbursement ratio is divided into three levels, with a minimum of 50%.

After the reimbursement of NCMS, those who have paid more than 10,000 yuan in compliance can be included in the reimbursement of NCMS serious illness insurance, and the 10,000 yuan part will be compensated at a rate of 50%, the part between 50,000 yuan and 100,000 yuan will be compensated at a rate of 55%, and the part above 100,000 yuan will be compensated at a rate of 65%, which will be subsidized in stages, with a ceiling of 300,000 yuan.

If there is no full self-payment, then look at the reimbursement ratio of the district (county, city) where you participate in the NCMS, taking Guiyang City as an example, the second reimbursement range of the first stage of serious illness in Guiyang (7000 yuan starting line, 7000-60000 reimbursement ratio is 50%), if the 10,000 yuan is not fully self-paid, the amount of secondary reimbursement for serious illness = (16500-7000) * 50% =4,750 yuan, if the full self-payment is 10,000 yuan, the personal compliance payment fee is 6,500 yuan, and less than the minimum payment line of 7,000 yuan will not be reimbursed!

Summary. In general, there is no limit to the number of reimbursements in a year, but there is a cap on the reimbursement amount, which varies by region. For example, in most areas, the reimbursement limit for rural cooperative medical outpatient services is 5,000 yuan per year, the reimbursement limit for special outpatient diseases is 10,000 yuan per year, the reimbursement limit for inpatient medical treatment is 150,000 yuan per year, and the reimbursement limit for critical illness insurance is 200,000 yuan per year.

Note that NCMS reimbursement is not a full reimbursement, and a certain percentage will be reimbursed according to different circumstances and expenses. Generally speaking, due to the different population and development situation of each region, the strength of NCMS and the cap on the reimbursement amount will be different. Judging from the situation in most parts of the country, the setting area of the cap line is about 10-250,000 yuan, but the specific cap amount is recommended to go to the relevant local medical insurance department for direct consultation, because the reimbursement ratio of designated hospitals at different levels is also different.

Hello, I am glad to answer for you that the maximum annual reimbursement limit of Haxin Nong is 120,000.

Generally speaking, there is no limit to the number of reimbursements in a year, but there will be an upper limit on the reimbursement amount, which varies from region to region. For example, in most areas, the reimbursement limit for rural cooperative medical outpatient services is 5,000 yuan per year, the reimbursement limit for special outpatient diseases is 10,000 yuan per year, the reimbursement limit for inpatient medical treatment is 150,000 yuan per year, and the reimbursement limit for critical illness insurance is 200,000 yuan per year. Note that NCMS reimbursement is not a full reimbursement, and a certain percentage will be reimbursed according to different circumstances and expenses.

Generally speaking, due to the different people's arguments and development conditions in each region, the strength of NCMS and the cap on the reimbursement amount will be different. Judging from the situation in most parts of the country, the setting area of the cap line is about 10-250,000 yuan, but the specific cap amount is recommended to go to the relevant local medical insurance department for direct consultation, because the reimbursement ratio of designated hospitals at different levels is also different.

Hello: I spent 50,000 yuan on hospitalization in a secondary hospital, and the NCMS reimbursed 35,000 yuan for the secondary hospital, 460 yuan for the starting line, 30% for self-payment, and 70% for reimbursement 1. The latest reimbursement ratio for rural cooperative medical care is the reimbursement ratio for the township (town) health center medical Chang Nachai fee is less than the resistance type yuan, the reimbursement yuan (exclusive) is more than 2,000 yuan, and the reimbursement yuan (exclusive) is more than 50%. If the reimbursement ratio of medical expenses of county-level designated medical institutions is less than 10,000 yuan, 50% will be reimbursed if the reimbursement ratio is less than 10,000 yuan, and if the reimbursement is more than 10,000 yuan.

If the reimbursement ratio of medical treatment expenses in secondary hospitals is less than 10,000 yuan, and if the reimbursement is more than 10,000 yuan, 50% will be reimbursed if the reimbursement is more than 10,000 yuan. Thank you for the new trust, the above is my reply, I hope it can help you, I wish you a happy life

Legal analysis: the annual cap line for NCMS medical expense compensation is 150,000 yuan, and the annual cap line for 23 major diseases is 200,000 yuan; For those who meet the 25 special outpatient diseases, the annual cap line for outpatient ** is 10,000 yuan; Among the 8 special outpatient diseases, including radiotherapy and chemotherapy for various malignant tumors, hemodialysis and peritoneal dialysis for chronic renal failure, anti-rejection after organ transplantation, aplastic anemia, hemophilia, thalassemia, severe psychosis, and multidrug-resistant tuberculosis, the compensable outpatient expenses shall be implemented with reference to the hospitalization compensation policy of hospitals at the same level, with an annual cap of 150,000 yuan.

Legal basis: "Social Insurance Law of the People's Republic of China" Article 24 The State shall establish and improve a new type of rural cooperative medical system. The management measures for the new type of rural cooperative medical care shall be stipulated by ***.

Generally, it can be reimbursed twice.

1. "Second reimbursement" means that residents of urban residents' medical insurance or NCMS, if they have high expenses for medical treatment last year, in addition to normal reimbursement, they can also apply for serious illness insurance again, and there is no cap line.

2. The second reimbursement of NCMS has nothing to do with how much money is spent at one time, but it is just an internal adjustment policy of NCMS, that is, at the end of each year, if the remaining part of NCMS exceeds 25% of the total, then the second subsidy will be implemented according to the requirements of the NCMS policy, and the method of implementing the second subsidy will be implemented by the NCMS department to formulate a detailed plan, and the reimbursement ratio will not meet a certain requirement for the implementation of the second subsidy.

The reimbursement criteria are as follows:

Between 15,000 yuan and 60,000 yuan, 55% of the yuan can be reimbursed.

Between 60,000 yuan and 100,000 yuan, 60% of the yuan can be reimbursed.

Between 100,000 yuan and 150,000 yuan, 65% of the yuan can be reimbursed.

More than 150,000 yuan can be reimbursed 70% of the yuan.

In addition, in the event of a transfer**, the flat rate of reimbursement is 50%.

The scope of secondary compensation for the new type of rural cooperative medical care is as follows:

1. Basic mode.

Hospitalization planning includes general hospitalization, medical treatment of critical illnesses, and normal delivery in the hospital.

Outpatient coordination includes general outpatient clinics and large-scale frontal deficiency outpatient clinics for special diseases.

2. Fundraising.

The individual payment of rural residents shall not be less than 60 yuan per year, and the local financial subsidy of Yinlun** and Yiqing is 280 yuan per person. The fund-raising standard for participating rural residents is not less than 340 yuan per person per year.

3. Allocation of funds.

Risk**: After raising the level of financing, it is necessary to supplement the exit of risk** so that its scale reaches 10% of the total amount of the current year.

General medical expenses: In principle, the subsidy amount of general medical expenses shall be determined according to the standard of not less than 16 yuan per participant, and each overall planning area can be adjusted according to the use of funds last year and the payment of the genus. l Diagnosis and treatment costs.