A farmer working in the field fell from the car and was reimbursed by NCMS

Can be reimbursed, detailed reasons:

NCMS reimbursement process:

Information required for reimbursement:

Outpatient reimbursement materials: outpatient invoices, cooperative medical certificates (or medical records).

Hospitalization reimbursement materials: hospitalization invoices, cooperative medical certificates (or medical records), detailed list of expenses, discharge summary, and other relevant certificates.

Outpatient special disease reimbursement materials: outpatient invoices, special disease cooperative medical certificate records.

Information for special diseases: special disease outpatient proposals, cooperative medical certificates, medical records, relevant laboratory reports, and two documents.

Reimbursement process: The insured household shall prepare the required information for reimbursement and submit it to the village (community) cooperative medical liaison, who will review it and report it to the town cooperative medical liaison, and the town liaison will send it to the district agricultural office settlement and reimbursement center for reimbursement. Guidelines for the reimbursement of new rural cooperative medical care.

Direct reimbursement by the hospital: When hospitalization due to illness goes through the hospitalization procedures, a new type of rural cooperative medical certificate will be issued to the hospital to directly participate in the reimbursement.

Accidental falls are reimbursable. In addition to fights, traffic accidents, suicide and self-harm, work-related (work-related) injuries and accidental injuries of the responsible party.

Within the scope of reimbursement of NCMS, the reimbursement ratio of NCMS within 50,000 yuan (including 50,000 yuan) shall be compensated according to the proportion prescribed by the corresponding level of medical institutions, the part of 50,000 yuan (including 80,000 yuan) will be compensated according to the proportion of 50,000 yuan (including 80,000 yuan), and the part above 80,000 yuan will be compensated at a rate of 90%.

Accidental falls can be reimbursed. Within the scope of reimbursement of NCMS, the reimbursement ratio of NCMS within 50,000 yuan (including 50,000 yuan) shall be compensated according to the proportion prescribed by the corresponding level of medical institutions, the part of 50,000 yuan (including 80,000 yuan) will be compensated according to the proportion of 50,000 yuan (including 80,000 yuan), and the part above 80,000 yuan will be compensated at a rate of 90%. In addition, for the participating patients who are referred to medical institutions outside the province for hospitalization** and the actual compensation ratio is too low, we will continue to adhere to the minimum compensation policy, and the total inpatient medical expenses will be compensated according to the reimbursement ratio of not less than 30% of the NCMS after removing the minimum payment line.

The national financing standards for NCMS are not uniform.

1. The reimbursement ratio is not uniform, and the state allows appropriate adjustments to be made according to the actual economic situation of the region within the scope of the policy. However, there are four reimbursement modes: First, outpatient reimbursement is co-ordinated, and the expenses paid by oneself at the time of participation are reimbursed and used in the village clinic and township health center, which is limited to the outpatient account funds; The second is the reimbursement of chronic disease outpatient clinics, which is in line with the regulations on chronic disease management, and can apply for the NCMS chronic disease certificate, and can be reported for medicine or examination in public medical institutions such as townships, counties, and cities; The third is the overall reimbursement of hospitalization for serious illnesses, which can be reimbursed for hospitalization due to illness, but the reimbursement ratio is the highest in township-level hospitals and the lowest at the provincial level, with the reimbursement ratio of general township health centers being 80-90%, county-level hospitals being 70-80%, municipal hospitals being 55-65%, and provincial-level hospitals being reimbursed between 40-55%, and the starting line is also very different; Fourth, the reimbursement of NCMS for serious illnesses is in line with the serious illness relief project, and is implemented according to the diagnosis and treatment mode of serious illness assistance, and its reimbursement ratio can reach 90%, and the types of diseases rescued are all severe diseases.

Legal basis: Article 26 of the Social Insurance Law The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with national regulations.

Legal Analysis: Yes. According to the regulations, the medical expenses for accidental injuries caused by work-related injuries and third-party infringement are not paid, and the expenses for accidental injuries caused by personal will or force majeure factors shall be reimbursed according to the same reimbursement ratio as disease treatment.

Legal basis: Social Insurance Law of the People's Republic of China

Article 24: The State is to establish and improve a new type of cooperative medical system for rural villages.

The management measures for the new type of rural cooperative medical care are stipulated by the first government.

Article 25 The State shall establish and improve the basic medical insurance system for urban residents.

The basic medical insurance for urban residents implements a combination of individual payment and subsidy.

Those who enjoy the minimum living guarantee, the disabled who have lost the ability to work, the elderly over the age of 60 and minors from low-income families, etc., will be subsidized by **.

Generally speaking, NCMS can be reimbursed for accidental falls. The reimbursement scope of the new rural cooperative medical care is: the drug expenses, examination fees, laboratory fees, surgery fees, ** fees, nursing expenses and other parts that meet the reimbursement scope of the medical insurance for urban employees incurred by the participants in the designated hospital for diagnosis and treatment due to illness during the overall planning period.

[Legal basis].Article 24 of the Social Insurance Law of the People's Republic of China 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 ***.

Article 26 of the Law of the People's Republic of China on Social Insurance for Town Stools The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with national regulations.

Article 28 of the Social Insurance Law of the People's Republic of China in line with the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and medical expenses for emergency and rescue shall be paid from the basic medical insurance in accordance with national regulations.

Article 29 of the Social Insurance Law of the People's Republic of China The part of the medical expenses of the insured persons that should be paid by the basic medical insurance** shall be directly settled by the social insurance agency and the medical institutions and drug business units.

The administrative department of social insurance and the administrative department of health shall establish a system for the settlement of medical expenses for medical treatment in other places to facilitate the insured persons to enjoy basic medical insurance benefits.

Article 30 of the Social Insurance Law of the People's Republic of China The following medical expenses are not included in the scope of payment of basic medical insurance**

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

2) It shall be borne by a third party;

3) It should 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. Basic medical insurance** has the right to recover from a third party after paying the tomato dust in advance.

The above is only the current information combined with my understanding of the law, please be cautious for reference!

If you still have questions about this issue, it is recommended that you organize the relevant information and communicate with a professional in detail.

Summary. Hello dear, glad to answer for you. If you fall while riding a bicycle at work, you can't be reimbursed by the rural cooperative medical care.

The following situations are not included in the scope of reimbursement for the new rural cooperative medical care: (1) Outpatient medical expenses of designated hospitals in non-districts (except for outpatient expenses for special diseases), expenses arising from failure to seek medical treatment in accordance with regulations, and self-purchased drugs (2) Expenses required for family planning measures and medical expenses in violation of family planning policies (3) Dental prosthesis, orthodontics, optometry, hearing aids, artificial organs, cosmetology, cosmetic and orthopedic surgery, sexual medical treatment (such as qigong, massage, massage, physiotherapy, magnetic therapy, etc.) As well as all kinds of escort expenses, medical transportation expenses, house visit fees, other miscellaneous expenses during hospitalization, etc.

If I am injured in a car while driving, can NCMS be reimbursed?

Hello, I have seen your question and am sorting out the answer, please wait a while Oh dear, hello, it is a pleasure to answer for you. If you fall while riding a bicycle at work, you can't be reimbursed by the rural cooperative medical care. The following situations are not included in the scope of reimbursement for the new rural cooperative medical care:

1) Outpatient medical expenses of designated hospitals in the non-district (except for outpatient expenses for special diseases), expenses arising from failure to seek medical treatment in accordance with regulations, and self-purchase of drugs (2) Expenses required for family planning measures, medical expenses in violation of family planning policies (3) Dental prosthesis, orthodontics, optometry and glasses, hearing aids, artificial organs, cosmetology, cosmetic surgery and orthopedic surgery, sexual medical treatment (such as qigong, massage, massage, physiotherapy, magnetic therapy, etc.) and all kinds of escort fees, medical transportation expenses, house visit fees, Other incidental expenses and other expenses during hospitalization.

I hope the above is helpful to you If you are satisfied with me, please give me a thumbs up

Injuries sustained while working on the construction site are not reimbursed by NCMS, and injuries sustained while working on the construction site are within the scope of work-related injury insurance, and NCMS is not reimbursed. At the same time, if an employee is injured in an accident or suffers from an occupational disease due to work and needs to suspend work to receive medical treatment for work-related injuries, the original salary and benefits shall remain unchanged during the period of suspension with pay, and shall be paid by the employer on a monthly basis.

If an employee has any of the following circumstances, it shall be found to be a work-related injury

1. Being injured in an accident during working hours and in the workplace due to work reasons;

2. Being injured in an accident while engaging in work-related preparatory or finishing work in the workplace before or after working hours;

3. During working hours and in the workplace, due to violence and other accidental injuries due to the performance of work duties;

4. Suffering from occupational diseases;

5. During the period of going out for work, the person is injured due to work reasons or the whereabouts of the accident are unknown;

6. Being injured in a traffic accident or an accident involving urban rail transit, passenger ferry, or train that is not the person's primary responsibility while commuting to or from work;

7. Other circumstances that shall be recognized as work-related injuries as provided by laws and administrative regulations.

After the work, the boss must give **, which is required by law; In case of accidents on the construction site and other third-party responsible persons, NCMS will not reimburse them.

Legal basis: Regulations on Work-related Injury Insurance

Article 33.

If an employee is injured in an accident or suffers from an occupational disease due to work and needs to suspend work to receive medical treatment for work-related injuries, the original salary and benefits shall remain unchanged during the period of suspension with pay, and shall be paid by the employer on a monthly basis. The period of leave without pay is generally not more than 12 months. If the injury is serious or the circumstances are special, it may be appropriately extended upon confirmation by the labor ability appraisal committee at the districted city level, but the extension shall not exceed 12 months.

After the disability level of the injured employee is assessed, the original benefit shall be suspended and the disability treatment shall be enjoyed in accordance with the relevant provisions of this chapter. If the injured employee still needs to be ** after the expiration of the period of suspension of work with pay, he or she shall continue to enjoy the medical treatment of work-related injury. If an injured employee who is unable to take care of himself needs nursing care during the period of suspension of work with pay, the unit to which he or she belongs shall be responsible.

Summary. Hello, generally speaking, the new type of rural cooperative medical accident injury can be reimbursed.

After being discharged from the hospital, the inpatient with accidental injury should also submit the "Confirmation of the Cause of Accidental Injury" signed and stamped by the household registration village and the hospital medical record. Where valid proofs and records cannot be provided, it will not be accepted. The reimbursement cycle shall be completed within 30 working days from the date of acceptance by the NCMS service window of the District Administrative Service Center, and the reimbursement shall be made after investigation and verification by the inspectors of the NCMS System Business Center; Where the responsibility is borne by a third party, no reimbursement will be made.

If I fall off my own truck and get injured, will the NCMS reimburse me?

Hello, generally speaking, the new type of rural cooperative medical accident injury can be reimbursed. After being discharged from the hospital, the inpatient with accidental injury should also submit the "Confirmation of the Cause of Accidental Injury" signed and stamped by the household registration village and the hospital medical record. Where valid proofs and records cannot be provided, it will not be accepted.

The reimbursement cycle shall be completed within 30 working days from the date of acceptance of the New Lead Cracked Agricultural Cooperative Service Window of the District Administrative Service Center, and the reimbursement shall be made as early as possible after investigation and verification by the inspectors of the New Rural Cooperative Cooperative System Business Center; Where the responsibility is borne by a third party, no reimbursement will be made.

Summary. The proportion of NCMS accident reimbursement is: the starting line of the township and town designated hospitals in the city is 300 yuan, and 60% compensation is paid for more than 300 yuan; The county-level payment line in the city is 900 yuan, and 45% compensation will be made for more than 900 yuan; The starting line of the municipal (prefecture city) is 2,500 yuan, and 40% compensation will be made for more than 2,500 yuan; The minimum payment line above the provincial level (inner) is 4,000 yuan, and the compensation for more than 4,000 yuan is 35%; The minimum payment line above the provincial level (outside) is 9,000 yuan, and the compensation for more than 9,000 yuan is 30%.

If I fall off my own truck and get injured, will the NCMS reimburse me?

Hello! OK. Accidental falls can be reported.

But you have to be hospitalized to report it.

If it is only an outpatient treatment, it cannot be reported.

I was from Wuwei City, Gansu Province, and I fell and injured myself while hauling goods in Ningxia and was hospitalized for a month. And then take the case to our local reimbursement.

Please wait. What's going on.

Hello! Queries take time to type.

Please wait. Gansu people who were hospitalized in Ningxia Province for falling injuries are reported to the cooperative medical treatment in **.

Hello! According to the regulations, when you are hospitalized in other places to bury oranges, you need to first apply to the medical insurance of the participating places, and you can be reimbursed after approval, otherwise you will not be reimbursed.

You bought it in your hometown, right? Did you report it first?

If you really don't have one and have already been discharged from the hospital, then you can take the following documents to the participating place and try it.

Your ID card (or household registration book), NCMS medical certificate, copy of curved accompanying medical records, hospitalization statement (some in the form of rental invoices), list of hospitalization expenses, and referral filing procedures should be reimbursed to the Joint Management Office.

Oh understood, thank you, a few percent of this situation like mine can be reported.

Hope mine can help you! I wish you all the best!

The proportion of reimbursement for accidental injuries in Xinxi Sou Nonghe is as follows: the starting line for township and town designated hospitals in the city is 300 yuan, and 60% compensation is 60% for more than 300 yuan; The county-level payment line in the city is 900 yuan, and 45% compensation will be made for more than 900 yuan; The starting line of the municipal (prefecture city) is 2,500 yuan, and 40% compensation will be made for more than 2,500 yuan; The minimum payment line above the provincial level (inner) is 4,000 yuan, and the compensation for more than 4,000 yuan is 35%; The starting point of the provincial level or above (outside) is 9,000 yuan, and the compensation for more than 9,000 yuan is 30%.

For your cross-reference.