What are the conditions and requirements for NCMS medical reimbursement?

1) The medical expenses incurred in the outpatient and emergency department are set at a minimum payment standard of 300 yuan (excluding the village clinic), and the part of the medical expenses that exceed 300 yuan within one year shall be paid by the overall coordinator according to a certain proportion, and the remaining part shall be borne by the individual. The balance of the cumulative reimbursement amount of the individual in the current year is less than 300 yuan can be offset against the minimum payment standard of the next year. outpatient and emergency and inpatient (including outpatient serious illness) basic medical reimbursement, with a cumulative annual cap of 105,000 yuan; After the reimbursement of basic medical care, the part of the self-borne expenses exceeding 8,000 yuan (50% of the per capita disposable income of farmers in Pudong New Area in the previous year) or more shall be reduced by 70% of the severe illness poverty alleviation (serious illness insurance), and the annual cumulative cap is 100,000 yuan; Outpatient and emergency, hospitalization, and serious illness poverty alleviation (serious illness insurance), with a total annual maximum limit of 205,000 yuan per person-year.

2) Scope of outpatient serious diseases: radiotherapy for malignant tumors, chemotherapy for malignant tumors, uremia dialysis and severe mental illness.

3) Half of the reimbursement of expenses for medical treatment directly to designated hospitals in districts and cities without referral from community health service centers and cross-designated community medical treatment without review and filing by the town cooperative medical office; In special circumstances, the expenses for treatment in non-designated public hospitals in the city will be reimbursed at a rate of 25%. The above three special circumstances do not enjoy poverty alleviation due to serious illnesses at the same time.

4) If the town-insured population chooses to participate in the co-ordination of cooperative medical outpatient and emergency care, they only enjoy the reimbursement of medical expenses for outpatient and emergency medical expenses of cooperative medical care, and the reimbursement of medical expenses for hospitalization (including outpatient serious illness) is enjoyed. The settlement and reimbursement of outpatient and emergency expenses of the town insurance and participation in the population must exclude the paid expenses such as account payment.

5) Participating in the cooperative medical population can not be repeatedly insured and repeatedly enjoy the basic medical insurance benefits, once the insurance period is found to have urban medical insurance or included in the urban medical insurance during the insurance period (subject to the information of the medical insurance network), the cooperative medical care will be automatically terminated, and the insurance fee will not be refunded. The agricultural population that has been included in the urban medical insurance can participate in the rural cooperative medical care within three months of the current year with the ID card, social security card, household registration booklet, work withdrawal form, village committee certificate, urban insurance sealing certificate and other relevant materials, and can enjoy the seamless connection between urban medical insurance and cooperative medical care.

6) The reimbursement catalogue of local cooperative medical drugs and the reimbursement scope of medical projects shall be implemented in accordance with the provisions of the city's urban employee medical insurance and the implementation rules of the new rural cooperative medical system in the district.

As long as it is a rural household registration, there is a medical certificate for agricultural cooperative medical services. And if you see a doctor in a designated hospital**, you can be reimbursed if the medical expenses exceed 800 yuan.

It will be clearer if you go directly to the hospital and ask, and ask clearly what you are doing.

Legal analysis: All farmers who participate in NCMS can be reimbursed by NCMS as long as they are outpatient or hospitalized in designated medical institutions. The scope of reimbursement mainly includes drug reimbursement, examination fee reimbursement, bed fee reimbursement, etc.

Taking drug reimbursement as an example, Class A and B drugs that are included in the scope of medical insurance reimbursement can be reimbursed.

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

Article 28 In line with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and medical expenses, emergency and rescue medical expenses, in accordance with the provisions of the State from the basic medical insurance **.

Article 29 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 institution and the drug business unit. 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.

The hospitalization cost 30,000 NCMS reimbursement is as follows:

1. The minimum reimbursement line for township-level hospitalization is 200 yuan, and 30,000 yuan will be reimbursed 25,500;

2. The minimum reimbursement line for hospitalization in county-level designated medical institutions is 500 yuan, and 30,000 will reimburse 27,000 yuan;

3. The minimum reimbursement line for hospitalization in municipal designated medical institutions is 700 yuan, and 30,000 will reimburse 16,500 yuan;

4. The minimum payment line for hospitalization reimbursement in provincial designated medical institutions is 1,000 yuan, and 30,000 yuan will be reimbursed 15,000 yuan.

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 of the new type of rural cooperative medical chiropractic treatment shall be governed by the law.

Article 8 of the Social Insurance Law of the People's Republic of China.

Social insurance agencies provide social insurance services and are responsible for social insurance registration, records of individual rights and interests, and payment of social insurance benefits.

Article 25 The State shall establish and improve the basic medical insurance system for urban residents. The basic medical insurance for urban residents implements individual payment and subsidy combined. 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 **.