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Hello, poor households commit suicide and are hospitalized and incur hospitalization expenses, which can be reimbursed in this case, but like commercial insurance.
Suicidal acts will not be reimbursed.
Costs incurred. The following is the method of reimbursement for poor households:
1. There are several ways to reimburse poor households:
For medical treatment in the county, with a medical certificate and ID card.
Poor households and low-income households.
The certificate of the five insured households and other materials will be directly reimbursed at the "one-stop" settlement window of the designated hospital. Provincial and municipal designated hospitals are hospitalized, and after discharge, bring relevant materials to the county government affairs hall (or handling agency) for reimbursement in accordance with the prescribed procedures.
2. NCMS.
Reimbursement process:
1. For NCMS reimbursement, there are two situations, the first situation is reimbursement in the local hospital, that is, when you are hospitalized, the hospital will automatically give reimbursement and print out the NCMS reimbursement documents.
2. In the reimbursement of the new rural cooperative households, they can go to the serious illness medical insurance office for reimbursement, and the reimbursement window is generally reimbursed in the local county-level government affairs convenience service hall. If you are treated in a hospital in the county**, your medical expenses will be covered by critical illness insurance at the time of discharge.
It has been reimbursed, mainly because NCMS and local insurance companies have been connected to facilitate the reimbursement of medical expenses by patients.
3. What subsidies can poor households receive?
1. Education subsidy: Now the poor households are registered and registered.
Subsidies are available at every stage of education.
2. Medical subsidy: Medical payment has now been implemented in individual and overall accounts, that is to say, medical subsidies will be issued to poor households through overall planning, and a series of preferential medical policies will be given.
3. Subsistence allowance: There are still some farmers in rural areas who have not been lifted out of poverty, and the poor households who have not registered for the card enjoy relatively little subsistence allowance.
4. Housing subsidies are now divided into households in rural areas because of childbirth, and rural households that meet the conditions for household separation can receive economic subsidies for building new houses, and the subsidies given according to different regions are also different, and the state will also give subsidies for price differences if the new houses are accepted.
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Poor households can be reimbursed for suicide hospitalization expenses, so a relatively high reimbursement ratio will be given. It is only right that poor households must strive for self-improvement and strive to survive.
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If the poor household is injured due to its own reasons, it should not be reimbursed in this case.
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NCMS can be reimbursed, but if it is a commercial insurance, it cannot be reimbursed.
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Commercial insurance is not reimbursed.
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There are several main ways to reimburse poor households:
For medical treatment in the county, with the joint treatment certificate, ID card, certificate of poor households, low-income households, five-guarantee households and other materials, directly reimbursement (assistance) at the "one-stop" settlement window of the designated hospital.
Provincial and municipal designated hospitals are hospitalized, and after discharge, bring relevant materials to the county government affairs hall (or handling agency) for reimbursement (assistance) in accordance with the prescribed procedures.
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 **.
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1. After being hospitalized, patients with serious illnesses must send the diagnosis certificate, basic medical insurance diagnosis and treatment manual and other materials to the medical insurance department of the hospital where they live for registration and verification as soon as possible, so as not to affect the reimbursement of inpatient medical expenses.
2. Outpatient medical expenses need to be reimbursed according to the specified time, and there are two opportunities to apply for outpatient reimbursement for 23 diseases such as liver cirrhosis a year, and 7 diseases such as leukemia have one application opportunity at the end of each quarter.
However, medical expenses incurred in one of the following circumstances are not within the scope of overall planning:
1. Seeking medical treatment in non-designated hospitals without approval (except for emergency rescue);
2. Suffering from occupational diseases, work-related injuries or work-related injuries;
3. Injuries caused by traffic accidents;
4. Injury caused by one's own violation of the law;
5. Food poisoning caused by liability accidents;
6. Caused by suicide (except for psychotic episodes);
7. Injuries caused by medical accidents;
8. According to the provisions of the state and the city, the medical expenses shall be borne by themselves.
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Improve the level of basic medical security, and increase the proportion of medical insurance reimbursement for hospitalization expenses of the rural poor by 10%; The level of protection for serious illness insurance will be raised, the threshold for critical illness insurance for the rural poor will be reduced by 50%, and the reimbursement rate within the scope of the hospitalization policy for serious illness will be increased to more than 90%.
Raise the level of medical assistance, include all eligible rural poor people in the scope of medical assistance for serious diseases, and provide poor people with esophageal cancer, stomach cancer, colon cancer, rectal cancer, end-stage renal disease, and childhood leukemia.
For children with congenital heart disease and other 9 major diseases (referred to as 9 major diseases) hospitalized**, the medical expenses of the medical expenses are reimbursed by basic medical insurance, serious illness insurance, various supplementary medical insurance, and commercial insurance, and the out-of-pocket expenses within the scope of the policy are provided according to the proportion of medical assistance.
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1. Reimbursement ratio for critical illnesses.
1. Town risk compensation: All inpatients who participate in rural cooperative medical insurance will be compensated for one-time or annual cumulative reportable medical expenses of more than 5,000 yuan, that is, 65% of 5,001-10,000 yuan and 70% of 10,001-18,000 yuan
2. The annual limit of compensation for town-level cooperative medical inpatient and uremia outpatient hemodialysis, tumor outpatient radiotherapy and chemotherapy is 10,000 yuan.
2. It does not fall within the scope of reimbursement of rural cooperative medical insurance.
1. Self-medical treatment (no designated hospital for medical treatment or no referral form), self-purchased drugs, drugs that cannot be reimbursed by publicly-funded medical regulations, and medical expenses that do not meet the requirements of family planning.
2. Outpatient fees, house call fees, hospitalization fees, food fees, escort fees, nutrition fees, blood transfusion fees, air conditioning and heating fees, ambulance fees, special care fees and other expenses.
3. Medical expenses for car accidents, fights, suicides, alcoholism, industrial accidents and medical accidents.
4. Orthopedics, plastic surgery, dental prosthesis, prosthesis, organ transplantation, roll call surgery fees, consultation fees, etc.
1. Settlement procedures for inpatient and special disease outpatient clinics.
Before the 10th of each month, the designated medical institutions shall report the cost statement, hospitalization statement and relevant information of the discharged patients in the previous month to the medical insurance agency, and the medical insurance agency shall review and approve it as the basis for monthly pre-allocation and year-end accounts. The medical insurance agency pre-allocates the overall expenses of the previous month's inpatient and special disease outpatient clinics** every month.
Insured persons who have been identified as suffering from special diseases shall go to a designated medical institution designated by the labor and social security department to seek medical treatment and purchase medicines, and the medical expenses incurred shall be directly billed and settled immediately.
2. Emergency settlement procedures.
Insured persons due to emergency rescue to the city's non-designated medical institutions and other medical institutions hospitalized**, the medical expenses incurred, first paid by the individual or unit, after the end of the emergency rescue, with the hospital emergency medical records, examination, laboratory reports, invoices, detailed medical charges to the medical insurance agency according to the provisions of the reimbursement procedures.
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There is a difference between poor households and subsistence households, which means that your family lives very poor, but it is not yet possible to eat subsistence allowance, and there are preferential policies for serious illness reimbursement for this type of household, and the medical expenses are 4-50,000 yuan, and you can apply for the second reimbursement of serious illness assistance from the civil affairs department.
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Poor households are reimbursed for hospitalization, just like everyone else.! After being discharged from the hospital, he applied for relief funds from the civil administration.
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All those within the scope of reimbursement stipulated by the state can be reimbursed.
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Summary. Under normal circumstances, the reimbursement rate of hospitalization in the county has reached 90% for poor households. In recent years, there has been a health poverty alleviation policy for poor households, and the cost of participating in the NCMS individual contribution part of the financial subsidy has been fully subsidized.
When you see a doctor, you can enjoy seeing a doctor first, paying later, and settling the bill when you are discharged from the hospital.
Under normal circumstances, the reimbursement rate of hospitalization in the county has reached 90% for poor households. In recent years, there has been a health source sedan poverty alleviation policy for poor households, and the full financial subsidy has been implemented for the expenses of participating in the NCMS individual payment of Datan. When you see a doctor, you can enjoy hail imitation first, pay later, and settle the bill when you are discharged.
Under normal circumstances, the reimbursement rate of hospitalization in the county has reached 90% for poor households. In recent years, there has been a health source sedan poverty alleviation policy for poor households, and the full financial subsidy has been implemented for the expenses of participating in the NCMS individual payment of Datan. When you see a doctor, you can enjoy hail imitation first, pay later, and settle the bill when you are discharged.
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I won't report it all. In the hospital, those who should be reported will be reported, and those who should not be reported may be given a certain reduction in humanistic care.
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Like everyone else.
After being discharged from the hospital, he went to civil affairs.
Apply for relief payments.
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Medical insurance should still be required.
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