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Anonymous users2024-02-12Rural cooperative medical services cannot be reimbursed for outpatient expenses for medical treatment in other places, and hospitalization expenses must be reimbursed in the place of household registration, but cannot be reimbursed in other places.
As far as reimbursement is concerned, most of the expenses of rural cooperative medical insurance participants are outpatient expenses, which cannot be reimbursed in the place of residence, and they still cannot be reimbursed if they get back to their place of residence.
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Anonymous users2024-02-11Yes, at present, NCMS is mainly divided into the following three situations: 1. Referral for medical treatment: 10% in the province and 15% outside the province, and then reimbursed according to the original proportion.
Reimbursement will be made directly at the original rate. 2. No referral for medical treatment: 10% reimbursement will be reduced according to the original proportion.
Reimbursement is made at 25%. 3. Residence in different places: 10% reduction in the proportion of the original foot of deferred banquet.
If you have a residence certificate, you can repay 45% of the money, and if you don't have a residence certificate, you can reimburse 35%. That is to say, in the worst case, you did not declare it like the local social security agency before being hospitalized in which department, but directly sought medical treatment and hospitalization outside the province, and finally it can be reimbursed.
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Anonymous users2024-02-10Legal Analysis: Reimbursable. If NCMS is hospitalized for surgery in a different place, the medical insurance bureau of the place where the insurance is insured will be reimbursed, and the following information will be provided:
Copy of inpatient medical records (including the first page of medical records, admission records, examination and examination reports, discharge certificates, long-term and temporary medical orders); Two copies of the ID card signed and stamped by the hospital (minors can use the household registration book instead, and the two pages of the head of household and the patient must be copied).
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 rural cooperative medical system. The management measures for the new type of rural cooperative medical care shall be stipulated by ***.
Article 26 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 the provisions of the State.
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.
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Anonymous users2024-02-09Legal analysis: New Rural Cooperation and rural residents serious illness insurance patients seeking medical treatment in designated medical institutions in different places in the province can apply for reimbursement and settlement at the nearest municipal branches and branches of Chinese Life Insurance Company, and the insurance company will electronically scan the relevant settlement materials and transmit the electronic version of the information to the Yingkou New Rural Cooperation Management Office, and the Yingkou New Rural Cooperation Management Agency will timely allocate the compensation to the patient's own resident health card (or bank source Liang digging card) after reviewIn this way, patients can be reimbursed for medical expenses in a timely manner without having to travel back and forth to the participating places.
The basis of the law and the nuclear law: "Opinions on the Integration of the Basic Medical Insurance System for Urban and Rural Residents" Article 4 The medical insurance system for urban and rural residents shall be implemented at the municipal (prefecture) level in principle, and all localities shall focus on the unified treatment policy, management, information system and medical settlement, and steadily promote the overall planning at the municipal (prefecture) level. Do a good job in the transfer and continuation of medical insurance relations and settlement services for medical treatment in other places.
According to the economic development and medical service level of each county (city, district) in the overall planning area, strengthen the hierarchical management, and fully mobilize the enthusiasm and initiative of the county-level and the management agency. Encourage qualified areas to implement provincial-level overall planning.
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Anonymous users2024-02-08Legal Analysis: Rural Cooperative Medical Care Can Be Reimbursed in Other Places. The reimbursement policies are different in different places, and the reimbursement methods are also different, which are divided into two types: local reimbursement and local reimbursement.
New Rural Cooperative Medical Reimbursement Process in Different Places:
1. Bring the patient's ID card, two one-inch color **, and NCMS medical certificate to the county joint management office for referral and filing procedures.
2. Bring the patient's ID card, NCMS medical certificate and referral filing procedures to the referral hospital for medical treatment and go through the NCMS hospitalization procedures.
3. After discharge, the patient should be reimbursed with the patient's ID card (or household registration book), NCMS medical certificate, copy of medical record, hospitalization settlement statement (some in the form of invoice), list of hospitalization expenses, and referral filing procedures.
Legal basis: Article 23 of the Law of the People's Republic of China on Social Insurance Article 23 Employees shall participate in the basic medical insurance for those who do not work, and the employer and the employee shall jointly pay the basic medical insurance premiums in accordance with the provisions of the state. Individually-owned businesses without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexibly employed persons can participate in the basic medical insurance for employees, and the basic medical insurance premiums shall be paid by the individual in accordance with the national regulations of Sengaona.
NCMS. Off-site reimbursement process:
1.The hospital provides patients with invoices, hospitalization details and other materials, retains the original invoices, and advances the reimbursement expenses of NCMS; Regularly transfer the bills to the NCMS agency where the patient is located. >>>More
A second reimbursement can be made after the normal reimbursement process. 10,000 yuan is the starting line for the second reimbursement. The remainder will be reimbursed at 50%. NCMS is only a basic guarantee. If you want to afford to see a doctor, you have to get your own insurance.
Legal analysis: Passports can be obtained in other places. Generally, the passport application is carried out at the place of household registration. >>>More
My father-in-law had a cerebral infarction and went to the hospital, the first day of medicine was 500 yuan, the second day was 2,600 yuan including the examination fee, the third day was 1,800 yuan including the examination fee, the fourth day was 700 yuan, and then 350 yuan per day After that, he stayed in the hospital for 10 days and spent about 8,000 yuan Among them, some imported drugs are deducted, that is, the good drugs that the doctor said are not included in the reimbursement The total reimbursement is less than 2,000 yuan I spent nearly 6,000 yuan I think the policy lies in the implementation The above data speaks for itself It seems that rural medical care shows that the reimbursement ratio is quite high But the actual medical treatment really gives you a headache I don't know if those examination fees are useful Just take a ** do a test Why is it so expensive. Follow-up question: It costs more than 8,000 in total, and the surgery fee alone is 5,000, I want to ask how much the surgery fee can be reimbursed? Thank you!
According to theSocial Insurance Act".Health insurance cardIt can be applied off-site. >>>More