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NCMS. Discharge is billed directly, and now the NCMS and urban residents have medical insurance.
The merger is collectively referred to as medical insurance for urban and rural residents.
The reimbursement process of resident medical insurance is the same as that of employee medical insurance, that is, if the insured person receives medical treatment in a designated medical institution during the normal treatment period after participating in the resident medical insurance, he or she will be swiped with the social security card for instant settlement. Among them, the medical expenses that meet the scope of the basic medical insurance drug list, diagnosis and treatment items and medical service facilities shall be paid from the basic medical insurance ** in accordance with the regulations.
A new type of rural cooperative medical care.
Referred to as NCMS, it has now been merged with urban residents' medical insurance, collectively referred to as urban and rural residents' medical insurance. To put it simply, there are five types of social insurance, while NCMS is just medical insurance.
The NCMS is to solve the current situation that rural people see a doctor is expensive and rare, and it is also the first time in the history of our country to solve the basic medical and health problems of farmers to carry out large-scale investment.
The payment method of NCMS is to start paying the next year's fee in the fourth quarter of each year, and now it is time to pay the NCMS premium in 2023. That is, from September 1 to December 31, 2022.
The bad news: the payment has risen again this year.
The standard for payment in 2023 has been raised again. According to the official standard, it is 350 yuan per person, which is 30 yuan per person compared with this year's NCMS standard. Therefore, for farmers, the cost of NCMS may be a "bad news"!
On July 8, the three major national departments issued the "Notice on Doing a Good Job in Basic Medical Security for Urban and Rural Residents in 2022", which clearly stipulates that the "Notice" requires a reasonable increase in the financing standard of residents' medical insurance, and the per capita financing standard reaches 960 yuan, of which the financial subsidy standard per capita increases by 30 yuan to no less than 610 yuan per person per year; Correspondingly, the individual payment standard will be increased by 30 yuan to 350 yuan per person per year. Continue from Resident Medicare**.
A certain amount will be allocated for serious illness insurance for urban and rural residents.
funds, individuals can enjoy critical illness insurance benefits without additional contributions, reducing the burden of high medical expenses.
China's new agricultural cooperative system began in 2003, the standard of payment in the first year is 10 yuan per person, and now it will be 350 yuan per person next year, and the range has reached 35 times. A rural family, both old and young, basically belongs to a family of six, and needs to pay 2,100 yuan for the NCMS in 2022. That's a lot of money.
Don't cut off your payment.
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The NCMS card is a medical insurance card, and the cardholder can directly enjoy the medical insurance reimbursement treatment when he or she settles the medical treatment by issuing the card.
In other words, direct use is reimbursement.
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Under normal circumstances, this NCMS card can be reimbursed after direct use, but it will not be reimbursed immediately because it needs to be reviewed.
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Yes, I think so. You can bring your own ID. Go to your local social security office or ** lobby to do another one.
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To go to the hospital for hospitalization, you also need to register for your NCMS medical insurance, so that you can be reimbursed directly when you are discharged, and if you go to other places for treatment, you also need to issue a referral certificate in advance.
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Tolerable. You can get your ID. Go to your local Social Security office or ** office to apply for another one.
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Tolerable. You can bring your own ID. Go to your local social security office or ** lobby to apply for another.
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It's okay to bring your own ID. Go to your local social security bureau or ** office to get another one.
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Endure. You can have your own ID. Go to your local Social Security office or ** office to apply for the next one.
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Yes, NCMS can be reimbursed with only a personal ID card. When visiting a designated hospital, the insured person needs to inform the NCMS of the hospital that he has not received the card and show his ID card, and the staff will use the ID card to read the patient's personal information, so that the expenses can be settled and reimbursed immediately.
Reimbursement Scope of New Rural Cooperative Medical Care:
During the overall planning period, the participants are hospitalized in designated hospitals due to illness and the drug costs, examination fees, laboratory fees, surgery fees, ** fees, nursing fees and other parts that meet the reimbursement scope of urban employee medical insurance (i.e., effective medical expenses).
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-district areas (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 glasses, hearing aids, artificial organs, cosmetology, cosmetic surgery and orthopedic surgery, sexual medical treatment (such as qigong, massage, massage, physiotherapy, magnetic therapy, etc.) and various escort fees, medical transportation expenses, home visit fees, other miscellaneous expenses during hospitalization, etc.;
4. In the case of 30,000 liability, the medical contract expenses arising from personal injury shall be borne by the third party responsible in accordance with the law, such as traffic accidents, medical accidents, work-related injuries, etc.;
5. Medical expenses arising from injuries caused by suicide, self-harm, drug use, drug abuse, fights and brawls, as well as intentional acts of their family members;
6. Medical expenses of Youwang during the period of going abroad to Hong Kong, Macao and Taiwan;
7. The medical insurance system for urban employees regulates the covenants and items that are not reimbursed.
Legal basis: Article 25 of the Social Insurance Law of the People's Republic of China The State establishes and improves 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 **.
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Yes, reimbursement is possible with a personal ID card. When visiting a designated hospital, the insured person needs to inform the hospital that he or she has not received the card and show his ID card, and the staff will use the ID card to read the patient's personal information, so that the expenses can be settled and reimbursed immediately.
Article 30 of the Social Insurance Law The following medical expenses are not included in the scope of payment of basic medical insurance**: (1) shall be paid from work-related injury insurance**; (2) It shall be borne by a third party; (3) It shall be borne by public health; (4) Seeking medical treatment outside the country. Medical expenses shall be reported to 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.
After the basic medical insurance** is paid in advance, it has the right to recover from a third party.
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NCMS can be reimbursed only with a personal ID card. When visiting the designated Bulianghao Hospital, the insured person needs to inform the NCMS of the hospital that he has not received the card yet, and show his ID card, and the staff will use the ID card to read the patient's personal information, so that the expenses can be settled and reimbursed immediately. Reimbursement Scope of New Rural Cooperative Medical Care:
During the overall planning period, the drug expenses, examination fees, laboratory fees, surgery fees, ** fees, nursing expenses and other parts that meet the reimbursement scope of urban employee medical insurance (i.e., effective medical expenses) incurred by the participants in the designated hospital due to illness are incurred.
Legal basis: Article 1 of the "2020 New Provisions on Rural Cooperative Medical Care" All rural residents with rural household registration in this city (including migrant workers, business farmers and landless farmers in urban lead areas) can participate in the new rural cooperative medical care on a household basis.
Article 2 of the 2020 New Provisions on Rural Cooperative Medical Care Farmers who have lived in our city for a long time but have not yet gone through the procedures for the transfer of household registration and migrant workers with rural household registration who do not have stable labor relations may participate in the NCMS at their place of residence (work site).
Article 3 of the 2020 New Provisions on Rural Cooperative Medical Care encourages parents to pay in advance for newborns who are expected to be born in the participating year, and the infants enjoy the same compensation policy as general participants in the participating year. Newborns born on February 29, 2018 who miss the payment deadline can be included in the scope of NCMS compensation for the current year with the participating mothers from the date of birth, but the compensation for the medical expenses incurred by the infant's hospitalization must be calculated together with the mother until the maximum limit for one person in the local area is reached.
Article 4 of the 2020 New Provisions on Rural Cooperative Medical Care subsidizes the participation of people in need in rural areas, such as rural five-guarantee households, low-income households, special care for the poor, and severely disabled people, to ensure that the rural people in need are included in the scope of the new rural cooperative medical system.
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.
Requirements: Hospitalization certificate, special diseases. >>>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!
First of all, judging from the current reimbursement situation of NCMS, giving birth to a child is reimbursed, but there are natural births and cesarean sections, there are reimbursement ratios of different medical institutions, and there are unplanned births and planned births, so this problem is not very good. >>>More
You need to go through the referral registration procedures at the local county cooperative medical office in Changle, and then go to Qilu Hospital for **, and after being discharged, bring the participation certificate, ID card, household registration book, diagnosis certificate, discharge certificate, settlement statement, expense list, case copy and referral certificate to the Changle first cooperative medical office for reimbursement.