NCMS surgery fee reimbursement, can NCMS surgery fee be reimbursed

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!

NCMS surgery costs are reimbursable. The reimbursement scope of the new rural cooperative medical care is: the part of the reimbursement scope (i.e., effective medical expenses) incurred by the participants in the designated hospital for diagnosis and treatment due to illness during the overall planning period, such as drug expenses, examination fees, laboratory fees, surgery fees, ** fees, nursing fees, etc., which meet the reimbursement scope of urban employees' medical insurance.

However, there are four situations in which reimbursement is not granted:

1. Abnormal referral to a higher-level hospital. If ordinary people go to non-designated areas for medical treatment without medical treatment in local hospitals, the medical expenses cannot be reimbursed. There is always a mentality among the common people, the local doctors are not good at medical skills, once they are sick, they go directly to the big cities, and even cross-provincial medical treatment is also very common.

2. Expenses not incurred due to illness. Second: those medical expenses not caused by diseases, such as cosmetic treatments, dental prostheses, glasses, hearing aids, cosmetic surgery, and some **sexual** means (such as acupuncture, massage, massage, physiotherapy, etc.), cannot be reimbursed.

In addition, the expenses for transportation, accommodation, nutrition, meals, etc., incurred in normal medical treatment cannot be reimbursed.

3. Expenses not incurred due to their own reasons. NCMS cannot reimburse non-self-caused injuries that require hospitalization due to physical injuries caused by traffic accidents, work-related injuries, or third-party torts.

The cost of the operation can be reimbursed by NCMS, and the following conditions can be met:

1. The surgical expenses are incurred in the NCMS designated medical institutions, and the reimbursement ratio is determined by the level of the medical institution, usually the higher the level of the medical institution, the lower the reimbursement ratio;

2. The surgery belongs to the first class of disease surgery, not the first type of surgery such as ophthalmic orthopedics;

3. Eligible surgical expenses will be reimbursed according to a certain proportion, and the part that cannot be reimbursed will be paid by the insured;

4. For medical treatment in other places, it is necessary to go through the referral procedures or register for the record in a timely manner.

Legal analysis: NCMS can reimburse surgical expenses, but the following conditions must be met: 1. The surgical fee is generated in the NCMS designated medical institutions, and the reimbursement ratio is related to the level of the hospital2. The type of surgery belongs to the category of disease, not other non-disease surgeries such as vision correction 3. If you do not seek medical treatment in a designated hospital, you need to have referral procedures, registration and filing certificates to be reimbursed.

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

Hello dear, glad to answer for you. NCMS can reimburse surgical expenses, but the following conditions must be met: 1. The surgical fee is generated in the NCMS designated medical institutions, and the reimbursement ratio is related to the level of the hospital2. The type of surgery belongs to the category of disease, not other non-disease surgeries such as vision correction 3. If you do not seek medical treatment in a designated hospital, you need to have referral procedures, registration and filing certificates to be reimbursed. Legal basis:

Social Insurance Law of the People's Republic of China 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. <>

Legal Analysis: The cost of the New Rural Cooperative Medical Surgery is reimbursable. The reimbursement scope of the new rural cooperative medical care is:

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: "Measures for the Administration of New Rural Cooperative Medical Care" Article 9 All agricultural populations residing in the county can participate in cooperative medical care.

<> "Hello friends, NCMS is China's rural medical insurance system, which aims to improve the level of medical security for residents of Nongyuan Manuscript Spring Village. According to the relevant regulations of NCMS, when surgery is required for necessary medical services, the cost of surgery can be reimbursed through NCMS. The exact reimbursement rates and limits may vary from province to province and region to province.

In general, surgical expense reimbursement is subject to the following regulations:1It must be a legal procedure performed in a formal operating room of a medical institution.

2.The surgery must be a medical service within the scope of NCMS. 3.

Relevant documents such as medical certificates and surgical invoices are required for reimbursement. It should be noted that different regions may have different regulations on the reimbursement ratio and limit of surgical expenses, and it is recommended to consult the local NCMS service agency for specific reimbursement details.