Can NCMS be reimbursed? NCMS can be reimbursed?

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.

Many people don't know that medical insurance can be reimbursed twice, how can they enjoy the second reimbursement of medical insurance? First, it must be enrolled in the medical insurance for urban and rural residents, or the rural new rural cooperative medical insurance, and purchased separately.

Second: If the annual expenses exceed the specified amount, you can enjoy a second reimbursement. Third:

When applying for a second reimbursement, you need to bring the case book, the voucher of the first reimbursement, and the discharge certificate.

For example, Lao Wang participated in the NCMS, and spent 80,000 yuan on a stroke last year, and the 80,000 NCMS was reimbursed 60%, which can be reimbursed 10,000 yuan, and he has to pay 10,000 yuan out of his own pocket. Last year, the average income of local rural residents in Laowang was 10,000 yuan, and this 10,000 yuan is the starting line. 10,000-10,000 = 10,000, and the second reimbursement for serious illness can also reimburse 50% = 10,000.

In these two cases, will NCMS be reimbursed for the second time?

NCMS can be reimbursed!

Did you know that our social security can be reimbursed twice? Most people only know that they use medical insurance for hospitalization, and the rest of the expenses are paid by themselves, in fact, the remaining expenses can be reimbursed twice, regardless of whether you are a resident medical care.

Did you know that NCMS can be reimbursed twice?

Can medical insurance and NCMS be reimbursed twice?

NCMS can be reimbursed twice. The reimbursement process for NCMS major illnesses is as follows:

1. NCMS insured persons who seek medical treatment in local second-class hospitals or designated hospitals due to serious illness can directly pay the critical illness insurance compensation funds directly at the hospital charging window, and will be automatically reimbursed according to the proportion of NCMS serious illness insurance when discharged, without additional reimbursement procedures;

2. If the reimbursement settlement is handled after discharge, the seriously ill patient needs to bring the diagnosis certificate, ID card, original participation certificate and other materials to the NCMS Settlement Department for review after discharge, and those who meet the conditions can get the NCMS compensation.

What materials are required for the second reimbursement of NCMS.

1. NCMS compensation statement;

2. The original household registration and participation certificate of the resident ID card;

3. Invoice for medical institution expenses, or a copy of the official seal of the original collection and storage unit;

4. A copy of the list of expenses, discharge statement or the official seal of the original receiving unit;

5. Hold a chronic disease certificate provided by a patient with a special chronic disease, or a special chronic disease diagnosis certificate and outpatient medical record issued by a medical institution at or above the second level;

6. Bank remittance by the patient himself or a related person with proof of relationship with the patient.

Legal basisArticle 28 of the Social Insurance Law of the People's Republic of China.

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be paid from the basic medical insurance in accordance with national regulations.

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.

Legal Analysis: Yes, the secondary reimbursement of NCMS refers to the reimbursement of critical illness insurance, and when the NCMS premium is paid every year, a part of it will be used for serious illness reimbursement. There is a time limit for the reimbursement of NCMS serious illness insurance, generally within 6 months after the end of the insured**, and it is necessary to bring the relevant materials to the relevant departments for reimbursement.

If there are special circumstances, you must apply to the relevant departments in advance, otherwise it will be deemed to have given up the reimbursement. But now some hospitals can be reimbursed directly at the hospital's NCMS window when discharged, so that there is no need to run around. There is also a time limit for the first reimbursement of NCMS, and under normal circumstances, NCMS can only reimburse medical expenses incurred during the current year.

The expenses reimbursed by NCMS for the second time do not include the part that has been reimbursed before, so after the normal reimbursement of NCMS, 55% of the out-of-pocket expenses can be reimbursed if the out-of-pocket expenses are between 10,000 yuan and 600,000 yuan. If the out-of-pocket expenses are between 10-150,000 yuan, the amount will be reimbursed 65%, and if the out-of-pocket expenses are more than 150,000 yuan, 70% will 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 Tanla insurance agency and the medical institutions and drug business units. 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.

Requirements: Hospitalization certificate, special diseases.

The conditions for the second reimbursement of NCMS are as follows:

1. Participated in the New Rural Cooperative Medical System of that year.

2. In that year, there was a large balance of NCMS, and the local government issued a secondary reporting policy, and the document was generally issued at the beginning of the second year.

3. If the medical expenses meet the minimum payment standard, (the specific amount depends on the requirements of local documents), the compliant medical expenses borne by individuals above the minimum payment standard will generally be reimbursed in different grades.

4. Theoretically, it must be a one-time medical expense to reach the minimum payment line, and multiple medical treatments cannot be combined into one time.

Congenital heart disease, childhood leukemia, cervical cancer, breast cancer, cleft lip and palate, end-stage renal disease, severe mental illness, tuberculosis, AIDS, colon cancer, gastric cancer, hemophilia, chronic myeloid leukemia, more than 20 kinds of diseases, friends who have participated in NCMS can enjoy the second reimbursement policy.

"Second reimbursement" means that residents of urban residents' medical insurance or NCMS can apply for serious illness insurance again in addition to normal reimbursement if they have high expenses for medical treatment last year, and there is no upper limit.

Reimbursement conditions: Expenses incurred in designated medical institutions of basic medical insurance that meet the reimbursement scope of basic medical insurance for urban and rural residents, after reimbursement by basic medical insurance, urban residents within the scope of the basic medical insurance policy pay more than the annual per capita disposable income of urban residents in the previous year, and rural residents within the scope of the basic medical insurance policy pay more than the annual per capita net income of rural residents in the previous year (hereinafter referred to as the "minimum amount"), included in the scope of payment of urban and rural residents' serious illness insurance, carried out" Secondary Reimbursement".

Reimbursement amount: calculated in stages and paid cumulatively". Expenses incurred in designated medical institutions of basic medical insurance above the "minimum payment amount" and within 50,000 yuan (inclusive) shall be reimbursed by 50% of the serious illness insurance funds; Expenses exceeding 50,000 yuan will be reimbursed by 60% of the critical illness insurance funds.

Heart] [prayer].

In these two cases, will NCMS be reimbursed for the second time?

You need to go to the civil affairs department to apply for a second reimbursement for serious illness assistance.

1. NCMS reimbursement process:

1. Information required for reimbursement:

Outpatient reimbursement materials: outpatient invoices, cooperative medical certificates (or medical records).

Hospitalization reimbursement materials: hospitalization invoices, cooperative medical certificates (or medical records), detailed list of expenses, discharge summary, and other relevant certificates.

2. Outpatient special disease reimbursement materials: outpatient invoices, special disease cooperative medical certificates.

Handling special disease carrying materials: special disease outpatient ** proposal, cooperative medical certificate record, medical record, relevant laboratory report, ** two.

2. Reimbursement process:

After the insured household prepares the required materials for reimbursement, it will be handed over to the village (community) cooperative medical liaison, who will review and report to the town cooperative medical liaison, and the town liaison will send it to the district agricultural office settlement and reimbursement center for reimbursement. Guidelines for the reimbursement of new rural cooperative medical care.

Direct reimbursement by the hospital: When hospitalization due to illness goes through the hospitalization procedures, a new type of rural cooperative medical certificate will be issued to the hospital to directly participate in the reimbursement.

Extended Materials. The new type of rural cooperative medical care (hereinafter referred to as "NCMS") refers to the system of mutual medical assistance and mutual aid for farmers that is organized, guided and supported, voluntarily participated by farmers, raised by individuals, collectives and multiple parties, and mainly based on the overall planning of serious diseases. It raises funds in the form of individual payment, collective support and funding.

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.

Can medical insurance and NCMS be reimbursed twice?

Did you know that NCMS can be reimbursed twice?

NCMS can be reimbursed!

NCMS has a second reimbursement, but only after participating in the normal NCMS reimbursement and the remaining out-of-pocket expenses exceed the annual per capita level of rural residents in the city in the previous year, the excess part can be reimbursed for the second reimbursement. You can apply for a second reimbursement at the local NCMS reimbursement point with your ID card, medical records, medical certificates, drug lists, bank cards, and reimbursement slips.