Can NCMS medical insurance be reimbursed in outpatient clinics?

1.Outpatient reimbursement: Be sure to visit a designated hospital. However, the insurance ratio of hospitals at all levels is different, and there is an upper limit for reimbursement every year, and the reimbursement ratio will be different due to the slight differences in medical insurance policies in various places;

2.Hospitalization reimbursement: According to the level of the hospital, the reimbursement ratio varies greatly. Generally, the reimbursement ratio of township-level hospitals is 80%-90%; 70%-80% in county and municipal hospitals; The proportion of provincial or inter-provincial reimbursement will be lower. Again, deductible.

It will also increase with the increase of the hospital level, from the township, county, city, and provincial level, and the deductible varies in different regions;

3.Critical illness reimbursement: Critical illness.

There will generally be a deductible for reimbursement, and the deductible will be different according to the local standard of living, and the reimbursement ratio will also be adjusted according to the grade of the ** expense.

Summary. Hello, according to the medical insurance policy, NCMS outpatient clinics can be reimbursed, in addition to drug reimbursement, as long as it is the purchase of drugs that support reimbursement, it can generally be reimbursed, and the reimbursement scope mainly includes drug reimbursement, examination fee reimbursement, bed fee reimbursement, etc.

Farmers who participate in NCMS can be reimbursed for outpatient and inpatient visits in designated medical institutions. However, it should be noted that the outpatient clinic in the township private hospital is generally not in the scope of reimbursement, and the hospitalization should be possible, the private hospital in the township is generally the county's NCMS designated unit, but the outpatient treatment in addition to the reimbursement of chronic diseases, the others are used in the outpatient co-ordination**, if your county does not implement the outpatient card policy, only in the village, the township clinic or the health center outpatient can be reimbursed!

Can NCMS medical insurance be reimbursed in outpatient clinics?

Hello, according to the medical insurance policy, NCMS outpatient clinics can be reimbursed, in addition to drug reimbursement, as long as it is the purchase of drugs that support reimbursement, it can generally be reimbursed, and the reimbursement scope mainly includes drug reimbursement, examination fee reimbursement, bed fee reimbursement, etc.

Farmers who participate in NCMS can be reimbursed for outpatient and inpatient visits in designated medical institutions. However, it should be noted that the outpatient clinic in the township private hospital is generally not in the scope of reimbursement, and the hospitalization should be possible, the private hospital in the township is generally the county's NCMS designated unit, but the outpatient treatment in addition to the reimbursement of chronic diseases, the others are used in the outpatient co-ordination**, if your county does not implement the outpatient card policy, only in the village, the township clinic or the health center outpatient can be reimbursed!

NCMS can reimburse outpatient clinics, however, NCMS outpatient clinics can only reimburse the prescribed expenses and proportions.

First, we first need to understand what is the new type of rural cooperative medical care

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.

In October 2002, China clearly proposed that all levels should actively guide farmers to establish a new type of rural cooperative medical system based on the overall planning of serious diseases. In 2009, an important strategic plan was made to deepen the reform of the medical and health system, and the status of the new rural cooperation as the basic medical security system in rural areas was established. On January 29, 2015, the National Health and Family Planning Commission and the Ministry of Finance issued a notice on doing a good job in the 2015 new rural cooperative medical work, proposing that the per capita subsidy standard for the new rural cooperative medical system at all levels will be increased by 60 yuan on the basis of 2014 to 380 yuan.

In 2017, the per capita subsidy standard for NCMS at all levels was increased by 30 yuan on the basis of 2016 to 450 yuan, of which: ** The new part of the government will be subsidized according to the proportion of 80% in the western region and 60% in the central region, and a certain proportion of subsidies will be provided to each province in the eastern region. The standard of individual farmers' payment will be increased by 30 yuan on the basis of Souzhou in 2016, and in principle, the national average will reach about 180 yuan.

Explore the establishment of a stable and sustainable financing mechanism commensurate with the level of economic and social development and the affordability of all parties.

Among them, we need to pay attention to the fact that in a person's life, disease is inevitable, and it is difficult for people to carry out the time, type and degree of disease occurrence, so participating in medical insurance can effectively share the risk of disease and improve the medical security capacity of the whole society.

2. The medical expenses that can be reimbursed by NCMS include:

1.Inpatient medical expenses within the regulations;

2.Outpatient medical expenses within the regulations, including outpatient clinics for special diseases, general outpatient clinics, statutory accident injury outpatient clinics for college and secondary school students, ordinary students and minor insured persons;

3.Subsidies for maternity medical expenses (including prenatal examination fees), etc.

The reimbursement ratio of NCMS outpatient clinics refers to the leakage (taking Changsha as an example):

1.The village clinic can be reimbursed 70% of the only knowledge, and 30% of the individual is responsible;

2.Township health centers and community health service centers can be reimbursed 60%, and individuals are responsible for 40%;

3.70% of the reimbursement can be made for college hospitals and infirmaries, and 30% of the insured college and secondary school students and ordinary students who are insured by the school as a unit.

The maximum reimbursement limit for outpatient medical expenses incurred within the scope of medical insurance in a billing year is 800

In addition to reimbursement of outpatient expenses, NCMS can also reimburse inpatient medical expenses, maternity medical expenses and serious illness medical treatment, while the reimbursement of NCMS in different regions is different, and the specific local laws shall prevail.

NCMS (New Rural Cooperative Medical Care) is a system that provides basic medical security for farmers, aiming to solve the problem of difficult and expensive medical treatment in rural areas. So, can NCMS outpatient clinics be reimbursed? The answer is yes.

According to the relevant national policies, the medical expenses covered by NCMS include hospitalization expenses and outpatient expenses, so NCMS outpatient services can be reimbursed. Specifically, when using medical services, farmers need to provide valid medical certificates and medical invoices, and submit them to the village committee or township health center for review and reimbursement of medical expenses. The reimbursement scope of NCMS outpatient clinics includes the following aspects:

1.Medical expenses: including ** fee, consultation fee, examination fee, laboratory fee, surgery fee, ** closed fee, ** fee, etc.

2.Drug costs: including Western medicine, Chinese medicine and Chinese medicine decoction pieces, etc.

3.Material cost: including surgical materials, examination materials, etc.

4.Examination** Fee: such as radiation, ultrasound, CT, etc.

It should be noted that the proportion and amount of reimbursement for NCMS outpatient clinics vary according to the policies of different regions, and farmers need to understand the relevant local policies in order to make the reimbursement correctly. In short, NCMS outpatient clinics can be reimbursed, which is an important medical security system for farmers, which can help them get better medical services.

If the insured person is outpatient in a designated medical institution, NCMS can be reimbursed; If it is an outpatient clinic in a township private hospital, it generally cannot be reimbursed; The relevant medical expenses shall be paid by the person concerned.

Article 26 of the Social Insurance Law of the People's Republic of China 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 of the Social Insurance Law of the People's Republic of China shall be paid from the basic medical insurance in accordance with the provisions of the basic medical insurance for the blind in accordance with the drug list, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses. Article 29 of the Social Insurance Law of the People's Republic of China 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 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.