What is the reimbursement ratio for non local medical treatment?

The reimbursement ratio of NCMS is calculated according to the following ratios:

For medical treatment in township health centers, the starting line is 100 yuan, and the reimbursement ratio is 90%; For medical treatment in county-level designated hospitals, the minimum payment line is 200 yuan, and the reimbursement ratio is 82%; For medical treatment in a designated hospital at the municipal level, the starting line is 500 yuan, and the reimbursement ratio is 65%; For medical treatment in provincial designated hospitals, the starting line is 700 yuan, and the reimbursement ratio is 55%; For medical treatment in non-designated hospitals outside the province, the starting line is 1,000 yuan, and the reimbursement ratio is 45%.

The expenses incurred in emergency, outpatient and inpatient treatment in other places can be reimbursed if they are covered by the reimbursement scope of the local NCMS. The reimburser only needs to bring the relevant materials to the Social Security Bureau to apply.

For medical treatment in township health centers, the starting line is 100 yuan, and the reimbursement ratio is 90%; For medical treatment in county-level designated hospitals, the minimum payment line is 200 yuan, and the reimbursement ratio is 82%; For medical treatment in a designated hospital at the municipal level, the starting line is 500 yuan, and the reimbursement ratio is 65%; For medical treatment in provincial designated hospitals, the starting line is 700 yuan, and the reimbursement ratio is 55%; For medical treatment in non-designated hospitals outside the province, the starting line is 1,000 yuan, and the reimbursement ratio is 45%.

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 state regulations.

Article 28 of the Social Insurance Law of the People's Republic of China conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and emergency and rescue medical expenses, in accordance with national regulations from the basic medical insurance **.

Article 24 of the Social Insurance Law of the People's Republic of China provides that the State shall 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 ***.

Legal analysis: The reimbursement ratio of NCMS in different places is generally about 30%-40% for cross-provincial medical treatment, and the reimbursement ratio of Anhui Province is referred to below

1. For hospitalization outside the province and city**, the starting line will be doubled according to the category of medical institutions in the city, and the reimbursement ratio will be reduced by 10%;

2. For hospitalization in hospitals outside the province, the starting line is calculated at 20% of the total hospitalization cost of the grade (the minimum is 2,000 yuan, the maximum is 10,000 yuan), and the reimbursement ratio is 55%. If you are hospitalized in another place without referral**, the reimbursement rate will be reduced by another 10%.

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 insurance agency and the medical institution and the drug business unit.

The reimbursement ratio of NCMS is 50% for general outpatient clinics, and the annual reimbursement limit for each person is 80 yuan. Patients with liver cirrhosis, cerebral thrombosis, sequelae of cerebral hemorrhage, rheumatoid arthritis, and necrosis of the femoral head can be reimbursed 10,000 yuan per year.

If it is a malignant tumor, uremia, hemophilia, patient can be reimbursed 30,000 yuan per year. The minimum reimbursement line for hospitalization at the township level is 200 yuan, and the reimbursement ratio is 85 percent. The minimum reimbursement line for hospitalization in county-level designated medical institutions is 500 yuan, and the reimbursement ratio is 70 percent.

Legal basis: Article 24 of the Social Insurance Law of the People's Republic of China: The State shall 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 25 of the Social Insurance Law of the People's Republic of China: The State shall establish and improve 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 **.

The reimbursement ratio of NCMS is the same as that of the local area, and the reimbursement is carried out according to the same reimbursement standard across the country

Generally speaking, the reimbursement ratio of NCMS is calculated according to the following ratios: for medical treatment in township health centers, the starting line is 100 yuan, and the reimbursement ratio is 90%, for medical treatment in county-level designated hospitals, the starting line is 200 yuan, and the reimbursement ratio is 82%, and for medical treatment in municipal designated hospitals, the minimum payment line is 500 yuan, then the reimbursement ratio is 65%, and for medical treatment in provincial-level designated hospitals, the starting line is 700 yuan, and the reimbursement ratio is 55%; For medical treatment in non-designated hospitals outside the province, the starting line is 1,000 yuan, and the reimbursement ratio is 45%.

NCMS reimbursement scope: Expenses incurred in emergency, outpatient and inpatient treatment in other places can be reimbursed if they are within the reimbursement scope of NCMS. The reimburser only needs to bring the relevant materials to the Social Security Bureau and the Medical Insurance Bureau to apply.

The reimbursement ratio of NCMS is generally about 30%-40% for inter-provincial medical treatment, and the reimbursement ratio in Anhui Province is referred to below:

1. For hospitalization outside the province and city**, the starting line will be doubled according to the category of medical institutions in the city, and the reimbursement ratio will be reduced by 10%;

2. For hospitalization in hospitals outside the province, the starting line is calculated at 20% of the total hospitalization cost of the grade (the minimum is 2,000 yuan, the maximum is 10,000 yuan), and the reimbursement ratio is 55%. If you are hospitalized in another place without referral**, the reimbursement rate will be reduced by another 10%.

Legal analysis: 1. Referred: Through referral, reasonable and legal delay to seek medical treatment in other areas, the reimbursement ratio is 10% in the province and 15% outside the province, according to the original proportion of the local NCMS.

2. No referral (general): no referral is processed, and the hospital outside the province is directly reimbursed, which will be reduced by 10% according to the original ratio.

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 treatment and basic medical insurance for urban residents shall be implemented in accordance with national regulations.

For medical treatment in township health centers, the starting line is 100 yuan, and the reimbursement ratio is 90%; For medical treatment in county-level designated hospitals, the minimum payment line is 200 yuan, and the reimbursement ratio is 82%; For medical treatment in a designated hospital at the municipal level, the starting line is 500 yuan, and the reimbursement ratio is 65%; For medical treatment in provincial designated hospitals, the starting line is 700 yuan, and the reimbursement ratio is 55%; For medical treatment in non-designated hospitals outside the province, the starting line is 1,000 yuan, and the reimbursement ratio is 45%.

Article 25 of the Social Insurance Law The State shall establish and improve 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 and the hungry over the age of 60 from low-income families, and minors will be subsidized by **.

Article 28 of the Social Insurance Law in line with the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards, as well as emergency and rescue medical expenses, in accordance with the provisions of the State from the basic medical insurance **.

For medical treatment in township health centers, the starting line is 100 yuan, and the reimbursement ratio is 90%; For medical treatment in county-level designated hospitals for the blind, the minimum payment line is 200 yuan, and the reimbursement ratio is 82%; For medical treatment in a designated hospital at the municipal level, the starting line is 500 yuan, and the reimbursement ratio is 65%; For medical treatment in provincial designated hospitals, the starting line is 700 yuan, and the reimbursement ratio is 55%; For medical treatment in non-designated hospitals outside the province, the starting line is 1,000 yuan, and the reimbursement ratio is 45%.

Article 28 of the Social Insurance Law.

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 that should be paid by the basic medical insurance** shall be directly settled by the social insurance cover key 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.