In 2022. January 20th. Critical illness reimbursement for the second time. I didn t get reimbursed!

Critical illness insurance, also known as the secondary reimbursement of NCMS, aims to share the disease risk of farmers and effectively reduce the burden of medical treatment for patients with serious illnesses in rural areas. At present, in 2016, the compensation work of NCMS serious illness insurance has been fully launched. On July 28, the reporter learned from the Municipal Health and Family Planning Commission that the compensation work of the new rural cooperative cooperative medical system serious illness insurance in 2016 has been fully launched.

The Municipal Health and Family Planning Commission reminded the participating farmers to go through the reimbursement procedures at the serious illness compensation service outlets as soon as possible. In order to focus on improving the level of protection for major illnesses of participating farmers, in May last year, our province adjusted the major illness insurance policy of NCMS, and appropriately increased the proportion of compensation for compliant out-of-pocket medical expenses after NCMS compensation. Jiaozuo City has fully implemented the compensation of the NCMS serious illness insurance, focusing on ensuring the implementation of the compensation work for the participating people.

According to statistics, in 2015, 8,893 people in Jiaozuo City enjoyed the NCMS major disease compensation, with a compensation amount of 10,000 yuan, which effectively alleviated the medical pressure of NCMS patients with serious diseases. According to reports, Jiaozuo City's 2016 NCMS serious illness insurance compensation work has been fully launched. It is worth noting that after the participating farmers pay according to the provisions of the NCMS policy in a participating year, the part of the eligible medical expenses borne by the individual that exceeds the reimbursement threshold of critical illness insurance (the minimum payment standard in 2015 is 10,000 yuan) is included in the reimbursement scope of critical illness insurance.

The specific reimbursement ratio is: 50% of the reimbursement ratio from 10,000 yuan to 50,000 yuan (including 50,000 yuan); 50,000 yuan to 100,000 yuan (including 100,000 yuan) reimbursement ratio 60%; The reimbursement ratio of more than 100,000 yuan is 70%, and the cumulative maximum reimbursement is 300,000 yuan in the year. Since the 2016 NCMS serious illness insurance compensation policy has not yet been introduced, it is now temporarily implemented according to the 2015 policy, and will be adjusted after the new policy is introduced.

Participating farmers are discharged from designated hospitals in our province immediately, and the reimbursement of serious illness insurance is paid by the hospital in advance at the time of discharge, and there is no need to apply again. In the case of non-immediate settlement and reimbursement such as medical treatment outside the province, it is necessary for the individual to pay all the hospitalization expenses, and after being discharged from the hospital, go to the NCMS office of the participating place with relevant materials for reimbursement, and then apply for serious illness reimbursement at the serious illness reimbursement network in the participating area. For farmers who were discharged from the hospital before June 30, 2016, they only need to provide the medical expense settlement certificate (with official seal) issued by the NCMS agency in the participating place for serious illness reimbursement; A copy of the participant's cooperative medical certificate or medical card; A copy of the ID card of the participant; A copy of the participant's bank card or passbook, marked with his or her name, mobile phone number, and bank card account opening name.

In addition to the above information, it is also necessary to provide the medical expense settlement certificate (with official seal) issued by the new rural cooperative system in the participating place for reimbursement of serious illness reimbursement for serious illness reimbursement of participating farmers; A copy of the medical record, including the first page of the medical record, long-term medical orders, temporary medical orders, discharge summary, and a summary list of hospitalization expenses, which need to be stamped with the hospital seal. Extended reading: [Insurance] How to buy, which one is better, teach you to avoid these insurance"pits"

Legal analysis: The conditions for the second reimbursement of serious illness in 2021 are as follows:

1. After the first reimbursement, if the financial burden is still very large, you can apply for the second reimbursement

2. The reimbursement amount must be higher than the local per capita annual income;

3. When applying, you also need to provide the type of disease, medical expenses list and other supporting materials.

The second reimbursement of medical insurance refers to the reimbursement of basic medical insurance, and the part of the amount that needs to be paid by individuals will be re-reported by retirees and military disability subsidies according to the corresponding proportion. The second reimbursement is carried out after the reimbursement of basic medical insurance, so the conditions of basic medical insurance should be met first, for example, employees should participate in basic medical insurance, and the employer should pay work-related injury insurance premiums according to the total wages of employees in the unit according to the rate determined by the social insurance agency, and it does not belong to the exclusion of the reimbursement scope of basic medical insurance. When receiving the second subsidy, please bring the original and photocopy of the second-generation resident ID card of the person enjoying the second subsidy, the original and photocopy of the bank card or passbook of the person enjoying the second subsidy, and if you do not come to apply in person, you must also provide the original and photocopy of the second-generation resident ID card of the agent.

Legal basis: 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.

Summary. The conditions for the second reimbursement of serious illness in 2021 are as follows:

1. After the first reimbursement, if the financial burden is still very large, you can apply for the second reimbursement

2. The reimbursement amount must be higher than the local per capita annual income;

3. When applying, you also need to provide the type of disease, medical expenses list and other supporting materials.

What are the conditions for the second reimbursement of serious illness in 2022.

In 2021, the conditions for the reimbursement of the second outpouring of serious illness are as follows: 1. After the first reimbursement, if the financial burden is still very large, you can apply for the second reimbursement: 2. The reimbursement amount must be higher than the local per capita annual income;3. When applying, you also need to provide the type of disease, medical expenses list and other supporting materials.

The second reimbursement of medical insurance refers to the fact that after the reimbursement of basic medical insurance, the part of the amount that needs to be paid by the individual will be re-reported by the retirees and military disability subsidies according to the corresponding proportion. The second reimbursement is carried out after the reimbursement of basic medical insurance, so the conditions of basic medical insurance should be met first, for example, employees should participate in basic medical insurance for employees, and the employer should pay work-related injury insurance premiums according to the total wages of employees of the unit according to the rate determined by the social remorse insurance agency, and it does not belong to the scope of basic medical insurance reimbursement excluded circumstances. When receiving the second subsidy, please bring the original and photocopy of the second-generation resident ID card of the person enjoying the second subsidy, the original and photocopy of the bank card or passbook of the person who is entitled to the second subsidy, and if you do not come to apply for it in person, you must also provide the original and photocopy of the second-generation resident ID card of the person who is applying for the second subsidy.