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Anonymous users2024-02-12A: Hello. Childhood leukemia, congenital heart disease, end-stage renal disease, cleft lip and palate, breast cancer, cervical cancer, severe mental illness, drug-resistant tuberculosis, AIDS infection, colon cancer, hemophilia, chronic myeloid leukemia, lung cancer, esophageal cancer, gastric cancer, etc. can enjoy the NCMS secondary reimbursement policy.
How much can be reimbursed for the second reimbursement of serious illness, in fact, the current medical insurance for serious illness usually adopts the method of segmented reimbursement. The higher the medical expenses spent, the higher the proportion of payments:
1. If the reimbursement ratio is 0-20,000 yuan (including 20,000 yuan), the reimbursement ratio of serious illness medical insurance is 50%;
2. If the reimbursement ratio is 20,000-40,000 yuan (including 40,000 yuan), the reimbursement ratio of serious illness medical insurance is 60%;
3. If the minimum payment standard for serious illness reimbursement is 40,000-60,000 yuan (including 60,000 yuan), the reimbursement ratio of serious illness medical insurance is 70%;
4. If the reimbursement ratio is more than 60,000 yuan, the reimbursement ratio shall reach 80%;
5. At the same time, the actual payment ratio of the city's urban residents' medical insurance and NCMS serious illness insurance within one year shall not be less than 53%.
Among them, the specific financing standards, reimbursement thresholds and other relevant indicators, the scope of segmented reimbursement, and the segmented reimbursement ratio need to be adjusted year by year according to local medical expenses, the growth rate of financing level, and the level of economic development.
6. If the insured person needs to be transferred to a medical institution outside the district for treatment, after being approved by the municipal medical insurance agency and going through the transfer procedures, the reimbursement ratio of reasonable medical expenses exceeding the starting line for serious illness will be unified to 50%.
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 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.
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Anonymous users2024-02-11Summary. The special cases of secondary reimbursement mainly include the following 15 diseases, such as cervical cancer, breast cancer, childhood leukemia, cleft lip and palate, congenital heart disease, AIDS, severe neuropathy, drug-resistant tuberculosis, gastric cancer, hemophilia, esophageal cancer, lung cancer, and chronic granulosa cell leukemia.
The special cases of secondary reimbursement mainly include the following 15 diseases, such as cervical cancer, breast cancer, childhood leukemia, cleft lip and palate, congenital heart disease, AIDS attack, severe neuropathy, drug-resistant tuberculosis, gastric cancer, hemophilia, esophageal cancer, lung cancer, chronic granulosa cell leukemia, these diseases can enjoy the second reimbursement of NCMS. Sincerely, brother.
Yes pro. Go back to your local social security bureau to apply? Or apply at the hospital where you are treated?
Go back to your local area and apply.
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Anonymous users2024-02-10Summary. Hello! According to the National Unified Critical Illness Insurance Drug Catalogue, the 15 major illnesses that apply for secondary reimbursement include:
Malignancy, liver transplantation, kidney transplantation, autologous hematopoietic stem cell transplantation, leukemia, lymphoma, aplastic anemia, progressive amyotrophic lateral sclerosis, myasthenia gravis, multiple sclerosis, leptospirosis, intracerebral hemorrhage, acute myocardial infarction, coronary artery bypass surgery, and heart valve surgery.
Hello! According to the National Unified Critical Illness Insurance Drug Catalogue, the 15 major diseases that apply for secondary reimbursement include: malignant tumors, liver transplantation, kidney transplantation, autologous hematopoietic stem cell transplantation, leukemia, lymphoma, aplastic anemia, amyotrophic lateral sclerosis of the excitted limb, myasthenic anterior stool, multiple sclerosis, leptospirosis, cerebral hemorrhage, acute myocardial infarction, coronary artery bypass surgery and heart valve surgery.
In addition to the 15 major diseases listed in the National Unified Critical Illness Insurance Drug Catalogue, there are other serious illnesses that medical institutions clearly stipulate that can apply for secondary reimbursement, such as epilepsy, remorse and chronic obstructive pulmonary disease. The regulations of different regions and hospitals generally vary, so please consult the relevant person in charge of the medical institution.
In addition, when applying for the second reimbursement, it is necessary to extract the diagnosis certificate, ** plan, fee list and other relevant materials issued by the hospital, and apply and review in accordance with the regulations of the medical institution. The national unified critical illness insurance system provides a certain degree of financial security for the insured, but it is still necessary to pay attention to prevention and timeliness, and maintain health and blindness. <>
Dear, is there anything else you don't understand? Tell me more about your situation and I'll answer for you. <>
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Anonymous users2024-02-09Summary. Hello, it is a pleasure to serve you. I am a workplace coach Mr. Wei Sen, good at all kinds of knowledge in the workplace, I already understand your problem, I need some time to proceed, it will not take more than 5 minutes, please be patient
Hello, it is a pleasure to serve you. I am a workplace coach Mr. Wei Sen, good at all kinds of knowledge in the workplace, I have understood your problem, I need some time to proceed, it will not take more than 5 minutes, please be patient and let me wait for Qin Zao.
Hello, can I apply for a second reimbursement for cerebral infarction in children?
Childhood leukemia, congenital heart disease, end-stage renal disease, cleft lip and palate, breast cancer, cervical cancer, severe mimetic mental disease, drug-resistant tuberculosis, AIDS infection, colon cancer, hemophilia, chronic granular cavity deficiency leukemia, lung cancer, esophageal cancer, stomach cancer, etc. can enjoy the secondary reimbursement policy for major diseases of NCMS.
Doesn't cerebral infarction count?
OK. There may be differences in the regulations on reimbursement for serious illnesses in various places, so it is generally possible to consult directly with the medical insurance department of the hospital to obtain reference materials for reimbursement. Good.
The second reimbursement of medical insurance can be reimbursed by the parties concerned with their ID cards, social security cards, medical payment documents and other materials to the designated hospitals. According to the provisions of the social insurance system, within one year, the first reimbursement, the starting amount is 1,300 yuan, the second time according to the first 50% of the standard to determine, within one year, the maximum payment limit of medical insurance is 70,000 yuan, the initial reimbursement line for emergency reimbursement is 2,000 yuan, and the retired employee is 1,300 yuan, the starting line. >>>More
Yes, a second reimbursement is possible after the normal reimbursement process. 10,000 yuan is the starting line for the second reimbursement, and the rest 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.
The second reimbursement of medical insurance is the reimbursement of supplementary medical insurance, but it is not compulsory, and not everyone can make a second reimbursement, only those who participate in the New Rural Cooperative Medical System or urban and rural residents' medical insurance are eligible to use it, and they must meet certain conditions to successfully carry out the second reimbursement.
Answer: 9 5 means 9 times 5, which can be written as 9 5, which is no problem, but the landlord's understanding behind has been deviated. >>>More
Secondary reimbursementFirst of all, it should be passedBasic medical insuranceReimbursement is made for items other than those involved. Supplemental medical insurance. >>>More