(1) outpatient compensation
1, 60% of the medical expenses of village clinics and village center clinics are reimbursed, and the prescription drug fee limit for each visit 10 yuan, and the prescription drug fee limit for temporary rehydration of hospital doctors is 50 yuan.
2. 40% reimbursement for medical treatment in the town health center, with the limit of 50 yuan for each medical examination and operation fee and the limit of prescription fee 100 yuan.
3. 30% reimbursement for medical treatment in secondary hospitals, with the limit of each examination fee and operation fee in 50 yuan and the limit of prescription drug fee in 200 yuan.
4. Reimbursement for medical treatment in tertiary hospitals is 20%, with the limit of each examination fee and operation fee in 50 yuan and the limit of prescription drug fee in 200 yuan; Chinese medicine invoice with prescription, each paste limit 1 yuan; The annual compensation limit for rural cooperative medical clinics is 5000 yuan.
(2) Hospitalization compensation:
A. Drug expenses: auxiliary examination: examination expenses such as electrocardiogram, X-ray fluoroscopy, radiography, laboratory tests, physiotherapy, acupuncture, CT, nuclear magnetic resonance, etc., limited to 200 yuan; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan).
B, the elderly over 60 years old are hospitalized in the town health center, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan.
Reimbursement ratio: town health centers reimburse 60%; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%.
Second, the scope of reimbursement for the new rural cooperative medical system:
1, the reimbursement scope of the new rural cooperative medical system is: medical expenses, examination expenses, laboratory expenses, operation expenses, treatment expenses, nursing expenses and other parts that meet the reimbursement scope of urban workers' medical insurance (that is, effective medical expenses).
2, the new rural cooperative medical fund payment qifubiaozhun and the highest payment limit.
3. The hospitalization expenses below the annual deductible of the hospital shall be paid by the individual. If the Qifubiaozhun is reached in the same overall period, the hospitalization expenses incurred by two or more hospitalizations can be reimbursed cumulatively.
4. The hospitalization expenses exceeding Qifubiaozhun shall be calculated in sections and reimbursed cumulatively, with the maximum amount of reimbursement per person per year.
Three, the new rural cooperative medical reimbursement procedures:
After the insured is discharged from the hospital, the hospitalization invoice, discharge record, expense list, referral certificate, a copy of my ID card or the household registration certificate signed or sealed by the patient shall be handed over to the township joint management office, and sent to the municipal agricultural insurance business management center after examination.