The insured can log in to the People's Social APP or the People's Social official website, and then go to official website to inquire about the payment between himself and the new rural cooperative medical system. After logging in to official website, we can see an inquiry channel on the homepage, and then enter the inquiry channel to input our ID card information, so we can inquire about the payment of the new rural cooperative medical system.
Or you can call the customer service number of the local social security agency, and then provide your personal information to the customer service, and the customer service can also help us inquire.
1. How much can the new rural cooperative medical system reimburse?
In different hospitals, the expenses that can be reimbursed are different.
1. If the treatment hospital you choose is a health center in the town, you can generally reimburse 40% of the expenses.
2. If the selected treatment hospital is a local secondary public hospital, medical expenses within 30% can generally be reimbursed.
3. However, if everyone is in a tertiary public hospital, the reimbursement rate will be very low, and only 20% can be reimbursed.
However, if people go to village clinics and health clinics for treatment, they will be able to reimburse more money, about 60%.
Second, the rural cooperative medical inquiry method
1, online query:
Log in to the local new rural cooperative medical network and enter the medical certificate number and name for inquiry.
2. Designated pharmacy:
You can check with the hospital staff when you buy medicine at the designated pharmacy, pay the outpatient expenses and hospitalization expenses, and reimburse the local medical insurance expenses.
3. Designated hospitals:
(1) Show the medical insurance card to prove the identity of the insured when seeking medical treatment in the designated hospital, and inquire when registering.
(2) Query the situation of hospitalization reimbursement.
There are various query methods now. With the popularity of the Internet, online inquiry is a convenient and quick method.
Three, the new rural cooperative medical reimbursement standards
Outpatient compensation
60% of the medical expenses of village clinics and village center clinics are reimbursed, and the prescription drug fee limit for each visit is 10 yuan, and the prescription drug fee limit for temporary rehydration of hospital doctors is 50 yuan.
40% reimbursement for medical treatment in the town health center, with the limit of examination fee and operation fee for each visit, and the limit of prescription drug fee 100 yuan.
The reimbursement for medical treatment in secondary hospitals is 30%, with the limit of each examination fee and operation fee in 50 yuan and the limit of prescription drug fee in 200 yuan.
Third-level hospitals will be reimbursed 20%, with the examination fee and operation fee for each visit limited to 50 yuan and prescription drug fee limited to 200 yuan.
Chinese medicine invoice with prescription, limit 1 yuan.
The annual compensation limit for rural cooperative medical clinics is 5000 yuan.
Hospitalization compensation
Reimbursement scope:
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%.
Serious illness compensation
Compensation from town risk fund: if the medical expenses of inpatients participating in cooperative medical care exceed 5,000 yuan at one time or for the whole year, they should be compensated by stages, that is, 5001-kloc-0/0000 yuan is 65%, and10001-8000 yuan is 75%.
The annual compensation limit for hemodialysis, radiotherapy and chemotherapy in town-level cooperative medical care inpatient and uremia outpatient department is 1. 1 0,000 yuan.
The special diseases reimbursed by the new rural cooperative medical fund are: chemotherapy and radiotherapy for malignant tumors; Hemodialysis and peritoneal dialysis for severe uremia; Anti-rejection therapy after tissue or organ transplantation; Schizophrenia with mental retardation; Systemic lupus erythematosus (one of the complications of heart, lung, kidney, liver and nervous system); Aplastic anemia; Anticoagulation therapy after cardiac surgery. Other special diseases that can be reimbursed shall be subject to local specific policies.
Specific outpatient treatment of special diseases includes necessary supportive treatment and symptomatic treatment of systemic and local reactions during treatment, while general adjuvant treatment is not included in the scope of reimbursement.
Inquiries about the new rural cooperative medical system can be made online or through designated pharmacies and hospitals. I hope the above introduction can help you.
I hope the above content can help you. If in doubt, please consult a professional lawyer.
Legal basis:
People's Republic of China (PRC) social insurance law
essay
The social insurance system adheres to the principles of wide coverage, basic protection, multi-level and sustainability, and the level of social insurance should be compatible with the level of economic and social development.
Article 4
Employers and individuals in People's Republic of China (PRC) pay social insurance premiums according to law, and have the right to inquire about payment records and personal rights records, and require social insurance agencies to provide social insurance consultation and other related services.
Individuals enjoy social insurance benefits according to law and have the right to supervise the payment of their own units.