Residents' medical insurance can generally reimburse outpatient expenses. When the parties go out for medical treatment or treatment, they should show their medical insurance cards to the designated hospitals to prove their insured status. At the time of checkout, the part paid by the individual is paid by himself with medical insurance card or cash, and the part reimbursed by medical insurance is settled by medical insurance and hospital, and the individual does not need to pay first and then reimburse.
Proportion of outpatient reimbursement for rural medical insurance:
(1) The reimbursement rate for village clinics and village center clinics is 60%, and the prescription is 10 yuan, and the prescription for temporary fluid replacement is 50 yuan.
(2) Reimbursement for medical treatment in town health centers is 40%. The limit of examination fee and operation fee for each visit is 50 yuan, and the limit of prescription drug fee is 100 yuan.
(3) The reimbursement for medical treatment in secondary hospitals is 30%, and the limit of each examination fee and operation fee is 50 yuan, and the limit of prescription drug fee is 200 yuan.
(4) 20% reimbursement for medical treatment in tertiary hospitals, with the limit of each examination fee and operation fee in 50 yuan and the limit of prescription drug fee in 200 yuan.
(5) The prescription attached to the invoice of traditional Chinese medicine is limited to 1 yuan.
(6) The annual compensation limit for rural cooperative medical clinics is 5,000 yuan.
I hope the above content can help you. Please consult a professional lawyer if you have any other questions.
Legal basis: Article 8 of People's Republic of China (PRC) Social Insurance Law.
The medical expenses incurred by the insured in the agreed medical institutions that meet the basic medical insurance drug list, diagnosis and treatment items and medical service facilities standards shall be paid from the basic medical insurance fund in accordance with state regulations.
If the insured really needs emergency treatment and rescue, he can seek medical treatment in a non-agreement medical institution;
The scope of drugs that must be used for rescue can be appropriately relaxed.
The specific measures for the administration of emergency and rescue medical services of the insured shall be formulated by the overall planning area according to the local actual situation.