Proportion of reimbursement for new rural cooperative medical insurance in Hunan Province

Reimbursement ratio of new rural cooperative medical insurance:

The outpatient expenses of the participants shall be reimbursed according to the following regulations: 25% in the designated village clinics and town and street health centers of the cooperative medical system, and the maximum outpatient compensation per person per year 150 yuan. Outpatient medical expenses of designated medical institutions above Grade II (inclusive) shall not be reimbursed.

Hospitalization reimbursement shall be handled in accordance with the following provisions:

(1) pay line. First-class designated medical institutions 100 yuan, medical expenses below the deductible line will not be reimbursed. Two or three designated medical institutions do not set deductible.

(2) Reimbursement ratio. The first-class designated medical institutions do not implement segmented compensation for hospitalization, and the proportion of medical expenses compensation within the scope of reimbursement is 65%. Second, third-level designated medical institutions will compensate by stages, which are divided into three sections (less than 5000 yuan (including 5000 yuan), more than 5000 yuan to 10000 yuan (including 10000 yuan) and more than 10000 yuan (the same below).

Extended data:

Urban residents hospitalized for more than two times in a settlement year, starting from the second hospitalization, no longer charge Qifubiaozhun fees. Transfer or hospitalization for more than two times, make up the difference of Qifubiaozhun in accordance with the provisions of transfer or hospitalization again.

1, students, children

In a settlement year, medical expenses less than 6,543,800 yuan+0.8 million yuan that meet the scope of reimbursement occurred. The threshold of tertiary hospitals is 650 yuan, with a reimbursement rate of 50% and an upper limit of 2,000 yuan; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.

2. At least 70 years old and above.

In a settlement year, medical expenses below 654.38+10,000 yuan that meet the scope of reimbursement occur. The threshold of tertiary hospitals is 650 yuan, with a reimbursement rate of 50% and an upper limit of 2,000 yuan; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.

3. Other urban residents

In a settlement year, medical expenses below 654.38+10,000 yuan that meet the scope of reimbursement occur. The threshold for tertiary hospitals is 659 yuan, the reimbursement rate is 50%, and the upper limit is 2,000 yuan. The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 60%. ?

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