Student medical insurance:? College students, colleges and universities, primary and secondary school students, children.
New rural cooperative medical system: all farmers.
2. Medical insurance expenses
Student medical insurance: the basic medical insurance premium for primary and secondary school students consists of two parts: individual contributions and government subsidies. The financing standard is 230 yuan per person per year, in which the government subsidizes 200 yuan and the individual pays 30 yuan; For low-income families and severely disabled students, individual contributions are fully subsidized by the government.
New Rural Cooperative Medical System: Financial departments at all levels subsidize 320 yuan per capita for the new rural cooperative medical system and residents' medical insurance. Among them, the central financial subsidy standard is 120 yuan, and individual farmers and urban residents pay about 90 yuan per person per year.
3. Reimbursement method
Student medical insurance: after the case is closed, the insurance company will transfer the compensation to the school account, and the financial department will send a notice in the bulletin board next to the school mailroom. After seeing the notice, students should bring their ID cards (student ID cards) to the financial department to receive insurance money in time.
New rural cooperative medical system: After the insured person is discharged from the hospital, he/she will submit the hospitalization invoice, discharge record, expense list, referral certificate, copy of his/her ID card or household registration certificate signed or sealed by the patient to the township cooperative management office, and then send it to the municipal agricultural insurance business management center for reimbursement.
4. Repayment ratio
Student medical insurance: outpatient expenses
1, if the medical expenses are insufficient 1000 yuan, 35% will be reimbursed;
2, medical expenses in 1000 yuan (including 1000 yuan) above, less than 5000 yuan, 45% reimbursement;
3, medical expenses in more than 5000 yuan (including 5000 yuan), less than 10000 yuan, 55% reimbursement;
4, medical expenses in 1 ten thousand yuan (including 1 ten thousand yuan) above, reimbursement of 65%.
Hospitalization expenses
1, medical expenses 10000 yuan, medical treatment in tertiary, secondary and primary medical institutions, with reimbursement rates of 55%, 65% and 75% respectively;
2. The medical expenses are above 10000 yuan (including 10000 yuan) and within 20000 yuan, and the reimbursement rates in tertiary, secondary and primary medical institutions are 60%, 70% and 80% respectively;
3, medical expenses in more than 20000 yuan (including 20000 yuan), in the tertiary, secondary and primary medical institutions, the reimbursement rate is 65%, 75% and 85% respectively.
New rural cooperative medical system;
Outpatient expenses
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. Reimbursement of 40% for medical treatment in town health centers, with the limit of examination fee and operation fee for each visit, and the limit of prescription fee 100 yuan.
3, the secondary hospital reimbursement of 30%, each examination fee and operation fee limit 50 yuan, prescription drug fee limit 200 yuan.
4, tertiary hospital reimbursement of 20%, each visit examination fee and operation fee limit 50 yuan, prescription drug fee limit 200 yuan.
5, township cooperative medical outpatient compensation annual limit of 5000 yuan.
Hospitalization expenses
1, drug expense: auxiliary examination: examination expenses such as electrocardiogram, X-ray fluoroscopy, radiography, laboratory tests, physiotherapy, acupuncture, CT and nuclear magnetic resonance. , limited to 200 yuan; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan).
2. The elderly over 60 years old are treated in urban hospitals, and the daily compensation for treatment and nursing expenses is 10 yuan, with the limit of 200 yuan.
3. Reimbursement ratio: town health centers reimburse 60%; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%.
Serious illness compensation
All inpatients who participate in cooperative medical care, whose medical expenses exceed 5,000 yuan at one time or for the whole year, should be compensated by stages, that is, 500 1- 10000 yuan is 65%, and1-18000 yuan is 70%.
Reference source Baidu Encyclopedia-reimbursement scope of new rural cooperative medical system
Reference source Baidu Encyclopedia-New Rural Cooperative Medical System
Reference source Baidu Encyclopedia-Student Medical Insurance
Reference source Baidu Encyclopedia-College Students' Medical Insurance