(A) the proportion of outpatient reimbursement
1. The reimbursement rate of village clinics (community health service stations) is 25%.
2. The reimbursement rate for outpatient service in township hospitals is 40%.
3. The proportion of outpatient reimbursement in county-level hospitals is 30%.
4. Out-of-county clinics (except specific chronic diseases) and expensive vaccines will not be reimbursed.
(2) Proportion of hospitalization reimbursement
1. The reimbursement rate of township hospitals from 0 to 300 yuan is 40%, and that of 300 yuan and above is 55%.
2. The reimbursement rate of county-level hospitals is less than 30% in 300 yuan, and 40% in 300 yuan and above.
3. The proportion of reimbursement for hospitalization of 0-20 thousand yuan in hospitals outside the county is 20%, and the proportion of reimbursement for hospitalization of more than 20 thousand yuan is 35%.
4 to participate in maternal and child health insurance, according to the proportion of hospitalization reimbursement of medical institutions. If the reimbursement amount is lower than that of 200 yuan, 200 yuan will be compensated.
Pregnant women who have not participated in maternal and child health insurance will not be reimbursed for hospital delivery.
5.65,438+065,438+0 patients with specific chronic diseases such as hypertension (including phase II), heart disease complicated with cardiac insufficiency, diabetes with ineffective diet control, decompensated cirrhosis, radiotherapy and chemotherapy clinic for malignant tumor, chronic bronchitis, psychiatric maintenance treatment, hemodialysis for chronic renal failure, peritoneal dialysis, organ transplant anti-rejection treatment, aplastic anemia, leukemia, etc. Visited the village direct reimbursement point.
According to the reimbursement ratio of village-level outpatient clinics, those who seek medical treatment in township and above medical institutions (referral is required for medical treatment outside the county) shall be reimbursed according to the reimbursement ratio of hospitalization in medical institutions in different places with the Diagnostic Certificate.
6. The top line of the total annual personal compensation is 60,000 yuan.
(three) the scope of reimbursement for participating farmers is the medicine fee, treatment fee, operation fee, inspection fee, prescribed nursing fee and bed fee in the catalogue;
Of course, local policies are different. I suggest you call 12333 for consultation, or go to a third-party insurance platform for consultation, such as Wobao.com.