Uraemic patients are reimbursed by medical insurance and the New Rural Cooperative Medical System for outpatient and inpatient dialysis, and 90% of the annual lump sum price is reimbursed by medical insurance, and individuals only need to pay 10%. Since hemodialysis belongs to the category of "special diseases", its settlement cycle is 360 days, and outpatient services are also reimbursed according to the proportion of hospitalization. Calculated according to the rules of urban medical insurance, after the starting line of out-of-pocket expenses of 1,300 yuan, if dialysis in a tertiary hospital costs 1,300 yuan to 30,000 yuan, the reimbursement rate is 85%; for 30,000 to 40,000 yuan, the reimbursement rate is 90%; The reimbursement rate for items above RMB 40,000 is 95%. And if it is a second-level hospital, the reimbursement ratio is 87% for 1,300 yuan to 30,000 yuan, 92% for 30,000 to 40,000 yuan, and 97% for more than 40,000 yuan.
Uraemic patients are reimbursed by medical insurance and the New Rural Cooperative Medical System for outpatient and inpatient dialysis, and 90% of the annual lump sum price is reimbursed by medical insurance, and individuals only need to pay 10%. Since hemodialysis belongs to the category of "special diseases", its settlement cycle is 360 days, and outpatient services are also reimbursed according to the proportion of hospitalization. Calculated according to the rules of urban medical insurance.
General reimbursement rates range from 60% to 90%. Dialysis is a common method of treating kidney failure. Dialysis treatment requires continuous medical support and is expensive. Rural Cooperative Medical Care is a medical insurance system provided to rural residents. Its reimbursement ratios and regulations may vary slightly depending on the region and specific policies. Here are some common regulations for reference: 1. Reimbursement ratio: Generally speaking, rural cooperative medical care can reimburse dialysis costs to a greater extent. The specific ratio depends on the region and policy, generally ranging from 60% to 90%. 2. Reimbursement limit: Different policies have different reimbursement limits. The reimbursement limit for dialysis treatment is generally calculated based on the cost of each treatment. 3. Implementation of a designated hospital system: Rural cooperative medical care sometimes implements a designated hospital system, which only provides reimbursement for dialysis treatment in designated hospitals or designated hospitals. It should be noted that rural cooperative medical policies vary by region and time. It is recommended to consult the local rural cooperative medical institution or the local medical insurance department for specific policies and reimbursement status.
I hope the above content will be helpful to you. If you still have any questions, please consult a professional lawyer.
Legal basis:
Article 2 of the "Social Insurance Law of the People's Republic of China"
The state establishes basic pension insurance, basic medical insurance, and work-related injury insurance , unemployment insurance, maternity insurance and other social insurance systems to protect citizens’ rights to obtain material assistance from the state and society in accordance with the law in the event of old age, illness, work injury, unemployment, childbirth, etc.
Article 26
The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with national regulations.
Article 28
Medical expenses that comply with the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue expenses shall be deducted from the basic medical insurance fund in accordance with national regulations. Pay.
Article 29
The part of the medical expenses of the insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance agency and the medical institution and pharmaceutical business unit .
The social insurance administrative department and the health administrative department should establish a medical expense settlement system for medical treatment in other places to facilitate insured persons to enjoy basic medical insurance benefits.
Article 30
The following medical expenses are not included in the payment scope of the basic medical insurance fund:
(1) Should be paid from the work-related injury insurance fund;< /p>
(2) Should be borne by a third party;
(3) Should be borne by the public health department;
(4) Seeking medical treatment abroad of.
Medical expenses should be borne by a third party in accordance with the law. If the third party fails to pay or the third party cannot be identified, the basic medical insurance fund shall pay first. After the basic medical insurance fund has paid in advance, it has the right to recover compensation from the third party.
Article 31
Based on the needs of management services, social insurance agencies may sign service agreements with medical institutions and pharmaceutical business units to standardize medical service behaviors.
Medical institutions should provide reasonable and necessary medical services to insured persons.