On June 6th, 65438, the National Medical Insurance Bureau, the Ministry of Finance, the National Health and Wellness Commission, and the National Bureau of Disease Control and Prevention issued the Notice on Optimizing the Relevant Policies of Medical Insurance for the Treatment Expenses of Infected Patients in novel coronavirus after the Implementation of Class B Management. According to the work arrangements of the National Medical Insurance Bureau and the Provincial Medical Insurance Bureau, the city optimized and adjusted the policies related to medical insurance for the treatment expenses of infected patients in novel coronavirus, and immediately carried out the system transformation test, and officially realized the policy 65438 at 0: 00 on1October 8.
65438 As of 0: 00 on1October 9, there were 8 1 medical institutions in COVID-19, and 970 people settled accounts. The medical insurance fund expenditure was 104534.62 yuan, and each reimbursement was121.
How to reimburse the hospitalization expenses of COVID-19 patients?
Answer: The hospitalization expenses incurred by insured patients in various medical institutions in our city that conform to the novel coronavirus infection diagnosis and treatment plan formulated by the health department shall be subject to the upfront cost guarantee policy. This policy is based on the patient's admission time and will be implemented until March 3, 20231day.
How to reimburse the local outpatient and emergency expenses in COVID-19?
A: Our city will provide special guarantee for the outpatient and emergency expenses related to novel coronavirus infection and suspected symptoms of insured patients in designated medical institutions at or below the second level in this city. There is no deductible line or capping line, and the reimbursement ratio is not less than 75%, which will be implemented until March 3, 20231.
The insured patients in our city are treated in the outpatient and emergency departments of three-level designated medical institutions, and they are directly settled by brushing the code (card) according to the general outpatient and emergency departments, and do not enjoy the special guarantee of outpatient service in COVID-19.
COVID-19 off-site reimbursement policy?
Answer: If the insured patients in our city are hospitalized outside the city to treat COVID-19, a unified cost guarantee policy will be implemented. This policy is based on the patient's admission time and will be implemented until March 3, 20231day.
The insured patient is in the emergency department in COVID-19, Zhejiang Province, and the insured person directly swipes the code (card) for settlement. Secondary and below designated medical institutions enjoy the special guarantee of outpatient service in COVID-19, and tertiary medical institutions are treated as ordinary outpatient service.
The outpatient and emergency expenses related to COVID-19's treatment in the designated medical institutions at the provincial level and below in our city need to be reimbursed manually at their own expense, and the insured person should obtain reimbursement materials such as outpatient cases, invoices and expense lists from medical institutions.
If the insured patients in our city seek medical treatment in the inter-provincial tertiary medical institutions, they will be paid directly by credit card (card) according to the general outpatient treatment.
How to define which expenses belong to COVID-19?
Answer: According to the novel coronavirus Infection Diagnosis and Treatment Plan (Trial Tenth Edition), it conforms to the novel coronavirus Infection Diagnosis and Treatment Plan formulated by the health department.
Is there any change in medical insurance drugs in COVID-19?
A: In order to adapt to the current epidemic situation and meet the drug demand of patients in COVID-19, the National Medical Insurance Bureau decided to temporarily expand the list of medical insurance drugs until March 3, 20231day. At present, there are 660 drugs used to treat COVID-19's disease (such as fever and cough) in the national medical insurance drug list. On this basis, the temporary payment policy of medical insurance is also applicable to COVID-19 drugs included in the novel coronavirus infection diagnosis and treatment plan. On this basis, according to the regulations of our province, at present, drugs for treating Covid-19 infection and commonly used drugs for family treatment, such as compound paracetamol and amantadine capsules, pediatric paracetamol and ephedrine suspension, Zhenyuan Qingyan powder, Chuanbei Qingfei syrup, compound Houttuynia mixture, compound Houttuynia dropping pills, Fupu Ganmao granules, Huang Zhen capsules, Tianyi Zhike syrup, antiviral dropping pills, compound licorice, Fritillaria thunbergii helium tablets, diquinium chloride, guaifenesin and so on.