Proportion of reimbursement for medical insurance of Class A, B and C

The reimbursement rate of Class A drugs is 100%, Class B drugs are 70%-90%, and Class C drugs are 0%.

1, the reimbursement rate of Class A drugs is 100%, that is, the expenses incurred by the insured in using Class A drugs can be paid in full according to the provisions of the basic medical insurance;

2. The reimbursement rate of Class B drugs is 70%-90%, that is, the insured needs to pay 10%-30% of the expenses for using Class B drugs, and the rest can be reimbursed according to the basic medical insurance regulations;

3. The reimbursement rate of Class C drugs is 0%, which means that the expenses of Class C drugs need to be paid by the insured at their own expense and are not included in the reimbursement scope of basic medical insurance.

Classification basis of medical insurance drugs:

1. Efficacy and safety: whether the drug has been clinically verified with clear efficacy and high safety;

2. Economy: the cost-benefit ratio of drugs, that is, the cost comparison under the same curative effect;

3. Indication scope: the types and scope of diseases that drugs are suitable for treatment;

4. Frequency and dosage of drugs: frequency and dosage requirements of drugs in clinical use;

5. Substitutability: whether there are other drugs that can be substituted, and the cost performance of alternative drugs;

6. National policy: adjustment according to national medical insurance policy and drug list.

To sum up, the reimbursement rate of Class A drugs is 100%, Class B drugs are 70%-90%, and Class C drugs are 0%, so the insured needs to pay at his own expense.

Legal basis:

Interim Measures for the Administration of Medication in Basic Medical Insurance

Article 25

The insured person uses "Class A drugs" to pay in accordance with the payment standards and allocation methods stipulated in the basic medical insurance; The use of "Class B drugs" is based on the payment standard stipulated in the basic medical insurance, and the insured pays a certain proportion first, and then pays according to the allocation method stipulated in the basic medical insurance. The proportion of "Class B drugs" prepaid by individuals shall be determined by the provincial or regional medical security administrative department.