National medical insurance reimbursement drug list

China's medical insurance reimbursement drug list mainly includes three parts: western medicine, Chinese patent medicine and Chinese herbal pieces. Among them, 1133 varieties of western medicine, 927 varieties of Chinese patent medicine and 47 varieties of ethnic medicines are allowed to pay for the basic medical insurance and industrial injury insurance funds respectively. There are 127 kinds and 1 category of Chinese herbal pieces that are not paid by medical insurance and industrial injury insurance funds. Among them, there are 99 kinds of unilateral non-payment, 28 kinds and 1 category of single and compound non-payment According to the relevant laws and regulations, the basic medical insurance diagnosis and treatment project refers to all kinds of medical technical services projects that meet the following conditions and projects that use instruments, equipment and medical materials for diagnosis and treatment:

(1) clinical diagnosis and treatment projects that are necessary, safe and effective, and have appropriate expenses;

(2) diagnosis and treatment items with charging standards set by the price and health departments;

(3) diagnosis and treatment projects within the scope of designated medical services provided by designated medical institutions for the insured.

the scope of basic medical insurance diagnosis and treatment items is determined by exclusion method, and the scope of diagnosis and treatment items that are not paid by the basic medical insurance fund and those that are not paid by the basic medical insurance fund are mainly those that are not necessary for clinical diagnosis and treatment, whose effects are uncertain or belong to special medical services. The basic medical insurance fund pays part of the cost of diagnosis and treatment projects, mainly some clinical diagnosis and treatment projects that are necessary, effective but expensive.

Legal basis

Scope of National Basic Medical Insurance Diagnosis and Treatment Projects Article 1 Basic medical insurance diagnosis and treatment projects refer to various medical technical services projects and projects that use instruments, equipment and medical materials for diagnosis and treatment that meet the following conditions: (1) Clinical diagnosis and treatment projects that are necessary, safe and effective, and have appropriate expenses; (two) by the price and health departments to develop the charging standard of diagnosis and treatment projects; (three) the diagnosis and treatment projects within the scope of designated medical services provided by designated medical institutions for the insured. The scope of basic medical insurance diagnosis and treatment projects is determined by exclusion method, which respectively stipulates that the basic medical insurance fund will not pay for the expenses and the scope of medical treatment projects that will pay for part of the expenses. The basic medical insurance fund will not pay for the medical treatment projects, mainly those that are not necessary for clinical diagnosis and treatment, whose effects are uncertain or belong to special medical services. The basic medical insurance fund pays part of the cost of diagnosis and treatment projects, mainly some clinical diagnosis and treatment projects that are necessary, effective but expensive.