The difference between medical insurance category A and category B

The scope of payment by the basic medical insurance fund includes basic medicines, basic diagnostic and therapeutic items, medical service facilities as well as emergency and rescue medical expenses required by the insured for treatment.

I. Difference between Class A and Class B

The medicines in the Basic Medical Insurance Drug List are divided into "Class A List" and "Class B List".

1. The medicines in the "Class A List" are those that are clinically necessary, widely used, have good therapeutic efficacy, and are low-priced among similar medicines.

2. Medicines in the "Category B List" are those that are available for clinical use, have good therapeutic effects, and are slightly more expensive than those in the "Category A List". Expenses incurred by basic medical insurance participants for the use of "Class A List" drugs are paid in accordance with the provisions of basic medical insurance. Expenses incurred for the use of drugs in the "Class B list" will be paid by the insured person as a percentage of his/her own expenses and then in accordance with the provisions of the basic medical insurance.

Second, medical insurance reimbursement conditions

These costs can only be covered by the integrated fund if they are included in the scope of the basic medical insurance drug list, diagnostic and treatment item list, and in line with the standard of medical service facilities.

Basic medical insurance to pay part of the cost of diagnostic and treatment items within the catalog, first by the insured person in accordance with the prescribed proportion of out-of-pocket payments, and then pay according to the provisions of the basic medical insurance.

Basic medical insurance medical service facilities refer to the living service facilities provided by the designated medical institutions, which are necessary for the participants in the process of receiving diagnosis, treatment and nursing care, and their costs mainly include inpatient hospital bed fees and outpatient (emergency) observation bed fees. The basic medical insurance fund will not pay for the daily necessities, hospital transportation supplies and water and electricity costs that have been included in the inpatient bed fee or outpatient (emergency) observation bed fee, and the designated medical institution shall not charge the insured person separately.