1. Medicines in Category A are those that are necessary for clinical treatment, widely used, with proven efficacy, and with a lower price or treatment cost than other medicines in the same category. Participants using "Class A drugs" will be paid according to the payment standards and sharing methods stipulated by the basic medical insurance.
2. Class B medicines are medicines that can be used for clinical treatment, have precise therapeutic effects, and are slightly more expensive or costly than Class A medicines in the same category. The use of "Class B drugs" by insured persons is subject to the payment standards stipulated by the basic medical insurance, with a certain percentage paid by the insured person first, and then according to the sharing method stipulated by the basic medical insurance.
The difference between Class A and Class B medical insurance:
1. Class A medical insurance reimburses for Class A drugs, while Class B medical insurance reimburses for Class B drugs. Class A drugs are nationally standardized, essential for clinical treatment, lower-priced drugs in the same category, and must be sold in pharmacies; Class B drugs are drugs that can provide a choice of clinical treatments for use, with good efficacy and higher prices, which can be sold in pharmacies in addition to ordinary businesses and other places.
2. Generally speaking, Class A drugs can be fully reimbursed, while Class B drugs can be partially reimbursed and partially paid for out-of-pocket, and the reimbursement rates vary according to the relevant policies in each region. For the part of the medical expenses, after higher than the starting standard of basic medical expenses, can only be reimbursed in accordance with the prescribed proportion and standard.
3. The OTC logo for Class A drugs is usually red, while the OTC logo for Class B drugs is green, and Class B drugs are safer.
In summary, Class A drugs and Class B drugs are the classification of drugs artificially made by social medical insurance (referred to as medical insurance, including urban and rural residents' medical insurance, employee medical insurance, etc.).
Legal basis:
Article 28 of the Social Insurance Law of the People's Republic of China
Medical expenses that conform to the basic medical insurance drug catalog, diagnostic and therapeutic items, medical service facility standards, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.
Article 29
The portion of the medical expenses of insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.
The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.