Category A drugs are reimbursed 100% according to the reimbursement rate.
The reimbursement rate for Class B drugs varies according to local policies and specific drugs. It is important to note that the portion that goes into the basic medical fee is reimbursed according to the prescribed rate and standard only after it is higher than the starting standard of the basic medical fee.
The otc logo for category A is marked in red, and the otc logo for category B is marked in green, and both category A and B drugs are covered by medical insurance.
The management of non-prescription drugs in category A must be sold in pharmacies, category B in addition to sales in pharmacies, but also in ordinary commercial enterprises and other places to sell, but it must be examined by the local local municipal drug supervision and management department, approval, registration, and meet the conditions of the issuance of category B non-prescription drugs permitted to sell the mark.
And the medical insurance catalog is based on the national basic drug catalog screening, category A and B is in accordance with the efficacy of the price ratio to determine, that is to say, the efficacy of the exact and low cost are included in the category A, do not need to pay out-of-pocket.
And the B basic out-of-pocket ratio, specifically by the local set; there are local labor and social security bureau of medical insurance B varieties have the right to adjust, transfer in and out of the total number of varieties of control in the varieties of the number of 15%, and all local do not have the right to medical insurance A varieties to do adjustments.
Expanded
National health insurance reimbursement scope:
1, basic health insurance drug reimbursement
Included in the scope of the basic health insurance coverage of the Class A and Class B drugs can be reimbursed. Among them, Class A drugs are those that are basically unified across the country and can guarantee basic clinical needs.
Category B drugs are included in the basic health insurance coverage after the employee pays a certain percentage of the cost, and the cost is generally paid in accordance with the basic health insurance coverage standard.
2, the basic medical insurance treatment program reimbursement
Basic medical insurance payment program must be in accordance with the national provisions of the "basic medical insurance treatment program scope" to determine. If part of the cost of the basic medical insurance to pay for the diagnosis and treatment of the catalog of items, you can first by the insured person to pay out of pocket, in accordance with the provisions of the basic medical insurance to pay.
The basic medical insurance treatment program must meet the following conditions: 1, by the designated medical institutions for the participants to provide designated medical services; 2, by the price part of the designated charges; 3, clinical diagnostic and treatment programs must be safe, effective, reasonable cost.
3, basic medical service facilities reimbursement
Basic health insurance medical service facilities reimbursement covers the participants in the process of diagnosis, treatment and care must be living service facilities, including outpatient and emergency hospitalization beds and inpatient beds.
The basic medical insurance fund cannot reimburse referral transportation fees, emergency vehicle fees, infant warming box fees, food warming box fees, nurse's fees and escort fees.
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