Category A, B and C drugs reimbursement ratio:
1, Category A drugs are reimbursed at a rate of 100%;
2, Category B drugs are generally paid by the person concerned 10% out of pocket, and the remaining 90% can be entered into the basic medical expenses in accordance with the provisions of the regulations;
3, and Category C drugs are generally paid for by the person concerned;
4, according to the provisions of the local regulations to determine the details.
Medical insurance coverage:
1, basic medical insurance drug reimbursement
Our country now divides the drugs into three categories, A, B and C, of which Category A drugs are within the scope of medical insurance, so only Category A drugs can be reimbursed by the use of medical insurance, while Category B and C can not be reimbursed;
2, the reimbursement of the basic health care facilities
This reimbursement scope mainly refers to the insured person, in the medical insurance designated institutions for diagnosis and treatment and nursing care, in the process, the incurred bed fee, emergency bed fee, consulting fees and so on;
3, the basic medical insurance reimbursement of diagnosis and treatment items
Must be safe and effective diagnosis and treatment, the charges are determined by the price department. You need to be treated in a designated medical institution.
Medical insurance reimbursement process:
1, in the medical insurance designated hospitals
Every city will have medical insurance designated hospitals, only in the medical insurance designated hospitals inside the diagnosis and treatment, only to be able to use the medical insurance to reimbursement. So if you want to use the medical insurance, you must go to the medical insurance designated hospitals, and to handle the relevant registration procedures;
2, ready to discharge information
In the discharge of the hospital in advance to the discharge of information to prepare, such as the diagnosis of the disease, the discharge record and the medical record, and so on. The doctor will help us to prepare these documents if we tell him that we need them during the treatment, and it is better to make a copy of these documents after you get them. One copy will be submitted to the medical insurance reimbursement office, and the other copy will be kept as a backup;
3. Discharge settlement
Take the hospitalization list and the invoice, and go through the settlement procedures in the hospital. After that, you can bring the relevant information to the medical insurance reimbursement department to reimbursement and audit;
4, wait for the reimbursement of expenses to the account
When the information has been handed over, you will receive a receipt, the reimbursement of the amount of money will be within 15 days to the account, you just need to wait patiently.
In summary, the reimbursement rate for Class A drugs is 100%; Class B is 90%; and Class C is 0%, which means that you have to pay for it out of pocket. The costs incurred by basic medical insurance participants for the use of drugs in the "Drug List" in the "Class A List" will be paid in accordance with the provisions of the basic medical insurance. Expenses incurred for drugs in the "Category B List" are paid by the insured person at a certain percentage of his/her own expense, and then according to the provisions of the basic medical insurance. Category C is borne by the individual.
Legal basis:
Article 26 of the Social Insurance Law of the People's Republic of China
The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with the state regulations.