(1) Medicare Part C medicines or therapeutic devices are generally paid for by the individual, and the state reimbursement rate is very small;
(2) self-pay is that the medicines or medical devices are paid for by the individual, and the state does not reimburse them.
1.C drugs and health insurance reimbursement amount has a relationship, A drugs can be fully reimbursed, B drugs can be reimbursed part of the C drugs almost belong to the out-of-pocket expenses, the reimbursement rate is very small.
2. C drugs are generally health care products, new drugs and high-grade drugs, are not reimbursed, so, if you need to be reimbursed, you can tell the doctor in advance not to prescribe or less C drugs.
Medicare types of out-of-pocket expenses can not be reimbursed. Medical insurance has the basic features of social insurance such as compulsory, mutual aid and social.
Medical insurance generally refers to basic medical insurance, a social insurance established to compensate workers for the economic losses caused by the risk of disease.
The medical insurance fund is established through the contributions of employers and individuals, and the medical insurance organization will give certain financial compensation to the insured after they incur medical expenses for sick visits. The establishment and implementation of the basic medical insurance gathered the economic strength of the unit and members of the community, coupled with financial assistance, can make the sick members of the community from the community to obtain the necessary material help, reduce the burden of medical expenses, to prevent the sick members of the community due to disease to poverty.
Medicare out-of-pocket expenses in terms of individual health insurance, to 5,000 yuan base for example: 5,000 yuan payment index to pay. Basically, there are two grades of medical insurance: low-grade and high-grade. Low-grade is 4% of the contribution standard, and high-grade is 8% of the contribution standard. If you calculate according to the 4% of the contribution standard, the monthly payment is 200 yuan, and the 12-month period is 2,400 yuan, plus the cost of the medical insurance for major illnesses, which is generally not more than 2,600 yuan.
Medicare out-of-pocket expenses, if calculated according to the 8% payment standard, the monthly payment is 400 yuan, 12 months is 4,800 yuan, plus the cost of major medical insurance, generally will not be more than 5,000 yuan.
There is a relationship between the C drugs and the amount of reimbursement from the medical insurance, the A drug can be reimbursed in full, the B drug can be reimbursed part of the reimbursement, the C drug is almost out-of-pocket, reimbursement rate is very small.
2. C drugs are generally health care products, new drugs and high-grade drugs, are not reimbursed, so, if you need to be reimbursed, you can tell the doctor in advance not to prescribe or less C drugs.
Medicare types of out-of-pocket expenses can not be reimbursed. Medical insurance has the basic features of social insurance such as compulsory, mutual aid and social.
Medical insurance generally refers to basic medical insurance, a social insurance established to compensate workers for the economic losses caused by the risk of disease.
The medical insurance fund is established through the contributions of employers and individuals, and the medical insurance organization will give certain financial compensation to the insured after they incur medical expenses for sick visits. The establishment and implementation of the basic medical insurance gathered the economic strength of the unit and members of the community, coupled with financial assistance, can make the sick members of the community from the community to obtain the necessary material help, reduce the burden of medical expenses, to prevent the sick members of the community due to disease to poverty.
Medicare out-of-pocket expenses in terms of individual health insurance, to 5,000 yuan base for example: 5,000 yuan payment index to pay. Basically, there are two grades of medical insurance: low-grade and high-grade. Low-grade is 4% of the contribution standard, and high-grade is 8% of the contribution standard. If you calculate according to the 4% of the contribution standard, the monthly payment is 200 yuan, and the 12-month period is 2,400 yuan, plus the cost of the medical insurance for major illnesses, which is generally not more than 2,600 yuan.
Medicare out-of-pocket expenses, if calculated according to the 8% payment standard, the monthly payment is 400 yuan, 12 months is 4,800 yuan, plus the cost of major medical insurance, generally will not exceed 5,000 yuan.
Hospitalization costs are usually reimbursed through the health insurance card, which you need to go to the appropriate desk in the hospital, or pay the hospitalization deposit and then give the card to the nurse's desk at the inpatient unit for reimbursement. If, during the subsequent treatment and examination process, you encounter medicines or examination items that are not covered by the hospitalization reimbursement, you will receive a payment list from the hospital, in which case you will need to go to the hospital's outpatient window and pay the fee on your own.
In order to be reimbursed for hospitalization expenses, you need to go to the hospital's service desk, or pay the hospitalization deposit and give your card to the nurse's service desk at the inpatient hospital for reimbursement. If, in the course of subsequent treatment and examination, you encounter medicines or examination items that are not covered by the hospitalization reimbursement, you will receive a payment list from the hospital, in which case you will need to go to the hospital's outpatient window and pay the fee on your own.
Legal basis
The People's Republic of China Social Insurance Law
Article 28 of the basic medical insurance drug catalog, diagnostic and therapeutic items, standards of medical services and facilities, as well as emergency and rescue medical expenses, in accordance with the provisions of the state from the basic medical insurance fund.
Article 29: The portion of the medical expenses of the insured 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 system of settlement of medical expenses for medical treatment in other places to facilitate the enjoyment of basic medical insurance by insured persons.