Medicine insurance can be used to buy medicines (over-the-counter medicines), medical devices, thermometers and blood pressure monitors and other such auxiliary checking equipment at designated pharmacies.
Meanwhile, employee health insurance is generally divided into individual account and co-ordinated account:
(a) Individual account can pay for the following expenses:
1, designated retail pharmacy drugstore purchase costs, outpatient, emergency medical expenses;
2, used for the purchase of their own commercial insurance, accidental injury insurance, etc.;
3, basic medical insurance co-ordination fund starting standard Medical expenses below the threshold of the Basic Medical Insurance Coordination Fund;
4. If the threshold of the Basic Medical Insurance Coordination Fund is exceeded, the individual will be responsible for the proportion of the expenses he/she has to bear;
5. If the individual account is insufficient to pay for the part of the expenses, the individual will pay for the part of the expenses he/she has to bear.
(2) The co-ordinated account mainly pays for the following expenses:
1. medical expenses for hospitalization;
2. outpatient medical expenses for radiation treatment of malignant tumors, renal dialysis, and anti-rejection drugs after renal transplantation;
3. medical expenses for the patients who are admitted to hospitalization after emergency rescue and are under hospitalization for the first seven days of their stay.
The following medicines can not be included in the scope of basic medical insurance medicines:
1, the main role of nutritional tonic medicines;
2, part of the animal and animal organs can be used in medicine, dried (water) fruit;
3, with Chinese herbs and Chinese medicine tablets of all kinds of alcohol preparations;
4, all kinds of medicines in the fruit-flavored preparation, oral
5, blood products, protein products (except for special indications and first aid, rescue);
6, labor security administrative departments at or above the provincial level, the basic medical insurance fund does not pay for other drugs.
The Drug List is divided into "Class A List" and "Class B List". The "Class A List" is selected on the basis of the "National Essential Drugs" and issued by the State to be used nationwide for clinical treatment of essential, widely used, effective and low-priced drugs of the same kind. The "Class B List" is selected on the basis of the "National Essential Drugs" and issued by the State, and each province, autonomous region and municipality directly under the central government may, according to the local economic level, medical needs and drug habits, increase or decrease the number of varieties of drugs by up to 15 percent of the total number of drugs in the "Class B List" formulated by the State, and the number of varieties of drugs in the "Class B List" formulated by the State shall be limited to 15 percent of the total number of drugs.
Within the scope of 15% of the total number of medicines in the "Class B List", appropriate adjustments can be made to the clinical treatment of choice for use, with good efficacy, and the price of similar medicines is slightly higher than that of the medicines in the "Class A List".
In summary, the drugs that can be swiped on the medical insurance card are divided into two categories, Class A and Class B. Class A drugs are those that are basically uniform across the country and can guarantee the basic needs of clinical treatment, and the cost of such drugs will be paid in accordance with the payment standards of the basic medical insurance.
Legal basis:
Social Insurance Law
Article 28
Medical expenses that are in line with the basic medical insurance drug directory, diagnostic and treatment items, standards of medical service facilities, 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.