In March, 2022, the National Medical Insurance Bureau issued a notice requesting: First, novel coronavirus antigen detection reagents and corresponding detection items should be temporarily included in the basic medical insurance service catalogue of this province according to procedures. The relevant expenses incurred by the insured in the designated primary medical institutions shall be paid according to the current regulations of the overall planning area, and the expenses for purchasing testing reagents in designated retail pharmacies may be paid by personal accounts; Second, timely adjust the COVID-19 treatment drugs included in the scope of medical insurance payment.
Half a year later, 343 kinds of drugs, such as the first oral drug in COVID-19, officially passed the formal examination, and were included in the list of declared drugs for national basic medical insurance, industrial injury insurance and maternity insurance in 2022.
With the implementation of "Class B Management" of infection in novel coronavirus, can COVID-19 drugs and hospitalization expenses previously included in medical insurance be reimbursed? In response to the new epidemic, Anhui, Fujian Jinjiang and other places have made clear the proportion of medical insurance reimbursement in COVID-19, and Beijing, Shaanxi and other places have temporarily included the new crown treatment drugs in the scope of medical insurance reimbursement.
Anhui: The reimbursement rate of outpatient expenses for infection in COVID-19 is 70%.
According to the news of Anhui Medical Insurance Bureau, on February 29th, 2022, Anhui Medical Insurance Bureau, Anhui Provincial Department of Finance and Anhui Provincial Health and Health Committee jointly issued an urgent notice on doing a good job in the outpatient treatment of novel coronavirus infection, clarifying that the medical expenses incurred by the insured in the general outpatient (emergency) treatment in the co-ordination area that meet the requirements of COVID-19 pneumonia diagnosis and treatment plan should be included in the scope of payment of the basic medical insurance co-ordination fund, and there is no deductible and reimbursement limit.
Designated medical institutions that have opened the settlement service of the basic medical insurance fund as a whole are temporarily included in the overall settlement scope of COVID-19 infection outpatient service; The medical category of "COVID-19 Outpatient Service (1 102)" was unified to settle the outpatient expenses of COVID-19 infection.
Hebei: sanhe city issued a policy document on medical insurance reimbursement for COVID-19 infected people.
According to the official WeChat account "Civilization Sanhe", sanhe city Medical Security Bureau issued the "Clear Document on Medical Insurance Reimbursement Policy for Infected Persons in COVID-19" on June 65438+February, 2022, clarifying that the minimum annual payment standard for employee medical insurance outpatient service is 1 00 yuan, the proportion of overall fund payment is 60%, and the annual payment limit is 2,000 yuan; Over 45 years old (inclusive), the overall fund payment ratio is 60%, and the annual payment limit is 3,000 yuan; The proportion of retirees' overall fund payment is 70%, and the annual payment limit is 4000 yuan.
The reimbursement policy for residents' medical insurance outpatient service as a whole is as follows: within an insured year, the insured will go to the designated medical institutions with the hospitalization qualification of urban and rural residents in the overall planning area for outpatient treatment, the annual Qifubiaozhun for outpatient service as a whole is 50 yuan, the proportion of payment from the overall planning fund is 50%, and the annual payment limit is 60 yuan. From June 5438+1 October1in 2023, the outpatient deductible line was cancelled and the annual payment limit was raised to 80 yuan/year.
In addition, there are corresponding regulations for employees and residents to be reimbursed for hospitalization in medical insurance co-ordination areas.
Fujian: Outpatients and hospitalizations in Jinjiang can be reimbursed.
According to Jinjiang News Network, Jinjiang City, Fujian Province issued a notice on medical insurance reimbursement after COVID-19's infection: In terms of outpatient service, insured persons can enjoy general outpatient treatment when they seek medical treatment in designated primary medical institutions. The reimbursement rate in township hospitals (community health service centers) is 70%, and the maximum payment limit is 420 yuan; In the designated village-level medical institutions in the city, the reimbursement rate is 50%, and the maximum payment limit is 50 yuan (the single reimbursement limit is 10 yuan). In terms of hospitalization, medical expenses incurred in designated medical institutions in other provinces of this Municipality are reimbursed by the basic medical insurance at 80% of the reimbursement amount of this Municipality, and medical expenses incurred in designated medical institutions outside the province are reimbursed by the basic medical insurance at 60% of the reimbursement amount of this Municipality.
Shandong: Online consultation of symptoms in COVID-19 is included in medical insurance reimbursement.
According to the website of Shandong Medical Insurance Bureau on February 28th, 2022, Shandong Medical Insurance Bureau and Shandong Provincial Health and Wellness Committee recently jointly issued the Notice on Doing a Good Job in Medical Insurance Services for Internet Infection in novel coronavirus, pointing out that the Internet diagnosis fee for related symptoms in COVID-19 is included in the basic medical insurance payment scope, which is consistent with the offline reimbursement policy. The medical insurance department should promptly settle and pay the Internet plus medical expenses, strengthen intelligent audit, and promote the rational and standardized use of medical insurance funds.
Beijing: Six kinds of drugs, such as Nai Mathevet tablets and Ritonavir tablets, are temporarily included in medical insurance.
In order to cope with the new epidemic situation, with the approval of the National Medical Insurance Bureau, Beijing Medical Insurance Bureau temporarily included six drugs, such as compound paracetamol capsules, compound paracetamol and ephedrine oral liquid, paracetamol for children, Anka Huang Min capsules, clofenHuang Min tablets and ambroxol oral liquid, into the scope of medical insurance and industrial injury insurance reimbursement in Beijing, and the reimbursement ratio was implemented according to Class A drugs. It will be implemented from 12 to 18 in 2022 and will be valid until March 2023 18.
In addition, in order to strengthen the treatment of patients who may develop into severe or critical illness after COVID-19's infection, recently, Naimavir Tablets/Ritonavir Tablets have also been included in the scope of medical insurance drug reimbursement in Beijing, and the reimbursement rate of community hospitals in Beijing is 90%.
Shaanxi: 234 kinds of COVID-19 drugs are temporarily included in medical insurance.
According to the news of "Health Shaanxi Release", on June 5438+February 2 1 day, 2022, Shaanxi Provincial Medical Security Bureau, Shaanxi Provincial Health and Wellness Committee and Shaanxi Provincial State Taxation Bureau jointly issued the Notice on Further Improving the Medical Security Work for Current Epidemic Prevention and Control. The confirmed and suspected patients will use 107 kinds of Chinese patent medicines recommended in the Notice of Shaanxi Provincial Health and Wellness Committee and Shaanxi Provincial Administration of Traditional Chinese Medicine on Printing and Distributing the Prevention and Treatment Scheme of Infection in Shaanxi Province (Trial Fourth Edition) (No.53 [2022] of Shaanxi Traditional Chinese Medicine) and two kinds of 65438 selected by experts organized by the provincial and provincial health and wellness committees, which have strong pertinence to the disease and obvious therapeutic effect.
Hubei: 36 kinds of COVID-19 drugs are temporarily included in medical insurance.
Hubei Provincial Medical Insurance Bureau reported on February 29, 2022 that with the approval of the National Medical Insurance Bureau, 36 kinds of COVID-19 drugs, such as paracetamol for children and compound pholcodine syrup, were temporarily included in the scope of medical insurance reimbursement in Hubei Province from February 29, 2022, and the reimbursement ratio was implemented according to Class A drugs.
Yunnan: 4 1 drugs are temporarily included in medical insurance.
Yunnan Provincial Medical Security Bureau reported in 65438 on February 30th, 2022 that 4 1 drugs such as "Sangju Yinqiao Powder" in the Catalogue of Drugs for Infected Persons in COVID-19, Yunnan Province (First Edition for Trial Implementation) were temporarily included in the scope of medical insurance payment, and they were managed according to Class A drugs, so as to further meet people's medical needs and reduce the cost burden of infected persons in COVID-19.
Guangxi: 15 kinds of COVID-19 drugs can be included in medical insurance.
According to Guangxi News Network, in order to further protect the people's demand for drugs, the Medical Security Bureau of the Autonomous Region temporarily included 15 kinds of drugs such as exogenous fever granules into the payment scope of the basic medical insurance fund of the whole region, and reimbursed them according to Class A drugs of medical insurance, which was implemented from February 22, 2022 to March 22, 2023.