Category A refers to the state regulations, clinical treatment needs of category A drugs.
Widely used in the same class of drugs, therapeutic efficacy, low price, the costs incurred in the use of these drugs should be included in the scope of contributions to the basic medical insurance fund, and in accordance with the provisions of the basic medical insurance scheme to pay, 100 percent of the drugs in category A by the reimbursement ratio.
Category B refers to Class B drugs. The basic medical insurance fund can pay for some medicines.
Expenses incurred for the use of the drug, after a certain percentage is included in the scope of payment by the basic medical insurance fund, will be paid by the insured person himself, and will be paid in accordance with the provisions of the basic medical insurance.
Expanded Information:
Category A and B reimbursement:
Category A and B are listed in red, and Category B is listed in green, and Category A and B medications are covered by Medicare. Category A drugs in the OTC Drugs Regulations must be sold in pharmacies. Class B drugs can be sold not only in pharmacies, but also in general commercial enterprises and other venues.
However, they must be approved and registered by the local drug supervision and management department at or above the municipal level and issued with a quasi-sale mark for Class B on-counter drugs as required. The medical insurance catalog is screened in accordance with the national essential drugs catalog. Category A and B are determined by the efficacy price ratio. That is to say, the efficacy of certainty, low cost, not self-care, included in Class A.
Category B basically has a self-payment ratio, determined by different regions. Local labor and social security bureaus have the right to adjust the varieties of medical insurance in category B. The total amount of import and export is controlled within 15 percent of the number of varieties, and localities do not have the right to adjust Class A medical insurance varieties.
When used in outpatient clinics, the card can be used to pay from the individual account of medical insurance. When used in hospitals, Class B drugs and other Class B expenses, when the insured settles the bill, Class B first bears 10% of its own expenses, then calculates the basic medical expenses together with Class A expenses and enjoys the proportion of full payment together with the portion that exceeds the basic hospital expenses.
Simply put, when Category B costs are hospitalized, they pay more on their own. Medicare hospitalization reimbursement-excluding personal expenses-is more than 80% for Category B expenses after paying 10% of the cost if it exceeds the threshold cost. Not a cash advance, but hospitalization at a designated Medicare hospital.
Baidu Encyclopedia-Medicare Category A
Baidu Encyclopedia-Medicare Category B