Category A drugs by the state unified development, clinical treatment is necessary, widely used, efficacy, low price of similar drugs, the use of such drugs incurred costs into the basic medical insurance fund to pay for the scope of the basic medical insurance scheme to pay the costs.
Medical insurance process:
1, prepare materials: you need to provide the original resident ID card, personal social security card, the hospital designated by the approval and diagnosis and treatment records.
2, go to the local social security center to submit an application and pay the appropriate fees.
3. Get the voucher and card issued by the social security center and go to the hospital.
4. Present your health insurance card when you register at the hospital to enjoy the reimbursement policy.
5. After completing the consultation, you can settle the bill at the hospital fee office or choose to settle the bill at the unified payment window.
6. If you settle the bill at the hospital fee office, you can get the invoice and receipt.
7. Go to the social security center for settlement and other follow-up procedures.
The three major catalogs of health insurance:
1, drugs: divided into two categories of drugs, A and B, are reimbursed according to a certain percentage, the difference is that some of the drugs of category A can be reimbursed 100%, but the drugs of category B can only be reimbursed part of the report, for example, report 80%, and the rest of the 20% have to pay out of their own pockets;
2, diagnostic and treatment items: also reimbursed according to a proportion of the report, some can be reported to 100%, and some can only be reported to a part of; and the medical examination, dental examination, and so on.
3, service facilities: the main reimbursement of ordinary bed fees, if you live in the VIP ward or special needs department, this part of the cost can not be reimbursed;
Summary of the above, the medical insurance can only reimburse the directory of the cost, but not necessarily all the reimbursement, the specific amount of reimbursement, according to the local medical insurance policy.
Legal basis:
Article 26 of the Social Insurance Law of the People's Republic of China
The standard of treatment for employees' basic medical insurance, new rural cooperative medical care and urban residents' basic medical insurance shall be implemented in accordance with the state regulations.
Article 27
Individuals who have participated in the basic medical insurance for employees and whose accumulated contributions have reached the number of years stipulated by the State when they reach the legal retirement age shall not pay any more basic medical insurance premiums after their retirement, and they shall enjoy the basic medical insurance benefits in accordance with the State's provisions; if they have not yet reached the number of years stipulated by the State, they may pay contributions until the number of years stipulated by the State.