Medicare drug catalog, diagnostic and treatment items (medical consumables) catalog and the scope of medical service facilities.
Expenses within the scope of the three catalogs can be reimbursed, and expenses not within the scope of the catalogs cannot be reimbursed. Among them, the Drug Catalog is divided into two categories, A and B. Category A expenses are all included in the scope of reimbursement, and Category B expenses are included in the scope of reimbursement after deduction of the percentage of out-of-pocket payment in advance.
The starting point for the calculation of the compensation of medical expenses incurred by the medical insurance co-ordination fund for the participants that are within the scope of the policy, and the medical insurance co-ordination fund will not pay for the medical expenses below this starting point.
Expanded Information:
Note:
The premium expenses should be planned according to the financial ability and family situation. For the amount of coverage, you can't blindly think that the more the better. In addition to referring to the family's actual ability to pay, you also need to measure the actual medical costs of the covered diseases.
It is important to understand the scope of liability of the insurance policy, only the liability of the scope of the insurance accident, the insurance company will fulfill the obligation to pay. Otherwise not only does not play the role of due protection, but also may cause unnecessary financial losses and claims disputes.
Baidu Encyclopedia - Health Insurance
People's Daily Online - Harbin City Health Insurance Bureau to answer the public's questions: "three directories" to determine the medical expenses can be