The expenses that can be reimbursed by medical insurance mainly include drug expenses, medical treatment project expenses and service facilities expenses.
1. Basic medical drug expenses: The medical insurance reimbursable drug expenses include Class A and Class B. Class A drugs are nationally unified drugs that can meet the basic requirements of clinical treatment, and the list of Class B drugs is adjusted by each region;
2. Basic medical expenses: expenses of hemodialysis, bone marrow transplantation and other treatment items within the scope of basic medical insurance diagnosis and treatment items;
3. Expenses of basic medical service facilities: the expenses incurred by the insured in the necessary living service facilities used in the process of diagnosis, treatment and nursing in designated medical institutions.
The three major catalogues of medical insurance reimbursement are drug catalogue, diagnosis and treatment project catalogue and medical service facilities catalogue. Dad then analyzed the three major directories of medical insurance in detail.
1. Directory of diagnosis and treatment items
The catalogue of diagnosis and treatment items mainly includes some necessary and effective but expensive items, such as hemodialysis and bone marrow transplantation.
It must be noted that medical items that are mainly unnecessary, uncertain in effect or belong to special needs, such as beauty and plastic surgery, are not included in the reimbursement scope.
2. Drug list
The drugs we prescribe in the hospital must be stipulated in the medical insurance catalogue before they can be reimbursed.
Drugs that can be reimbursed by medical insurance can be divided into the following two categories:
(1) Class A drugs: drugs that are necessary for clinical treatment and are cheap and easily available. The state has unified regulations, which can be reimbursed at the rate of 100%.
(2) Class B drugs: drugs that are dispensable, convenient to use but slightly expensive, and the general reimbursement ratio is 70%-80%.
However, it should be noted that diet pills, hangover drugs, some specific drugs, imported drugs and other nourishing and health care drugs are not in the drug list and cannot be reimbursed.
3. Catalogue of medical service facilities
The catalogue of medical service facilities refers to the necessary service facilities fees in the process of diagnosis and treatment, such as bed fees. However, the expenses of non-essential service facilities, such as hospitalization escort expenses, nursing expenses and entertainment expenses, cannot be reimbursed.
In addition, not everyone can do myopia surgery, so detailed preoperative examination is very important. Only after strict preoperative examination can we determine whether the operation can be performed.