oseltamivir cannot be covered by medical insurance.

the national medical insurance bureau issued the notice on doing a good job in influenza prevention and treatment for insured persons with basic medical insurance, which requires that all localities can appropriately relax the conditions in terms of admission standards and the selection of designated hospitals according to the actual situation of influenza epidemic and the needs of patients, so as to ensure that insured patients can receive timely treatment.

it is clear in the notice that during the influenza epidemic, the limited payment scope of medical insurance for oseltamivir (oral dosage form and granule) and peramivir sodium chloride (injection) is temporarily adjusted to limit the anti-influenza virus treatment for high-risk groups and severe patients with severe influenza. More often, oseltamivir is usually available in medical institutions, and patients can't buy it at pharmacies themselves.

reimbursement conditions for medical insurance

According to the basic requirements for the payment of basic medical insurance benefits in China, the insured person who goes to the medical insurance institution to reimburse the medical expenses incurred by his own medical treatment generally meets the following conditions:

1. The insured person must go to the designated medical institution of basic medical insurance to seek medical treatment and purchase medicines, or purchase medicines from the designated retail pharmacies determined by the social insurance institution with the medical prescriptions issued by doctors in designated hospitals.

2. The medical expenses incurred by the insured in the process of seeing a doctor must conform to the scope and payment standards of the basic medical insurance drug list, diagnosis and treatment items and medical service facilities standards, before they can be paid by the basic medical insurance fund according to regulations.

3. among the medical expenses that the insured meets the payment scope of the basic medical insurance, the part above the threshold and below the maximum payment limit of the social medical pooling fund shall be paid by the social medical pooling fund in a unified proportion.