1, the insured employees and residents are hospitalized, and the hospitalization expenses that meet the basic medical insurance regulations in the overall planning area occur.

2, insured workers and residents suffering from special chronic coronary heart disease, malignant tumor, organ transplant anti-rejection treatment, after application, identification and confirmation, can be treated in outpatient medical expenses. The specific chronic diseases of employees and residents shall be stipulated by the overall planning area.

3, outpatient special examination, special treatment of medical expenses.

4. It can be used to pay the medical expenses incurred by the insured and their spouses, parents and children in designated medical institutions, as well as the expenses incurred by individuals in purchasing medicines, medical devices and medical consumables in designated retail pharmacies.

The payment standard of medical insurance premium is as follows:

1, basic medical insurance

The employer shall pay 6% of the total wages of its employees, including retired employees, in the previous year; the individual employees shall pay 2% of the wage income in the previous year, and retirees shall not pay the basic medical insurance premium from the month following the retirement formalities. If the proportion of retirees in the employees of this unit exceeds the standard of this Municipality, it shall be implemented in accordance with the relevant provisions of this Municipality. If the average wage of employees in the employing unit is lower than 60% of the average wage of employees in the county last year, 60% shall be the base of payment; Higher than 300% of the average wage of employees in the county last year, with 300% as the payment base:

2. Supplementary medical insurance for major diseases

According to the standard of 120 yuan per person per year, including retired employees, 70% of which are borne by the employer and 30% by the employees. If the employer participates in the insurance midway, it shall pay the supplementary medical insurance premium for serious illness according to the annual standard.

To sum up, the medical insurance department did not limit the amount of drugs. Dose shall be prescribed by the attending physician according to the patient's condition and in accordance with the Prescription Management Measures and relevant regulations.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.