1. Duplex is a Class B drug, which requires 20% of the individual's own expenses.
2, the insured in the selected designated community health service institutions in accordance with the provisions of the basic medical expenses, the basic medical insurance fund to pay 70%. The first-visit community health service institutions can refer the insured according to the needs of diagnosis and treatment.
The following medical expenses will not be reimbursed:
1, medical expenses incurred in non-designated medical institutions without approval;
2, except suicide, self-mutilation (mental illness);
3, fighting, fighting, alcoholism, drug abuse and other crimes or violations of public security management;
4. Traffic accidents, accidental injuries, medical accidents, etc. ;
5, due to beauty, plastic surgery, physical defects and other reasons. ;
6. Belonging to industrial injury insurance (including occupational diseases) or maternity insurance;
7, the national and provincial medical insurance policies and other non payment.
Legal basis: Article 29 of the Social Insurance Law of People's Republic of China (PRC).
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.
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.
Article 30
The following medical expenses are not included in the payment scope of the basic medical insurance fund:
(a) shall be paid by the industrial injury insurance fund;
(2) It shall be borne by a third party;
(three) shall be borne by public health;
(4) Go abroad for medical treatment.