The basic medical insurance drug list divides drugs into three categories: the first category A, which can all enter the scope of medical insurance reimbursement and be reimbursed according to the proportion of medical insurance; The second category B, the use of such drugs requires individuals to bear part of the expenses according to a certain proportion, and the rest will enter the scope of medical insurance reimbursement and be reimbursed according to the proportion of medical insurance; Class III and Class C, these drugs are not reimbursed, and all of them are borne by individuals. Therefore, for Class A drugs, except the items that must be deducted, all others are reimbursed at 100%; Only 70%-80% of Class B drugs are reimbursed, and self-funded drugs need to be fully borne by themselves. That is, 15% of the total cost has nothing to do with medical insurance, that is, the so-called class C expenses are paid in cash.
The difference between Class A and Class B of medical insurance
Class A drugs refer to drugs formulated by the state, which are necessary for clinical treatment, widely used, with good curative effect and low price among similar drugs. The expenses incurred in the use of such drugs are included in the scope of payment of the basic medical insurance fund, and the expenses are paid according to the provisions of the basic medical insurance measures. Class B drugs are available for clinical use, with good curative effect and higher price than class A drugs at the same level.
Medicare Class B drugs refer to Class B drugs, and the basic medical insurance fund has the ability to pay part of the expenses. The expenses incurred by using such drugs shall be paid by the insured according to a certain proportion, and then included in the scope of payment of the basic medical insurance fund, and the expenses shall be paid according to the provisions of the basic medical insurance.
I hope the above content can help you. Please consult a professional lawyer if you have any other questions.
Legal basis: Article 12 of the Social Insurance Law of People's Republic of China (PRC).
The employing unit shall pay the basic old-age insurance premium according to the proportion of the total wages of its employees stipulated by the state, and record it in the basic old-age insurance pooling fund.
Employees shall pay the basic old-age insurance premium in accordance with the proportion of wages stipulated by the state and record it in their personal accounts.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic old-age insurance in the employing unit and other flexible employees who have participated in the basic old-age insurance shall pay the basic old-age insurance premiums in accordance with state regulations and record them in the basic old-age insurance pooling fund and individual accounts respectively.