Before July 20 17, the cost of targeted therapy could not be reimbursed by medical insurance. Later, Ministry of Human Resources and Social Security published the 20 17 version of the national medical insurance catalogue, half of which were tumor-targeted drugs, so the targeted drugs in the medical insurance drug catalogue were reimbursed by medical insurance, but the proportion of medical insurance reimbursement for targeted drugs in different regions was very different, so there was no national unification.
Targeted drugs are managed separately by the outpatient department of designated medical institutions. After the targeted drug therapy is audited and put on record, all patients with targeted drugs designated in our hospital can be reimbursed in the outpatient department. If the insured needs targeted drug therapy, he must go through targeted drug therapy review and filing in accordance with the regulations before purchasing drugs and enjoying targeted drug therapy, otherwise he will not be reimbursed.
Article 28 of the Social Insurance Law of People's Republic of China (PRC) conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities and emergency and rescue medical expenses standards, and shall be paid from the basic medical insurance fund in accordance with state regulations.
Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.
Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope:
(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.
Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.
Article 25 The state establishes and improves the basic medical insurance system for urban residents.
The basic medical insurance for urban residents combines individual contributions with government subsidies.
People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.