The reimbursement policies for chronic diseases in medical insurance are as follows:

1. The insured patients seek medical treatment in the outpatient clinics of designated medical institutions in this city, or the outpatient clinics of selected medical institutions in different places according to regulations specify the corresponding specialist drug costs for chronic diseases, and the employee social medical insurance co-ordination fund will pay 85% of the basic medical institutions and 65% of other medical institutions;

2. The maximum payment limit of the employee social medical insurance co-ordination fund for the corresponding specialist medicine fees and general medical treatment fees for the designated chronic diseases of the insured patients is 2 yuan per person per month for each disease. The maximum monthly payment limit standard of the employee social medical insurance co-ordination fund is valid in the current month, and it is not accumulated or accumulated;

3. Insured patients suffering from various outpatient designated chronic diseases can choose up to 3 diseases to enjoy the corresponding outpatient designated chronic disease medical insurance benefits. Once the disease is selected, it will not be changed in principle within 1 year. Insured patients are not allowed to enjoy the medical insurance benefits for chronic diseases designated by the outpatient department during hospitalization;

4. The employee social medical insurance co-ordination fund shall pay the corresponding specialist drug fees for the chronic diseases designated by the insured outpatients, which shall conform to the list of drugs for chronic diseases designated by the social medical insurance outpatients in this Municipality. The list of drugs designated for chronic diseases in specific outpatient departments is published on the portal website of the Municipal Human Resources and Social Security Bureau.

medical insurance also has two major functions of insurance, risk transfer and compensation transfer. That is, the economic loss caused by the disease risk of an individual is distributed to all members threatened by the same risk, and the economic loss caused by the disease is compensated by the centralized medical insurance fund.

Legal basis:

Social Insurance Law of the People's Republic of China

Article 3 The following medical expenses are not included in the payment scope of the basic medical insurance fund:

(1) Those that should be paid from the industrial injury insurance fund;

(2) It shall be borne by a third party;

(3) It shall be borne by public health;

(4) seeking medical treatment abroad.

the medical expenses shall be borne by the third party according to law. if the third party fails to pay or cannot determine the third party, the basic medical insurance fund shall pay in advance. After the basic medical insurance fund has paid in advance, it has the right to recover from the third party.