1. Basic Medical Insurance Drug Catalog

2. Diagnosis and Treatment Item Catalog

3. Medical Service Facilities Catalog

These three major catalogs It is the most basic criterion for the implementation and reimbursement of my country's medical insurance policy. The basic medical insurance drug catalog refers to the policy basis and standards for drug payment by medical, industrial and commercial, and maternity insurance; it selects drugs that are necessary for treatment, cheap, and effective on the basis of national essential drugs.

Drugs covered by basic medical insurance are divided into Category A and Category B.

Class A drugs refer to drugs that are basically unified across the country and can meet the basic needs of clinical treatment. The cost of such drugs is included in the payment scope of the "Basic Medical Insurance Fund" and is paid in accordance with the "Benefit Standards of Basic Medical Insurance".

The Catalog of Class B drugs is also formulated by the state, but each province and city can adjust it on its own, but the adjustment cannot exceed 15% of the state's set list. Such drugs must first be paid by employees at a certain percentage, and then be included in the payment scope of the "Basic Medical Insurance Fund" and paid in accordance with the "Basic Medical Insurance Benefit Standards". Generally speaking, the out-of-pocket ratio for Class B drugs is between 10% and 30%. Chongqing’s latest policy in 2019 is to include 90% of Class B drugs into the scope of overall payment. In other words, employees only need to pay 10% out of pocket. Drugs that are not included in the Category A and Category B drug catalogs are "out of the catalog." Those outside the catalog are all self-funded (commonly known as "Category C").

Legal basis:

"Notice of the Ministry of Human Resources and Social Security of the National Medical Insurance Administration on Issuing the "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog (2021)"" No. Make timely adjustments to the scope of payment

The "2021 Drug Catalog" contains 2,860 types of Western medicines and Chinese patent medicines, including 1,486 types of Western medicines and 1,374 types of Chinese patent medicines. In addition, there are 892 kinds of traditional Chinese medicine pieces that can be paid for by the fund. All localities must strictly implement the "2021 Drug Catalog" and are not allowed to adjust the limited payment scope and A-B classification of drugs in the catalog on their own. The information system should be adjusted in a timely manner, the database should be updated and improved, and the drugs transferred in this adjustment should be included in the fund payment scope according to regulations, and the drugs transferred out should be simultaneously transferred out of the fund payment scope.