Critical illness medical insurance mainly reimburses the insured person's personal burden within the reimbursement scope of the basic medical insurance.
The proportion of compensation that can be paid will vary according to different ranges.
Among them, the annual maximum payment limit is in principle no less than 300,000 yuan. Ametinib is a third-generation EGFR-targeted drug for the treatment of lung cancer. It has been included in medical insurance in China. The reimbursement ratio may vary in different regions. It is recommended that patients consult their local
The Medical Insurance Bureau understands.
The coverage of Amele’s medical insurance payment is: limited to patients with disease progression during or after epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) treatment, and locally advanced or metastatic EGFR T790M mutation-positive disease confirmed by testing.
Adult patients with non-small cell lung cancer.
First of all, there is a difference between medical insurance drugs and non-medical insurance drugs. The reimbursement threshold also differs according to the hospital level. Generally, Class A drugs can enjoy full reimbursement, while Class C drugs need to be fully reimbursed, while Class B drugs require 80% reimbursement and 20% self-payment.
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If a person spent 10,000 yuan in the hospital, if he was treated in a first-level hospital, then 500 yuan would be deducted first; if he was treated in a second-level hospital, then 1,000 yuan would be deducted first; if he was treated in a third-level hospital, then 1,000 yuan would be deducted first;
, just subtract 2,000 yuan first. This is the difference in the deductible.
1. Special medical expenses include the cost of organ and tissue transplantation due to illness, the cost of purchasing organs and tissues, and the cost of using anti-rejection drugs and immunomodulatory drugs that are beyond the drug reimbursement scope of Zhenjiang Employees’ Medical Insurance; 2. Work-related injuries and occupational diseases;
3. Female workers giving birth; 4. Gangster fights; 5. Injuries caused by alcoholism; 6. Traffic accidents; 7. Intentional injuries by others; 8. Medical accidents; 9. Beauty and health examinations; 10. Others not covered by social medical insurance funds.
cost of.
[Extended information] 1. Medical expenses incurred by insured employees on business trips or visits to relatives in other places will only be reimbursed for out-of-town emergency expenses that comply with medical insurance regulations. All expenses will not be reimbursed for hospitalization due to non-emergency reasons.
2. If insured employees live abroad for more than 6 months, medical expenses will be reimbursed according to the nature of long-term residents living abroad.
3. People who live out of town for a long time should provide certificates from their units, identify two designated hospitals (which should be designated medical institutions for local medical insurance), and promptly apply for Zhenjiang long-term non-local employees’ medical expense reimbursement cards. 4. Long-term employees who live out of town must adhere to the principle of economy.
Prescribe medicines according to prescribed limits (for each visit, the dose for acute diseases should be within 3 days, the dose for chronic diseases should be within 10 days, and the dose for tuberculosis, hypertension, and diabetes can be extended to 30 days). If the above standards are exceeded, the medication will not be reimbursed.
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5. Referrals for employees who live out of town for a long time must be signed by the local designated hospital, and the referrals shall be made step by step according to the territorial principle.
The referral hospital is a special hospital designated by the city's employee medical insurance. Individuals will pay 10% of the total expenses first, and then be reimbursed according to medical insurance regulations. For other hospitals, individuals will pay 20% of the total expenses first, and then be reimbursed according to medical insurance regulations.
cost.