Is there a difference between buying commercial insurance and using drugs in the hospital?

Social security drugs are drugs within the scope of social security reimbursement. Many people want to know more about social security drugs. After all, this involves a major issue of personal interests. In order to avoid discovering that some drugs cannot be reimbursed after treatment. What's the difference between social security drugs and commercial insurance? What social security drugs can be reimbursed? What drugs are not covered by social security?

The difference between social security drugs and commercial insurance

Many people who have paid commercial insurance will ask, what is the difference between social security drugs and commercial insurance reimbursement? In fact, social security drugs and commercial insurance reimbursement are basically the same. Social security drug reimbursement is carried out in proportion, generally floating around 70%. The proportion and amount of reimbursement for social security drugs are related to factors such as self-examination, drug use and medical level. For example, it is clear that Class A drugs can enjoy full coverage, Class C drugs need to bear all the costs, and Class B drugs will report 80% and bear 20% of the costs.

We analyze the reimbursement of social security drugs through examples. Someone spent a total of 9000 yuan on medical expenses, and the reimbursement formula is as follows: (9000-500 "deductible"-self-paid medicine) *70%. If self-funded drugs account for a large proportion, there is not much amount to be reimbursed.

Through this story, I believe you should have a clearer understanding of the scope of reimbursement of social security drugs. If you want to know more clearly whether the medicine you are using is social security medicine, you can also ask the medical staff before making a decision.

The increase and change of the scope of social security drugs

Recently, according to the principle of dynamic addition, gradual advancement and strict examination and approval, the designated medical institutions section of Yantai Social Insurance Service Center has deleted and added some drugs in the drug list of basic medical insurance, industrial injury insurance and maternity insurance in Yantai City.

The list of drugs for basic medical insurance, industrial injury insurance and maternity insurance in Yantai deleted buflomedil oral sustained-release dosage form (western medicine No.929), buflomedil injection (western medicine No.931), buflomedil sodium chloride injection (western medicine No.931) and buflomedil sustained-release controlled-release dosage form (western medicine No.95/kloc-0)

At the same time, Ginkgo biloba granules (Chinese patent medicineNo. 1924), Ginkgo biloba leaves (Chinese patent medicineNo. 1925) and Ginkgo biloba capsules (Chinese patent medicineNo. 1926) were added to the drug list of basic medical insurance, industrial injury insurance and maternity insurance in Yantai, and these three kinds of drugs were included in the scope of medical insurance reimbursement.

Zhongshan: Social security cards can only buy drugs in the medical insurance drug list.

The reporter learned from the Municipal People's Social Security Bureau that among the 292 medical insurance designated retail pharmacies in our city, social security cards can only be used to purchase more than 2,400 kinds of drugs in the medical insurance drug list.

According to reports, only citizens who have participated in supplementary medical insurance and have personal medical accounts can buy drugs in the medical insurance drug list at designated retail pharmacies with social security cards. Some citizens have reported that health care products such as Ganoderma lucidum and American ginseng can be purchased at designated medical insurance pharmacies with social security cards. According to the person in charge of the Medical Insurance Department of the Municipal People's Social Security Bureau, this is an illegal act. Once found out, the social security department will stop the social medical insurance service business of the pharmacy for 6 months.