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Can nine-price social security be reimbursed?
I. Introduction of Nine-valent Vaccine
1, the nine-valent vaccine, its main significance is that it covers a wider range of human papillomavirus, and the human papillomavirus it targets is mainly 6, 1 1, 16, 18, 3 1, 33, 43.
2. It can prevent about 93% cervical cancer and 90% genital warts.
3. The vaccination program was carried out for the first time and ***3 times after February and June, and its applicable population was mainly women aged 16-26.
4. Although the nine-valent vaccine has been used and the coverage is relatively wide, it is still necessary to conduct corresponding cervical cancer screening regularly afterwards. Nine-valent cervical cancer vaccine has good immunogenicity. After three doses of inoculation, the seroconversion rate of related types of serum antibodies can almost reach 100%. After vaccination 1 month, the peak geometric average titer of antibody can reach 100 times of the antibody level after natural infection, and this value will drop to 10 times in the next two months, and will remain in the platform period. The antibody level of the vaccine can be maintained for at least 4 years. In the clinical trial of the curative effect of the nine-valent cervical cancer vaccine, the main observation end points are the persistent infection of related human papillomavirus type, genital warts of related human papillomavirus type, cervical intraepithelial neoplasia (CIN), external genital or vaginal intraepithelial neoplasia (VIN or VaIN). Clinical trials show that vaccination with nine-valent cervical cancer vaccine can produce good protective effect, effectively reduce the persistent infection and precancerous lesions of human papillomavirus in cervix, vagina and external genitalia, and the protective effect can reach more than 90%. Nine-valent cervical cancer vaccine contains human papillomavirus -6 and human papillomavirus-1 1 VLP, which has a good preventive effect on genital warts.
Second, the scope of medical insurance reimbursement
The basic medical insurance co-ordination fund and individual account shall delimit their respective payment scope and be accounted for separately. Medical expenses that meet the payment scope of the basic medical insurance fund shall be reimbursed in accordance with the prescribed basic medical insurance drug list, diagnosis and treatment project list, service facilities scope and payment standard.
1, outpatient and emergency medical expenses: the medical expenses of employees in the current year (11October-1February-31February) that meet the basic requirements of medical insurance coverage exceeded 2,000 yuan.
2. Settlement ratio: 50% of the part of the dispatched personnel above 2,000 yuan will be reimbursed during the contract period, and 50% will be paid by the individual; Within one year, the maximum amount of accumulated reimbursement for outpatient and emergency services of dispatched personnel is 20,000 yuan.
3. The insured shall properly keep the medical documents (including receipts and prescriptions for large amounts) in the outpatient department of the designated hospital. ), as a medical expense reimbursement certificate.
4. Outpatient treatment of three kinds of special diseases: when the insured person needs to take anti-rejection drugs after radiotherapy and chemotherapy for malignant tumor, renal dialysis and renal transplantation, the second-and third-level designated hospitals where the insured person is treated will issue the Certificate of Disease Diagnosis, fill in the Application and Approval Form for Special Diseases of Medical Insurance, and report it to the district medical insurance center for approval and filing. Outpatient treatment and drug collection for these three special diseases are limited to designated hospitals that have approved treatment, and cannot be purchased in designated retail pharmacies. The medical expenses incurred meet the prescribed scope of outpatient special diseases, with reference to hospitalization settlement.
5. Hospitalization.
After paying medical insurance for 20 years, you can enjoy medical insurance reimbursement after retirement.
It is universal, economical and compulsory. Basic medical insurance is the basis of medical security system. The basic medical needs of the insured can be guaranteed by the principle that both employers and employees share the burden, pay jointly, plan as a whole in the city and combine individual accounts with the overall fund. Mainly used to pay for general outpatient, emergency and hospitalization expenses. The basic medical insurance premium shall be paid by the employer and individual employees.
The basic medical insurance co-ordination fund and individual account shall delimit their respective payment scope and be accounted for separately. Medical expenses that meet the payment scope of the basic medical insurance fund shall be reimbursed in accordance with the prescribed basic medical insurance drug list, diagnosis and treatment project list, service facilities scope and payment standard.
legal ground
People's Republic of China (PRC) social insurance law
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope: (1) should 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.
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