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What materials are needed to apply for the special
Outpatient special diseases, referred to as outpatient special, refers to a specific number of chronic diseases that require long-term treatment on an outpatient basis at a higher cost, and whose condition is stable enough not to require hospitalization.
Outpatient special diseases include coronary heart disease, hypertension III, diabetes, liver cirrhosis, mental illness, malignant tumor radiotherapy, chemotherapy, analgesic treatment, renal dialysis, post-renal transplantation, post-hematopoietic stem cell transplantation, Parkinson's disease, rheumatoid arthritis, chronic renal insufficiency, systemic lupus erythematosus, breast cancer (endocrine therapy).
Resident medical insurance outpatient special chronic disease treatment:
1. No starting line, 50% reimbursement.
2. Reimbursement according to the payment limit of the disease: 800 yuan for hypertension stage II or above, emphysema, post-endometrial sequelae, 1,200 yuan for coronary heart disease, pulmonary heart disease, rheumatoid arthritis, osteomyelitis, psychiatric illness, post-stroke sequelae, 1,200 yuan for diabetes mellitus (comorbidity), Parkinson's, cirrhosis of the liver, epilepsy.
3. The general tuberculosis declaration limit is 3,000 yuan, with 50% reimbursement.
Legal basis:
The People's Republic of China*** and the State Social Insurance Law
Article 26
The standard of treatment of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with the state regulations.
The Social Insurance Law of the People's Republic of China
Article 28
Medical expenses that conform to the basic medical insurance drug catalog, diagnostic and treatment items, standards of medical service facilities, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.
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