The Latest Policy of Xi 'an Chronic Disease Reimbursement in 2023

In 2023, the reimbursement rate standard of Xi 'an chronic disease medical insurance is as follows:

1. Outpatient medical expenses that meet the requirements of patients with chronic diseases of Class A shall be paid by the overall fund at 85%. The expenses of outpatient hemodialysis, peritoneal dialysis and cyclosporine A after organ transplantation in patients with chronic renal failure were further increased by 10 percentage point.

2. Qifubiaozhun for Class B chronic diseases: 300 yuan. Outpatient medical expenses that meet the requirements of patients with chronic diseases of Class B shall be paid 80% above the deductible standard, and shall not exceed the maximum payment limit for chronic diseases within one medical year or within the validity period;

3. The insured can identify two chronic diseases of Class B at the same time, and manage them according to the two diseases identified first, and calculate the deductible for each disease separately. The identification and management of chronic diseases and the maximum payment limit shall be adjusted by the human resources and social security department according to the overall fund income and expenditure. The standards, rules and procedures for the identification of chronic diseases shall be formulated separately by the municipal administrative department of human resources and social security.

Medical insurance reimbursement process:

1. Confirm reimbursement scope: During the treatment, you need to confirm whether your treatment items are within the scope of medical insurance reimbursement;

2. Collect reimbursement materials: collect relevant treatment records, drug receipts, medical expense lists and other relevant materials;

3. Go to the social security department for reimbursement: submit relevant materials for medical insurance reimbursement to the local social security department;

4. Pending review: The social security department will conduct relevant review and comparison to confirm the reimbursement ratio and reimbursement amount; Receive reimbursement: After approval, you can receive medical insurance reimbursement at the designated bank.

To sum up, according to the relevant regulations, those who participate in the basic medical insurance for urban workers or the basic medical insurance for urban and rural residents who suffer from designated chronic diseases may apply for outpatient treatment of chronic diseases. After the insured person is approved, he will enjoy the outpatient treatment of special chronic diseases this quarter from the next month. The insured person who has passed the examination and approval can take my social security card to see a doctor in the outpatient department of a designated medical institution and buy medicine in a designated pharmacy for chronic diseases. The reimbursement standard for chronic diseases is: the annual deductible standard is 300 yuan, which meets the requirements of overall disease treatment, 80% for urban workers and 50% for urban residents above the deductible standard.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.