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Can medical insurance reimburse drugs?
Second, the scope of medical insurance card reimbursement:
1, drugs reimbursed for basic medical insurance are included in the payment scope of basic medical insurance, which are divided into Class A and Class B. Class A drugs refer to drugs that are basically unified in the whole country and can ensure the basic needs of clinical treatment. The expenses of such drugs are included in the payment scope of the basic medical insurance fund, and the expenses are paid according to the basic medical insurance payment standard.
2. Reimbursement of basic medical insurance diagnosis and treatment items should meet the following conditions: (1) Clinical diagnosis and treatment must be safe and effective with appropriate expenses; (2) The price department has set the charging standard; (3) within the scope of designated medical services provided by designated medical institutions for the insured.
3. Reimbursement of basic medical service facilities The reimbursement scope of basic medical insurance medical service facilities includes the living service facilities provided by designated medical institutions and necessary for the insured to receive diagnosis, treatment and nursing, mainly including inpatient bed fees or outpatient (emergency) observation bed fees. You can only buy medicine at designated pharmacies. When purchasing drugs in designated retail pharmacies, the insured person who participates in the personal account of medical insurance can use the funds in the personal account to purchase drugs; In addition, if there are funds deposited in the financial account of the social security card, you can use the payment function equivalent to the ordinary bank card to purchase drugs. Legal basis: Detailed Rules for the Implementation of People's Republic of China (PRC) Social Insurance Law.
Article 8 The medical expenses incurred by the insured in the agreed medical institutions shall be paid by the basic medical insurance fund in accordance with the provisions of the state if they meet the basic medical insurance drug list, diagnosis and treatment items and medical service facilities standards. If the insured really needs emergency treatment and rescue, he can seek medical treatment in a non-agreement medical institution; The scope of drugs that must be used for rescue can be appropriately relaxed. The specific measures for the administration of emergency and rescue medical services of the insured shall be formulated by the overall planning area according to the local actual situation.
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