How much can cancer medical insurance reimburse?

The amount of medical insurance reimbursement for cancer patients is 70%~95%. Expensive drugs, special inspections and special treatments are reimbursed by 70%; 80% reimbursement for Class B drugs; The threshold fee is more than 3,000 yuan, and it is reimbursed at 88%; 90% reimbursement for 3000-5000 yuan; 5000- 10000 yuan is reimbursed 92%; If it exceeds the maximum payment limit 10000 yuan, it will be reimbursed by 95%.

12 critical illness is included in critical illness medical insurance.

1, lung cancer;

2. Esophageal cancer

3. Gastric cancer;

4. Colon cancer;

5. Rectal cancer;

6. Chronic myeloid leukemia;

7. Acute myocardial infarction;

8. Cerebral infarction;

9. Hemophilia;

10, 1 type diabetes;

1 1, hyperthyroidism;

12, cleft lip and palate

Which critical illness medical insurance will not be reimbursed?

1, not approved for treatment in non-designated hospitals (except emergency rescue);

2. Suffering from occupational diseases, work-related injuries or recurrence of old injuries;

3. Injuries caused by traffic accidents;

4. Injuries caused by my illegal acts;

5. Food poisoning caused by accidents;

6. receiving treatment for suicide;

7. Injuries caused by medical accidents;

8, according to the provisions of the state and the city should take care of medical expenses.

Reimbursement of serious illness medical insurance

Reimbursement scope of serious illness medical insurance: medical expenses exceeding the maximum payment limit of the basic medical co-ordination fund will be reimbursed by the social security department for 85% below RMB 0-40 thousand, 90% below RMB 40-80 thousand and 95% above RMB 80 thousand. The maximum payment limit for each medical year is 6.5438 yuan +0.5 million yuan.

According to the relevant regulations, local enterprises (hereinafter referred to as enterprises) and their employees and retirees who are applicable to cities, districts and counties within the administrative area of this Municipality can enjoy medical insurance for serious illness. Retirees who do not pay the basic medical insurance premium and continue to enjoy the basic medical insurance benefits are not in the "serious illness medical insurance coverage".

Serious illness medical care can be divided into two types from the form of insurance. One is serious illness social insurance, which is a special medical insurance fund set up to ensure the medical needs of urban workers for major diseases. It is used to pay the medical expenses that the insured person has accumulated over the maximum payment limit of the basic medical insurance for urban workers during the year. The other is the serious illness medical treatment in commercial insurance, which is the major illness protection that the insurance company underwrites for a specific insurer according to the insurance clauses.

It should be noted that the explanations of these two serious diseases in the scope of medical insurance are not exactly the same, and consumers should have a choice when insuring and using them.

At present, people are plagued by hypertension, hyperlipidemia, hyperglycemia and fatty liver everywhere, and the age of illness is getting younger and younger. It is reported that the youngest hypertensive patient is only 6 years old! Moreover, some diseases that were originally major diseases began to become common. Many insurance institutions' medical insurance for serious illness has also been adjusted accordingly.

The actual medical expenses incurred in the reimbursement of social security serious illness within the scope of medical insurance need to be invoiced, which can be divided into ordinary outpatient and emergency expenses reimbursement and hospitalization expenses reimbursement, as well as large medical co-ordination, with a certain limit; The serious illness expenses within the medical insurance coverage of commercial insurance are paid in advance, that is, as long as the serious illness on the policy is diagnosed in the hospital, it will be paid in full according to the contract immediately.

Social security ability is limited, and only a low level of security can be given; Commercial insurance can be paid according to the insured amount set by the insurer.

The medical insurance for major diseases does not cover the following areas:

1. See a doctor in a non-designated hospital without approval (except for emergency rescue);

2. Suffering from occupational diseases, work-related injuries or recurrence of old injuries;

3. Injuries caused by traffic accidents;

4. Injuries caused by my illegal acts;

5. Food poisoning caused by accidents;

6. receiving treatment for suicide;

7. Injuries caused by medical accidents;

8. According to the regulations of the state and this Municipality, medical expenses should be taken care of.

Pay attention to two points when handling the transfer procedure of medical insurance relationship:

First, if there is a receiving unit, the unit shall handle the medical insurance procedures. If there is no receiving unit, the individual shall pay the insurance premium within three months after the termination of the original basic medical insurance relationship.

Second, when handling the transfer of medical insurance relationship, the three medical insurance relationships can be freely converted. The three medical insurance relationships refer to the basic medical insurance for urban workers, the basic medical insurance for urban residents and the new rural cooperative medical system.

After the transfer of medical insurance, you will enjoy the corresponding treatment at the transfer place from the next month. Medical expenses occurred in the process of handling the formalities, and if the insurance payment is made within the prescribed 3 months, the transfer agency shall pay the relevant medical expenses according to the regulations. For those who have not been insured for more than 3 months, the transfer agency will not pay the medical expenses during the unpaid period.

Transfer and connection process of medical insurance relationship

In order to ensure smooth and simple information transmission, Ministry of Human Resources and Social Security will cooperate with the Ministry of Health to design a unified certificate of basic medical insurance for employees of urban enterprises or new rural cooperative medical insurance. The ID number is the unique identification code of the insured. When the medical insurance relationship is transferred, the insured only needs to show it to the social security agency, and the insured information can be updated in time.

The process of medical insurance relationship transfer and subsequent medical insurance transfer contains two meanings.

One is to transfer in,

The second is to transfer out. For the transfer of medical insurance, we should understand these two aspects. After all, the process between the two is also different.

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.