What's the difference between Class A and Class B of national medical insurance?

When medical insurance is reimbursed, it is generally reimbursed according to the relevant catalogue of medical insurance. There are three catalogues of medical insurance, namely, the basic medical insurance drugs catalogue, the diagnosis and treatment items catalogue and the medical service facilities catalogue. The basic medical insurance drug list and the diagnosis and treatment project list can be divided into Class A and Class B..

1. Different prices: The price of Class A drugs is relatively low among similar drugs, which can ensure the basic needs of clinical treatment. Class B drugs are more expensive than class A drugs of the same class, and can be used as the choice of clinical treatment with better curative effect.

2. The reimbursement ratio is different: the expenses of Class A 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. When the insured uses "Class A" drugs, they can all be included in the scope of reimbursement. When the insured uses "Class B" drugs, if the proportion of personal burden is not indicated, the individual shall bear a certain proportion of drug expenses first (different laws and regulations in different places), and the rest shall be included in the scope of medical insurance fund payment.

3. Different sales channels: Class A drugs can only be sold in pharmacies, while Class B drugs can be sold not only in pharmacies, but also in hotels or shops with the approval of drug supervision departments.

The catalogue of diagnosis and treatment projects is divided into "Class A projects" and "Class B projects". The differences between Class A projects and Class B projects are as follows:

1. The concept is different: the diagnosis and treatment items in Class A are necessary, safe, effective and affordable for clinical diagnosis and treatment. The diagnosis and treatment items in Class B catalogue can be used for clinical diagnosis and treatment, and the effect is positive, but the use needs to be properly controlled.

2. The reimbursement ratio is different: Class A projects are all included in the scope of reimbursement, while Class B projects require individuals to bear part of the expenses first, and the rest are included in the scope of reimbursement.

The drug list of basic medical insurance refers to the drug list that is necessary to ensure the clinical treatment of employees and is included in the scope of payment of basic medical insurance. It is a way to manage the scope of basic medical insurance drugs. Its main function is to control the scope of drug expenses paid by basic medical insurance, and it is the basis for social insurance agencies to pay drug expenses for insured persons. Its purpose is to ensure the basic medical needs of the insured and the stable income and expenditure of the medical insurance fund. It consists of two parts: the directory and the directory.

Legal basis:

Article 2 of People's Republic of China (PRC) Social Insurance Law

The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

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.