Are Chinese herbal medicines included in medical insurance?

Most Chinese herbal medicines are included in medical insurance.

The traditional Chinese herbal pieces corresponding to non-traditional Chinese herbal pieces have been included in the national medical insurance catalogue of Chinese herbal pieces or the newly added catalogue of Chinese herbal pieces in Hunan Province. Only those that meet the relevant standards of the state and Hunan Province can be included in the medical insurance payment.

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.

Medical insurance reimbursement standard:

1, residents' reimbursement ratio: town health centers reimburse 60%; 40% reimbursement for secondary hospitals; 30% reimbursement for tertiary hospitals;

2, urban residents, in a settlement year, the medical expenses that meet the scope of reimbursement are 65,438+10,000 yuan, the threshold for tertiary hospitals is 659 yuan, the reimbursement ratio is 50%, and the upper limit is 2,000 yuan; The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%; There is no Qifubiaozhun in the first-class hospital, and the reimbursement rate is 60%;

3. You need to go back to your hometown for reimbursement, and the reimbursement rate is 35-65%, which varies according to the level of the hospital.

To sum up, gamma knife treatment can be reimbursed. As early as 20 12, the cost of gamma knife surgery in China has been included in the scope of medical insurance, but the reimbursement costs in various places are determined by local hospitals themselves. The charging standards in different hospitals are different, and the reimbursement ratio in different places is also different. Reimbursement of rural cooperative medical care is carried out in proportion, generally floating around 25%-80%. The proportion and amount of reimbursement are related to their own examination and medication, medical level and other factors.

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.