How to reimburse the serious illness medical treatment for buying medicine?

The reimbursement for purchasing medicine for serious illness medical treatment needs to bring the reimbursement voucher, outpatient invoice and prescription issued by the hospital, and report to the local social security bureau for review. At the same time, we should pay attention to whether the drugs meet the medical insurance catalogue and quota.

Serious illness medical care is a major disease security system provided by the state, which aims to provide certain cost compensation for people with serious diseases. Pay attention to the following aspects in reimbursement for serious illness: bring legal evidence: when purchasing medicine, you need to show the doctor the reimbursement certificate for serious illness, outpatient invoice and prescription for future review and reimbursement. Meet the medical insurance conditions: the scope and limit of drug reimbursement are clearly defined. For drugs and dosage forms that must be in the national medical insurance catalogue, the part that exceeds the limit needs to be paid at its own expense. Review and declaration process: you need to submit the drug purchase voucher and related documents to the local social security bureau to receive the threshold and method for reimbursement of medical insurance designated retail pharmacies. Timing: When handling reimbursement, you need to pay attention to the time difference between each process and submit the reimbursement voucher as soon as possible to avoid missing the reimbursement opportunity.

What if the drug reimbursement application is rejected? If the drug reimbursement application is rejected, you can first look at the reasons why the Social Security Bureau refuses to reimburse, which may be due to incomplete information, drugs that do not meet the medical insurance catalogue or exceeding the limit.

Generally speaking, the reimbursement procedure for serious illness medical treatment is complicated, but as long as the application and review are carried out according to the prescribed steps, the due expenses can be compensated.

Legal basis:

Article 28 of the Regulations on the Basic Medical Insurance for Urban Workers in People's Republic of China (PRC) shall be used to pay medical expenses beyond the scope of the overall fund; If the personal account is insufficient to pay, I shall be responsible for the losses. Twenty-ninth serious illness hospitalization medical expenses, according to the following methods to pay:

(a) Qifubiaozhun in principle control in the city, county, autonomous county last year, the average social wage of workers 9%-0%.

(two) the maximum payment limit is controlled in principle at 3-5 times of the average social wage of employees in cities, counties and autonomous counties in the previous year.

(three) medical expenses above the minimum deductible and below the maximum payment limit are mainly paid by the overall fund, and individuals bear a certain proportion. Give appropriate care to the proportion of retirees who bear medical expenses. The scope of serious diseases, the specific standards of Qifubiaozhun and the maximum payment limit, and the proportion of sharing medical expenses above Qifubiaozhun and below the maximum payment limit shall be determined by the provincial people's government. Thirtieth medical expenses below the minimum deductible and above the maximum payment limit shall not be paid by the overall fund.