What is the starting line for chronic disease reimbursement in 2024

Generally speaking, the starting line for chronic disease reimbursement is determined by the local health insurance department based on the income and expenditure of the health insurance fund, the level of economic development and other factors, so the starting line standard may vary in different areas.

Taking the chronic disease reimbursement policy of some regions in 2023 as an example:

1. The starting line of the outpatient chronic disease reimbursement policy for urban and rural residents' health insurance is 400 yuan per year in some regions, and the reimbursement rate is 60%.

2. The starting standard for chronic diseases in designated community health service organizations and first-class hospitals is generally 200 yuan, and the starting standard for chronic diseases in second-class hospitals is 400 yuan.

3. In some areas, there is no starting line for outpatient chronic diseases, and reimbursement will be made at 70% of the expenses within the policy scope within the annual reimbursement limit of the corresponding diseases.

Procedure for reimbursement of chronic diseases:

1. The patient himself applies to the social security center and fills in the official application form.

2. The diagnostic certificates from hospitals above the second level will be submitted to the social security center, and the chronic disease certificates will be processed after appraisal and examination by the expert committee.

The expert committee's appraisal of chronic diseases is held once a quarter, and the costs required for the appraisal are borne by the individual or unit.

3. Patients see the doctor and buy medicines in the outpatient department of the designated hospital.

4. Within a specified period of time, they will be reimbursed for their chronic disease medical expenses at the Social Security Center, and at the same time, they will file the "List of Chronic Disease Outpatient Medical Expenses" together with the prescriptions, invoices, chronic disease certificates, medical records, and various examination report forms.

In summary, the starting line and reimbursement rate for reimbursement of chronic diseases in 2024 vary according to regions and specific policies, and participants should understand and apply according to the specific regulations of their regions.

Legal basis:

The Social Insurance Law of the People's Republic of China

Article 28

Medical expenses that are in line with the basic medical insurance drug catalog, diagnostic and therapeutic items, medical service facility standards, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.

Article 29

The portion of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units. The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.