Proportion of medical insurance reimbursement for radiotherapy and chemotherapy

Where the medical expenses of hospitalized patients who participate in medical insurance exceed 5,000 yuan at one time or in the whole year, they should be compensated by stages, that is, 500 1- 10000 yuan is 65%, and1-18000 yuan is 70%. The annual compensation limit of town-level cooperative medical system hospitalization, uremia outpatient hemodialysis and tumor outpatient radiotherapy and chemotherapy is 1. 1 ten thousand yuan.

60% reimbursement for town hospitals; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%. Among them, the annual compensation limit of town-level cooperative medical system hospitalization, uremia outpatient hemodialysis and tumor outpatient radiotherapy and chemotherapy is 1. 1 ten thousand yuan. All inpatients who participate in cooperative medical care, whose medical expenses exceed 5,000 yuan at one time or cumulatively throughout the year, should be compensated by stages, that is, 500 1- 10000 yuan is 65%, and1-18000 yuan is 70%.

Description of medical insurance reimbursement:

1, the use of special medical materials or disposable medical materials with a unit price of more than 1000 yuan, and the installation and replacement of artificial organs shall be paid by the basic medical insurance pooling fund at the prevailing domestic price.

2, chronic renal failure outpatient dialysis, organ transplantation outpatient anti-rejection drug therapy, malignant tumor outpatient chemotherapy, radiotherapy, interventional therapy or radionuclide therapy of basic medical expenses, by the basic medical insurance fund to pay 90%.

3, outpatient special examination and treatment costs by the basic medical insurance fund to pay 80%, the individual pays 20%.

4. Continuous payment is linked to the reimbursement ratio. After two years of continuous insurance, the reimbursement rate increased to 765,438+0%, and after four years of continuous insurance, the reimbursement rate increased to 72%, and so on.

legal ground

People's Republic of China (PRC) social insurance law

Article 2 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 in case of old age, illness, industrial injury, unemployment and maternity.

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.