Reimbursement ratio of social security categories A, B and C

Reimbursement ratio of social security categories A, B and C

The specific reimbursement rates of drugs A, B and C are as follows:

The reimbursement rate of Class A drugs is100%;

Class b is 90%;

Class c 0%, that is, at their own expense.

The expenses incurred by the insured of the basic medical insurance in using the drugs in the Drug Catalogue shall be paid in accordance with the provisions of the basic medical insurance. The expenses incurred by the drugs listed in Class B shall be paid by the insured according to a certain proportion and then according to the provisions of the basic medical insurance. Class C shall be borne by the individual.

List of drugs for basic medical insurance.

In the drug list of basic medical insurance, it is mainly divided into Class A and Class B:

Among them, the drugs in the Class A catalogue correspond to Class A drugs;

Drugs in the Class B drug list correspond to Class B drugs;

Drugs outside the drug list are called Class C drugs.

Class a drugs

Drugs in Class A catalogue usually refer to drugs that are necessary for clinical treatment, widely used, with good curative effect and lower price among similar drugs.

Class b drugs

Drugs in Class B list usually refer to drugs that can be used for clinical treatment and have good curative effect, and the prices of similar drugs are slightly higher than those in Class A list.

Class C drugs

As for class C drugs, there are drugs with good curative effect and drugs with only health care function. As for class C drugs with good therapeutic effect on patients, the prices are generally very expensive.

So what is the specific reimbursement ratio of class A drugs, class B drugs and class C drugs?

Because class A drugs are the least, the treatment effect is good for patients, so the reimbursement ratio of class A drugs in general medical insurance is 100%.

Class B drugs are a little more than Class A drugs, so the general medical insurance for Class B drugs is 60%-90% reimbursed;

As for class C drugs, medical insurance will not reimburse them because they are not in the medical insurance drug list.

Legal basis: Article 8 of the Interim Measures for the Administration of Medication Scope of Basic Medical Insurance for Urban Employees.

The expenses incurred by the insured of the basic medical insurance in using the drugs in the Drug List shall be paid according to the following principles. The expenses incurred in using Class A drugs shall be paid in accordance with the provisions of the basic medical insurance.

The expenses incurred in the use of "Category B drugs" shall be paid by the insured according to a certain proportion, and then according to the provisions of the basic medical insurance. The specific proportion of individual pays shall be stipulated by the overall planning area and reported to the administrative departments of labor security of provinces, autonomous regions and municipalities directly under the Central Government for the record.

The expenses incurred in the use of Chinese herbal pieces shall be paid in accordance with the provisions of the basic medical insurance, except for drugs that are not paid by the basic medical insurance fund.