What are Class A and Class B within the scope of social security?

Among the three major catalogues of medical insurance, the catalogue of medical insurance drugs and the catalogue of medical treatment items are divided into "Class A" and "Class B". "A" and "B" have different reimbursement ranges for drugs and medical treatment items.

No. 1

What are the meanings of "Class A" and "Class B" in the medical insurance drug list?

Drugs in the medical insurance drug list are divided into "Class A" and "Class B".

Class A drugs are necessary for clinical treatment, widely used, with good curative effect and low price among similar drugs. Class B drugs can be used in clinic with good curative effect, and the price of similar drugs is higher than that of class A drugs.

When the insured uses "Class A" drugs, they can all be included in the scope of reimbursement.

When the insured uses "Class B" drugs, if the proportion of personal burden is not marked, the individual shall bear 10% of the drug cost first, and the rest shall be included in the payment scope of the medical insurance fund. If the proportion of personal burden has been marked, it shall be borne by the individual according to the marked proportion, and the rest shall be included in the payment scope of medical insurance fund.

Drug category query method

second

What are the meanings of "Class A" and "Class B" marked in the catalogue of diagnosis and treatment items?

The diagnosis and treatment projects are divided into "Class A projects" and "Class B projects".

The diagnosis and treatment items in Class A Catalogue are necessary, safe, effective and affordable for clinical diagnosis and treatment.

The diagnosis and treatment items in Class B Catalogue can be used for clinical diagnosis and treatment, and the curative effect is exact, but it needs to be properly controlled. Some items in the "Class B Catalogue" are limited according to clinical indications, hospital level and specialty characteristics, and qualifications of medical technicians.

Category A projects are all included in the scope of reimbursement.

Category B projects require individuals to bear part of the expenses in advance, and the rest will be included in the scope of reimbursement.

In order to interest everyone.

Reimbursement provisions for Class B projects

Have a clearer understanding

here

Give you a few examples.

Fixed payment for diagnosis and treatment projects

Example 1

The medical service fee for general outpatient service in tertiary hospitals is 50 yuan, paid by the individual 10 yuan, and paid by the medical insurance fund to 40 yuan;

Example 2

The bed fee for the triple room is 60 yuan, paid by the individual in advance 10 yuan, and the rest of 50 yuan is included in the reimbursement scope.

Individuals should bear the diagnosis and treatment projects first in proportion.

Example 1

Head X-ray CT scan 135 yuan/time, 8% in advance, and the rest included in the reimbursement scope;

Example 2

Stereotactic radiotherapy device refers to: gamma knife (R knife) 16000 yuan/case, with 20% paid in advance by individuals and the rest included in the reimbursement scope.