How to reimburse the medical expenses of tuberculosis?

The reimbursement method of medical expenses for tuberculosis;

Details are as follows:

1. At present, conventional drugs for tuberculosis belong to the category of national reimbursement. In specialized tuberculosis hospitals, a large part of the cost of tuberculosis treatment can be reimbursed. In addition, it should be noted that during the treatment of tuberculosis, some examination-related expenses need to be borne accordingly. In the whole treatment process of tuberculosis, it is necessary to carry out corresponding systematic examination and evaluation in regular specialized hospitals and give corresponding treatment. The specific expenses need to be judged according to the patient's specific condition and expenses. The hospital expenses corresponding to each region may be different and need to be confirmed in different regions.

2. TB reimbursement policy needs to consult the local medical insurance center. In addition, patients with pulmonary tuberculosis need to go to designated medical institutions for treatment and be properly isolated according to whether they are infectious or not.

Medical insurance reimbursement scope:

1. Insurance liability for hospitalization medical expenses within the scope of medical insurance, as well as some expenses in the medical insurance catalogue that are still borne by individuals after being reimbursed by basic medical insurance, serious illness insurance and medical assistance. , shall bear the liability for compensation within the agreed scope of insurance liability. 1 10,000 insured amount,10.5 million free of compensation, the reimbursement rate is 80%, and the reimbursement rate for continuous participation is increased to 85%;

2. The insurance liability of hospitalization medical expenses outside medical insurance coverage, as well as the part that is still borne by individuals after the expenses outside the medical insurance catalogue are reimbursed by basic medical insurance, serious illness insurance and medical assistance, shall be liable for compensation within the agreed scope of insurance liability. 1 10,000 insured amount,1.8,000 free of compensation, the reimbursement rate is 60%, and the reimbursement rate for continuous participation is increased to 65%;

3, outpatient specific high drug costs insurance liability, in designated hospitals, designated pharmacies, drug costs borne by individuals, within the agreed scope of insurance liability, bear the liability for compensation. 700,000 insured amount, 26 kinds of drugs, and 20,000 yuan shared with the insurance responsibility of outpatient drugs/hospitalization medical insurance expenses for rare diseases, with a compensation ratio of 80%;

4. Designate the insurance liability of outpatient drugs for rare diseases/hospitalization medical insurance expenses, and pay part of the drug expenses paid by individuals in designated hospitals and pharmacies within the agreed scope of insurance liability. 300,000 insured amount, 12 drugs, sharing 20,000 yuan with the insurance responsibility of outpatient specific high drug expenses, and the reimbursement ratio is 70%.

To sum up, the treatment of tuberculosis can be reimbursed, which is divided into two parts. One part is normal medical insurance, including employee medical insurance, resident medical insurance and the new rural cooperative medical system. The hospitalization expenses can definitely be reimbursed. The other is that outpatient treatment with anti-tuberculosis drugs can also be reimbursed. Generally speaking, it provides drugs free of charge. Even if you choose drugs at your own expense, its cost is not very large, unless it is some drug-resistant tuberculosis. If the drug cost of drug-resistant tuberculosis is relatively high, the state currently provides a certain amount of free drugs.

Legal basis:

Article 2 of People's Republic of China (PRC) Insurance Law

The term "insurance" as mentioned in this Law refers to the commercial insurance behavior in which the applicant pays the insurance premium to the insurer according to the contract, and when the insured dies, suffers from disability, illness or reaches the age and time limit agreed in the contract, the insurer shall be liable for the property losses caused by the possible accidents agreed in the contract.

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This Law is applicable to insurance activities in People's Republic of China (PRC).

Article 5

The parties to insurance activities shall exercise their rights and perform their obligations in accordance with the principle of good faith.