1. New drugs 148 basic drugs, major diseases, chronic diseases, and children's drugs. At the same time, medical insurance covers 128 kinds of cancer drugs, which greatly reduces the cost of cancer family drugs. The new drugs are added and others are reduced. 150 drugs were "kicked out" a new list for obvious abuse and low clinical value. The state also clearly stipulates that local drugs shall not formulate medical insurance directory by themselves, and shall not adopt flexible methods to increase the variety of drugs in the medical insurance directory. The scope of the medical insurance limit payment list shall not be adjusted. 2. Drug level adjustment 74 species of type B drugs was adjusted to type A drug payment. The list of Chinese medicines is divided into three categories by medical insurance: A, B, and C, so it is a good thing. In 74, it was fully compensated by Class B drugs A. The list of medical insurance is also to better protect residents' health and standardized medical insurance reimbursement and drugs. Is what are the scope of medical insurance without reimbursement 1. There is no consumption of designated institutions in medical insurance The words "medical insurance designated institutions" and "medical insurance designated hospitals" can be reimbursed with medical insurance cards, otherwise they can only pay at their own expense. 2. Medical costs do not reach the scope of medical insurance reimbursement The minimum amount of medical insurance reimbursement, the medical expenses consumed in designated hospitals must also reach the starting line to reimburse. To 3. Medical costs are lower than the reimbursement limit for medical insurance. In the actual level of national economic development, the starting point is generally between 100 yuan and 1800 yuan. If the cost is too low, it will not meet the insurance threshold and can only pay by itself. 4. Special medical The medical expenses incurred by the insured person due to plastic surgery and weight loss are not reimbursed. The how to pay for medical insurance to pay the fee The people who have no working unit to participate in social insurance should be implemented in accordance with the method of participating in social insurance in freelancers. Freelancers can only participate in endowment insurance and medical insurance. In terms of freelance in medical insurance, individual households can choose to build only a coordinated fund, do not build a personal account, and pay the basic medical insurance premiums at 4.2%of the average monthly salary of the previous year; 8%pay, establish a personal account! The employee participation in medical insurance is 6%and individuals bear 2%. If it is a rural household registration, you can participate in rural cooperative medical insurance. The medical insurance scope of urban residents is established for personnel other than participating in urban employee medical insurance. It is paid for one year and one year. [Legal basis] "Opinions on Deepening the Reform of the Medical Security System" . Improve fair and moderate treatment guarantee mechanism Fair and moderate treatment guarantee is to improve people's health and well -being Internal requirements. It is necessary to promote a more mature and setting of the statutory medical security system, improve the medical insurance and rescue system of severe diseases, coordinate and plan high -quality development of various medical security, and steadily improve the level of medical security in accordance with the level of economic development and funding. (4) Improve the basic medical insurance system. Adhere to and improve the basic medical insurance system and policy system that covers the entire population and participate in according to law. The classification guarantees of employees and urban and rural residents, the treatment and payment are linked, and the funds are established and accounts for accounting. Unified basic medical insurance levels, medical insurance directory, and standardize the method of determining medical insurance payment policies. Gradually incorporate outpatient medical expenses into the scope of payment of basic medical insurance overall funds, reform the basic medical insurance account of employees, and establish and improve the outpatient help mechanism. (5) Implement the medical security treatment list system. Establish and improve the system of medical security treatment list, standardize government decision -making authority, scientifically define the basic system, basic policies, fund payment projects and standards, and promote the legalization of the medical security system, scientific decision -making, and standardization of management. Each region should ensure smooth political order, and policies that exceed the scope of the list of lists without approval. Strictly implement the scope and standards of basic payment, implement fair and moderate guarantee, and correct the problems of over -guarantee and insufficient guarantee. (6) Improve a unified and standardized medical assistance system. Establish a timely and accurate identification mechanism for rescue objects, and scientifically determine the scope of rescue. Comprehensively implement the policy of funding for key rescue targets, and improve the medical expense assistance mechanism for key rescue targets. Establish a long -term mechanism for preventing and resolving poverty due to illness. Enhance the guarantee function of medical rescue support, reduce medical costs by clarifying the diagnosis and treatment plan, standardizing referrals, improve the annual medical assistance limit, and reasonably control the proportion of the cost of the poverty -stricken people's policy. (7) Improve the medical treatment cost guarantee mechanism for major epidemics. In emergencies such as emergencies, ensure that medical institutions are treated first and then charged. Improve the medical insurance payment policy of major epidemics, improve the direct settlement system for medical treatment for different places, and ensure that patients do not affect medical treatment due to expenses. Explore the establishment of special groups and medical expenses for specific diseases, and have a targeted exemption of restrictions on medical insurance directory, payment limit, and dosage. The use of medical security funds and public health services funds will be used to increase the proportion of payment to grass -roots medical institutions, and effectively connect public health services and medical services. (8) Promote the development of a multi -level medical security system. Strengthen basic medical insurance, major illness insurance and medical assistance triple protection functions, promote the complementary connection of various types of medical security, and improve the level of major diseases and diversified medical needs. Improve and standardize residents' serious illness insurance, large medical expenses subsidies for employees, medical subsidies for civil servants, and enterprise supplementary medical insurance. Accelerate the development of commercial health insurance, enrich the supply of health insurance products, and use the personal income tax policy of commercial health insurance to study and expand the scope of insurance products. Strengthen market behavior supervision and highlight
1. New drugs
148 basic drugs, major diseases, chronic diseases, and children's drugs. At the same time, medical insurance covers 128 kinds of cancer drugs, which greatly reduces the cost of cancer family drugs.
The new drugs are added and others are reduced. 150 drugs were "kicked out" a new list for obvious abuse and low clinical value. The state also clearly stipulates that local drugs shall not formulate medical insurance directory by themselves, and shall not adopt flexible methods to increase the variety of drugs in the medical insurance directory. The scope of the medical insurance limit payment list shall not be adjusted.
2. Drug level adjustment
74 species of type B drugs was adjusted to type A drug payment. The list of Chinese medicines is divided into three categories by medical insurance: A, B, and C, so it is a good thing. In 74, it was fully compensated by Class B drugs A. The list of medical insurance is also to better protect residents' health and standardized medical insurance reimbursement and drugs.
Is what are the scope of medical insurance without reimbursement
1. There is no consumption of designated institutions in medical insurance
The words "medical insurance designated institutions" and "medical insurance designated hospitals" can be reimbursed with medical insurance cards, otherwise they can only pay at their own expense.
2. Medical costs do not reach the scope of medical insurance reimbursement
The minimum amount of medical insurance reimbursement, the medical expenses consumed in designated hospitals must also reach the starting line to reimburse. To
3. Medical costs are lower than the reimbursement limit for medical insurance.
In the actual level of national economic development, the starting point is generally between 100 yuan and 1800 yuan. If the cost is too low, it will not meet the insurance threshold and can only pay by itself.
4. Special medical
The medical expenses incurred by the insured person due to plastic surgery and weight loss are not reimbursed.
The how to pay for medical insurance to pay the fee
The people who have no working unit to participate in social insurance should be implemented in accordance with the method of participating in social insurance in freelancers. Freelancers can only participate in endowment insurance and medical insurance. In terms of freelance in medical insurance, individual households can choose to build only a coordinated fund, do not build a personal account, and pay the basic medical insurance premiums at 4.2%of the average monthly salary of the previous year; 8%pay, establish a personal account!
The employee participation in medical insurance is 6%and individuals bear 2%.
If it is a rural household registration, you can participate in rural cooperative medical insurance.
The medical insurance scope of urban residents is established for personnel other than participating in urban employee medical insurance. It is paid for one year and one year.
[Legal basis]
"Opinions on Deepening the Reform of the Medical Security System"
. Improve fair and moderate treatment guarantee mechanism
Fair and moderate treatment guarantee is to improve people's health and well -being Internal requirements. It is necessary to promote a more mature and setting of the statutory medical security system, improve the medical insurance and rescue system of severe diseases, coordinate and plan high -quality development of various medical security, and steadily improve the level of medical security in accordance with the level of economic development and funding.
(4) Improve the basic medical insurance system. Adhere to and improve the basic medical insurance system and policy system that covers the entire population and participate in according to law. The classification guarantees of employees and urban and rural residents, the treatment and payment are linked, and the funds are established and accounts for accounting. Unified basic medical insurance levels, medical insurance directory, and standardize the method of determining medical insurance payment policies. Gradually incorporate outpatient medical expenses into the scope of payment of basic medical insurance overall funds, reform the basic medical insurance account of employees, and establish and improve the outpatient help mechanism.
(5) Implement the medical security treatment list system. Establish and improve the system of medical security treatment list, standardize government decision -making authority, scientifically define the basic system, basic policies, fund payment projects and standards, and promote the legalization of the medical security system, scientific decision -making, and standardization of management. Each region should ensure smooth political order, and policies that exceed the scope of the list of lists without approval. Strictly implement the scope and standards of basic payment, implement fair and moderate guarantee, and correct the problems of over -guarantee and insufficient guarantee.
(6) Improve a unified and standardized medical assistance system. Establish a timely and accurate identification mechanism for rescue objects, and scientifically determine the scope of rescue. Comprehensively implement the policy of funding for key rescue targets, and improve the medical expense assistance mechanism for key rescue targets. Establish a long -term mechanism for preventing and resolving poverty due to illness. Enhance the guarantee function of medical rescue support, reduce medical costs by clarifying the diagnosis and treatment plan, standardizing referrals, improve the annual medical assistance limit, and reasonably control the proportion of the cost of the poverty -stricken people's policy.
(7) Improve the medical treatment cost guarantee mechanism for major epidemics. In emergencies such as emergencies, ensure that medical institutions are treated first and then charged. Improve the medical insurance payment policy of major epidemics, improve the direct settlement system for medical treatment for different places, and ensure that patients do not affect medical treatment due to expenses. Explore the establishment of special groups and medical expenses for specific diseases, and have a targeted exemption of restrictions on medical insurance directory, payment limit, and dosage. The use of medical security funds and public health services funds will be used to increase the proportion of payment to grass -roots medical institutions, and effectively connect public health services and medical services.
(8) Promote the development of a multi -level medical security system. Strengthen basic medical insurance, major illness insurance and medical assistance triple protection functions, promote the complementary connection of various types of medical security, and improve the level of major diseases and diversified medical needs. Improve and standardize residents' serious illness insurance, large medical expenses subsidies for employees, medical subsidies for civil servants, and enterprise supplementary medical insurance. Accelerate the development of commercial health insurance, enrich the supply of health insurance products, and use the personal income tax policy of commercial health insurance to study and expand the scope of insurance products. Strengthen market behavior supervision and highlight