Is the tumor covered by medical insurance, and how much can be reimbursed by tumor medical insurance

Cancer Medicare can cover it. In addition, some outpatient clinics** for cancer will be included in the management of special diseases, and there is a separate reimbursement policy. However, if you use imported drugs and other self-financed drugs for cancer, you cannot be reimbursed because self-financed drugs are not covered by reimbursement.

1. What is the reimbursement ratio of cancer medical insurance? - 85% reimbursement for less than 40,000 yuan;

90% reimbursement for less than 10,000-80,000 yuan;

95% reimbursement for more than 10,000 yuan.

2. 12 types of serious illnesses are included in the medical insurance coverage for serious illnesses1. Lung cancer;

2. Esophageal cancer.

3. Gastric cancer; 4. Colon cancer;

5. Rectal cancer;

6. Chronic myeloid leukemia;

7. Acute myocardial infarction;

8. Cerebral infarction;

9. Hemophilia;

10. Type 1 diabetes;

11. Hyperthyroidism;

12. Cleft lip and palate.

3. Which serious illness medical insurance is not reimbursed? 1. Seeking medical treatment in non-designated hospitals without approval (except for emergency rescue);

2. Suffering from occupational diseases, work-related injuries or work-related injuries;

3. Injuries caused by traffic accidents;

4. Injury caused by one's own violation of the law;

5. Food poisoning caused by liability accidents;

6. Caused by suicide;

7. Injuries caused by medical accidents;

8. According to the provisions of the state and the city, the medical expenses shall be borne by themselves.

The malignant tumor subsidy policy is:

1. In-service and retired employees apply for subsidies at the trade union of their units;

2. The unemployed apply for subsidies to the civil affairs department of the community or sub-district;

3. When applying, you must bring all cancer diagnosis records, including examination and diagnosis, specific medication, payment records during the ** period, and ID card;

4. If you are unable to apply in person, you need to show proof of the relationship between the agent and me.

What is the subsidy standard for malignant tumors.

1. Cancer subsidy policy: a subsidy of 5,000 yuan per person for rural cancer patients;

2. Uremia subsidy policy: as long as you participate in the medical insurance, 90% of the dialysis and other expenses will be reimbursed according to the regulations, and individuals only need to pay 10%. 3. Breast cancer subsidy policy, breast cancer is a common malignant tumor in middle-aged and elderly women;

3. It should be determined according to the pathological stage, pathological type, whether there is metastasis and the general physical condition of the patient.

Outpatient special diseases refer to those that can be outpatient ** without hospitalization**. Chronic diseases that still require long-term dependence on medication to maintain stable condition. It usually refers to diseases such as malignant tumors requiring radiation** and chemistry**, renal insufficiency requiring long-term renal dialysis**, and long-term anti-rejection drugs** after kidney transplantation.

For the medical expenses incurred in the outpatient clinic for special diseases**, the minimum payment standard is 500 yuan within one year, and 85% of the outpatient medical expenses for diseases managed by Class A will be reimbursed for the part exceeding 500 yuan; 75% reimbursement of outpatient medical expenses for diseases managed by category B. The outpatient fee for special diseases and the inpatient medical fee paid by the co-ordinated ** are calculated together, and the maximum payment limit within one year is 50,000 yuan. The part exceeding 50,000 yuan will be reimbursed by the large amount of medical assistance according to the regulations.

Of course, there is still a certain gap in medical insurance in various places, and the details need to be based on the exact information of the relevant parts.

Legal basis: Article 27 of the Implementation Measures for Basic Medical Insurance for Urban and Rural Residents in Hunan Province.

The part of the hospitalization medical expenses incurred by the insured residents in the designated medical institutions of the basic medical insurance in the overall planning area within the policy scope shall be paid by the urban and rural residents' medical insurance ** in proportion: not less than 80% of the township health centers and community health service institutions; county-level medical institutions shall not be less than 70%; Municipal medical institutions shall not be less than 60%. Each co-ordinating area shall reasonably determine the specific payment ratio according to the income and expenditure of urban and rural residents' medical insurance.

Social security includes basic medical insurance and endowment insurance.

Wait. More precisely, the basic medical insurance in the social security is responsible for the reimbursement of medical expenses.

There is a requirement for the number of years of social security contributions, if you have paid social security before, and the social security is valid, if you have a malignant tumor.

Medical insurance can reimburse the associated expenses.

The national basic medical insurance is divided into employee medical insurance, urban residents' medical insurance, and the New Rural Cooperative Medical System.

Medical insurance, corresponding to different groups of people. As long as there is one of these types of insurance, the ** cost will be reimbursed in proportion to the cost.

Malignant tumors can apply for the following policies: 1. In-service and retired employees apply for subsidies at the trade union (or party office) of their unit. Generally, according to the standards formulated by the system or the unit, the relative subsidy amount is higher; 2. The unemployed apply for subsidies to the civil affairs department of the community or sub-district;

Generally, it is strictly in accordance with the standards of the relevant provisions of the national civil affairs, and the subsidy amount is relatively fixed, but there are differences between regions; 3. When applying, you must bring all cancer diagnosis records, including examination and diagnosis, specific medication (the bottom prescription of the prescription), payment records during the ** period, and ID card. If you are unable to apply in person, you need to show proof of the relationship between the agent and me (usually a household registration book or marriage certificate, etc.), and you can apply for it on your behalf.

According to. Social Insurance Law of the People's Republic of China

Article 20 The State shall establish and improve a new type of rural social endowment insurance system.

The new rural social endowment insurance implements a combination of individual contributions, collective subsidies and subsidies. Article 23 Employees shall participate in the basic medical insurance for employees, and the employer and the employees shall jointly pay the basic medical insurance premiums in accordance with the provisions of the State.

Individually-owned businesses without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other flexibly employed persons may participate in the basic medical insurance for employees, and the individual shall pay the basic medical insurance premiums in accordance with the provisions of the state. Article 25 The State shall establish and improve the basic medical insurance system for urban residents.

The basic medical insurance for urban residents implements a combination of individual payment and subsidy.

Those who enjoy the minimum living guarantee, the disabled who have lost the ability to work, the elderly over the age of 60 and minors from low-income families, etc., will be subsidized by **. Article 27 Individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, the cumulative contributions reach the number of years prescribed by the State, and they will no longer pay the basic medical insurance premiums after retirement, and enjoy the basic medical insurance benefits in accordance with the provisions of the State; If the number of years prescribed by the state has not been reached, the fee can be paid until the number of years prescribed by the state. Article 30 The following medical expenses are not included in the scope of payment of basic medical insurance**

1) It should be paid out of work-related injury insurance**;

2) It shall be borne by a third party;

3) It should be borne by public health;

4) Seeking medical treatment outside the country.

Medical expenses shall be borne by the third party in accordance with the law, and if the third party does not pay or the third party cannot be determined, the basic medical insurance shall pay in advance. After the basic medical insurance** is paid in advance, it has the right to recover from a third party.

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Legal analysis - 85% reimbursement for less than 40,000 yuan;

90% reimbursement for less than 10,000-80,000 yuan;

95% reimbursement for more than 10,000 yuan.

Legal basis: Social Insurance Law of the People's Republic of China

Article 2: The State shall establish social insurance systems such as basic endowment insurance, basic medical insurance, work-related injury insurance, unemployment insurance, and maternity insurance, to protect citizens' right to receive material assistance from the State and society in accordance with law in the event of old age, illness, work-related injury, unemployment, childbirth, and so forth.

Article 26 The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with the provisions of the State.

Article 28 In line with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and medical expenses, emergency and rescue medical expenses, in accordance with the provisions of the State from the basic medical insurance **.

1. What is the reimbursement ratio of cancer medical insurance?

- 85% reimbursement for less than 40,000 yuan;

90% reimbursement for less than 10,000-80,000 yuan;

95% reimbursement for more than 10,000 yuan.

2. 12 types of serious illnesses are included in the medical insurance coverage for serious illnesses

1. Lung cancer; 2. Esophageal cancer.

3. Gastric cancer; 4. Colon cancer;

5. Rectal cancer;

6. Chronic myeloid leukemia;

7. Acute myocardial infarction;

8. Cerebral infarction;

9. Hemophilia;

10. Type 1 diabetes;

11. Hyperthyroidism;

12. Cleft lip and palate.

3. Which serious illness medical insurance is not reimbursed?

1. Seeking medical treatment in non-designated hospitals without approval (except for emergency rescue);

2. Suffering from hail illness, work-related injury or work-related injury;

3. Injuries caused by traffic accidents;

4. Injury caused by one's own violation of the law;

5. Poisoning the waiter in the food due to a liability accident;

6. Caused by suicide;

7. Injuries caused by medical accidents;

8. According to the provisions of the state and the city, the medical expenses shall be borne by themselves.