How is cancer covered by medical insurance, and is cancer medical insurance reimbursed

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.

Cancer Medicare can cover it. The reimbursement rates for cancer medical insurance are as follows:

85% reimbursement to less than 40,000 yuan; Yard pose.

90% reimbursement from 10,000 yuan to less than 80,000 yuan;

95% reimbursement for more than 10,000 yuan. Cancer is a disease within the scope of reimbursement by medical insurance for serious illnesses, and if it meets certain conditions, it can apply for a second reimbursement. The specific reimbursement ratio and reimbursement procedures shall be determined in accordance with local laws and regulations.

There may be some differences in the proportion of cancer reimbursement between regions.

The reimbursement scope of medical insurance is:

1. Reimbursement scope of resident medical insurance: including reimbursement for general outpatient services, serious illnesses and special outpatient services;

2. The reimbursement scope of employee medical insurance: it is divided into a co-ordinated account and a personal account, the co-ordinated account can reimburse inpatient medical expenses, special outpatient medical expenses, etc., and the personal account can directly pay for the cost of ordinary outpatient and designated pharmacies, and the self-paid part of inpatient medical expenses;

3. Whether it is resident medical insurance or employee medical insurance, when reimbursing related medical expenses, there are usually restrictions on the starting line, reimbursement ratio and limit. In addition, although the scope of reimbursement for medical insurance in various places is similar, the regulations on the starting line and reimbursement ratio may be different, so it depends on how the local medical insurance reimbursement policy is stipulated.

Legal basisArticle 28 of the Social Insurance Law of the People's Republic of China.

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be paid from the basic medical insurance in accordance with national regulations.

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.

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.

Legal basis: Article 30 of the Social Insurance Law of the People's Republic of China 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.

- Reimbursement below 40,000 yuan, reimbursement below 10,000 yuan, reimbursement below 80,000 yuan, 95% reimbursement above 10,000 yuan. 12 types of serious diseases are included in the medical insurance coverage for serious illness1, lung cancer; 2. Esophageal cancer 3. Gastric cancer; 4. Colon cancer branches; 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.

Legal basis] Article 64 of the Full Text of the Social Insurance Law of the People's Republic of China provides that social insurance includes basic endowment insurance, basic medical insurance, work-related injury insurance, unemployment insurance, and maternity insurance. In addition to the basic medical insurance** and maternity insurance** combined accounts and accounting, other social insurance and malpractice insurance** are separately established and accounted for separately according to the type of social insurance insurance. Social insurance** implements a unified national accounting system.

The special funds for social insurance are used exclusively and shall not be embezzled or misappropriated by any organization or individual. The basic endowment insurance will gradually implement the national overall planning, and other social insurance will gradually implement the provincial overall planning, and the specific time and steps shall be stipulated by the national level.

If you still have questions about this issue, it is recommended that you organize the relevant information and communicate with a professional in detail.

Not reported. (It is recommended that the landlord first clarify the concept of "self-financed medicine").

1. Self-financed drugs. As the name suggests, it is a part of the medicine that you can pay for.

2. In the calculation of general medical insurance reimbursement, the cost of the entire ** is divided into 3 categories: medical insurance reimbursement all, medical insurance partial reimbursement (that is, medical insurance reimbursement part, personal burden), medical insurance complete non-reimbursement (all personal responsibility). In the future, calculate the total amount of medical insurance reimbursement and how much the individual bears.

3. Generally, most drugs and ** are "partial reimbursement by medical insurance".

4. Medical insurance reimbursement, generally we tell the doctor (hospital) whether we have bought medical insurance at the beginning of the medical treatment (because the same effect or result of the use of two drugs, whether the medical insurance can be reimbursed is different, the general doctor guides whether the medical insurance is available, and can help you choose and suggest from the economic aspect), at the end of the medical checkout, the system (computer) has been charged in the payment system (computer) according to the drug varieties of automatic settlement. Patients are generally only required to pay the personal portion. Other systems automatically settle with the Social Security Administration.

5. Of course, there are some areas (especially in rural areas), because the development of social security is not comprehensive, resulting in the need for patients to first pay the "medical insurance reimbursement part" together in the ** settlement, and then go back to the village office and other local social security units for reimbursement.