What is the difference between medical insurance category A and category B?

As we all know, medical insurance can give a guarantee when people are seriously ill, and can provide a certain percentage of reimbursement expenses, thereby reducing the burden on families. There is a difference between medical insurance category A and class B, and they are different in the type and proportion of reimbursement, so let's give you a specific explanation. <>

1.There is a big difference in the reimbursement ratio between Category A and Category B of medical insurance.

I once went to see a doctor with a friend, and my friend used Category A medical insurance at that time, and for Category A patients, they only need to bear a self-conceited ratio, and the proportion covered by medical insurance may be 100%. However, Category B needs to bear the proportion twice, the first is to bear the same as Category A, and secondly, it has to bear a self-payment, and the proportion of reimbursement for Category A will be relatively higher. Class B medical insurance, some can only be reimbursed 20%.

2.There are also differences in the categories of reimbursement between Category A and Category B of medical insurance.

We can see this in many places, first of all, the reimbursement of Class A must be sold in pharmacies, and Class B can also be sold in other places in addition to being sold in pharmacies, but it must also be reviewed and approved for registration, so the scope of Class B is also larger, but the proportion of reimbursement is not too large. <>

3.We can choose the categories A and B of medical insurance according to our actual needs.

Category A and Category B of medical insurance have their own advantages and disadvantages, for example, Category A can reimburse a larger proportion, but the types are relatively small, and Category B is relatively small in terms of reimbursement, but the scope of reimbursement is wide. Generally, there is an undulation line, and above and below this undulation line, a certain amount of category C fees will be calculated, so we have to choose according to our actual situation.

All in all, there are many differences between Category A and Category B of medical insurance. For example, in terms of reimbursement ratio, the reimbursement ratio of medical insurance is larger, but in the scope of reimbursement, the scope of reimbursement of medical insurance is wider, and we can choose category A or category B according to our actual situation, which will be better.

The reimbursement ratio of medical insurance class A and class B is different, and 100% of class A drugs are reimbursed on a proportional basis. Category B has to pay a portion out of pocket. Class A drugs are generally widely used and have good efficacy, **low, and Class B drugs** are higher.

The difference is the scope of reimbursement and the proportion of reimbursement. Category A reimbursement has a narrow scope and a high reimbursement ratio, while Category B reimbursement has a wide range and a high self-responsibility ratio.

The reimbursement ratio of Class A drugs is 100%, and the reimbursement ratio of Class B drugs is 70%-80%. The National Drug Catalogue of Basic Medical Insurance divides drugs into three categories: Class I, Class A, which can all be reimbursed by medical insurance and reimbursed according to the proportion of medical insurance; The second category B is that the individual is required to bear part of the expenses according to a certain proportion, and the remaining part is included in the scope of medical insurance reimbursement, and the reimbursement is made according to the medical insurance proportion set by the law; The third category of category C, this part of the medicine is not reimbursed, all borne by the individual.

Medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by the risk of disease.

Through the employer and individual payment, the establishment of medical insurance**, after the insured person is sick and incurs medical expenses, the medical insurance institution will give him a certain amount of economic compensation.

The establishment and implementation of the basic medical insurance system gathers the economic strength of the unit and the members of the society, coupled with the best funding, which can enable the sick members of the society to obtain the necessary material help from the society, reduce the burden of medical expenses, and prevent the sick members of the society from becoming poor due to illness. Since Class A drugs are the least and have a good effect on patients, the general Class A drug medical insurance will be reimbursed at a rate of 100%; Category B drugs are slightly more than Class A drugs, so the general medical insurance for Class B drugs is reimbursed at a ratio of 60%-90%; As for Class C drugs, because they are not included in the list of drugs covered by medical insurance, they are not reimbursed by medical insurance.

Extended Information: What is the difference between Class A and Class B and Class C of medical insurance drugs?

Basic medical insurance drugs refer to the drugs that are clinically necessary to ensure employees and are included in the scope of basic medical insurance payments, which are divided into two types: Class A and Class B.

Class A drugs refer to drugs that are basically unified across the country and can ensure the basic clinical needs. The cost of such drugs is included in the scope of basic medical insurance** and is paid according to the standard of basic medical insurance.

Category B drugs refer to the basic medical insurance ** has part of the ability to pay for the cost of drugs, such drugs are first paid by the employee a certain percentage of the cost, and then included in the basic medical insurance ** payment scope, and according to the basic medical insurance payment standard to pay the cost.

Legal basis: Article 23 of the Social Insurance Law of the People's Republic of China Employees shall participate in the basic medical insurance for employees, and the employer and the employee 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 28 In line with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and emergency and rescue medical expenses, in accordance with the provisions of the state from the basic medical insurance ** payment.

Hello, friend<>

We are happy to serve you, in response to your questions, after inquiry, as follows, please take a closer look at the <> there is a difference in the reimbursement ratio between medical insurance category A and category B. Under normal circumstances: medical insurance personnel enjoy a relatively higher reimbursement ratio.

The reimbursement ratio of medical insurance category B personnel will be lower than that of category A. Specifically: Category A personnel:

Work-related injuries, mothers, and children can be reimbursed 80%-95%. Retirees can be reimbursed 70%-80%. 60% of the basic medical care for urban workers can be reimbursed.

Category B personnel: 50% of the basic medical care for non-urban employees can be reimbursed. The reimbursement rate of basic medical care for employees is about 30%-40%.

Serious illness discretion standard, the reimbursement ratio is low. The main difference is that the health insurance system is different.

Category A personnel participate in the basic medical insurance for urban employees, and the reimbursement ratio is high; Category B participates in the new type of rural cooperative medical care, and the reimbursement rate is low. The standards are different. The standard of Class B medical hand auction insurance is unified, and the reimbursement ratio is relatively conservative; Class A medical insurance has been adjusted according to the level of urban development, and the reimbursement ratio has been gradually increased.

Financial support. Due to the large number of people who enjoy high medical subsidies, the financial investment is also relatively high.

The reimbursement ratio of medical insurance category A and medical insurance category B is set for different types of medical insurance drugs and medical items. Medical insurance Class A drugs refer to drugs that are necessary for diseases, have limited purchases, and have scientifically identified and clinically proven to be effective in active ingredients, and their reimbursement rates are usually 90% to 100%. These drugs play a very important role in serious diseases, and the increase in the reimbursement ratio of medical insurance class A can reduce the financial burden of patients and promote the effectiveness of diseases.

Category B drugs under medical insurance refer to drugs that are not necessary for the disease, but may be helpful for the disease, and the reimbursement rate of jujube celery is usually low, generally between 50% and 70%. The medical insurance class B stool is suitable for the auxiliary of mild and chronic diseases, which can alleviate symptoms and improve the quality of life. In addition to the reimbursement ratio of drugs, medical insurance also sets the reimbursement ratio of different categories of medical items.

Generally speaking, the medical items listed in the medical insurance catalogue can be reimbursed, of which the reimbursement ratio of diagnosis and treatment expenses, hospitalization expenses, surgical expenses, etc. in the medical insurance category A is between 80% and 100%, and the common examination, laboratory tests, radiology, ultrasound and other items in the medical insurance category B reimbursement rate is between 50% and 70%.

Summary. Hello <>

The reimbursement ratio of medical insurance category A and category B is different. Class A drugs refer to drugs that have been strictly approved by the state and have been clinically proven to have definite efficacy, high safety and reasonable quality, such as the commonly used penicillin. Within the scope of medical insurance reimbursement, the reimbursement ratio of Class A drugs generally ranges from 50% to 90%, which may vary according to different regions and policies.

Category B drugs refer to non-Class A drugs, including some auxiliary or functional drugs. Because its efficacy is relatively unclear and the scope of use is relatively narrow, the reimbursement ratio of medical insurance is lower than that of Class A drugs. Under normal circumstances, the reimbursement ratio of Class B drugs within the scope of medical insurance is about 40% to 70%.

It is important to note that the reimbursement ratio is not fixed and can be affected by various factors. For example, policy adjustments, drug ** changes, etc. may have an impact on the reimbursement ratio. At the same time, reimbursement ratios may vary from region to region and from hospital to hospital.

Reimbursement ratio of medical insurance category A and category B.

Hello <>

The reimbursement ratio of medical insurance category A and category B is different. Class A drugs refer to drugs that have been strictly approved by the state, and have been clinically proven to have definite efficacy, high safety and coarse penetration, and reasonable quality, such as commonly used penicillin. Within the scope of medical insurance reimbursement, the reimbursement ratio of Class A drugs generally ranges from 50% to 90%, which may vary according to different regions and policies.

Category B drugs refer to non-Mingji Class A drugs, including some auxiliary or functional** drugs. Because its efficacy is relatively unclear and the scope of use is relatively narrow, the reimbursement ratio of medical insurance is lower than that of Class A drugs. Under normal circumstances, the reimbursement ratio of Class B drugs within the scope of medical insurance is about 40% to 70%.

It is important to note that the reimbursement ratio is not fixed and can be affected by various factors. For example, policy adjustments, drug ** changes, etc. may have an impact on the reimbursement ratio. At the same time, reimbursement ratios may vary from region to region and from hospital to hospital.

In addition, in addition to Class A and Class B, there is also a special medical insurance drug - special drugs. This drug is mainly used for some rare diseases and special diseases, which is relatively high, because the reimbursement ratio of this medical insurance is relatively high, generally more than 70%. However, applying for reimbursement also needs to meet certain conditions.