Can medical insurance biologics be reimbursed in 2018

It can be reimbursed, taking Beijing as an example.

Beijing Municipal Measures for Basic Medical Insurance for Urban Residents have corresponding provisions on it:

19th insured persons in line with the city's basic medical insurance and student and children's serious illness medical insurance drug catalog, diagnosis and treatment items catalog, medical service facilities within the scope of medical expenses, by the urban residents of the basic medical insurance ** according to the provisions of the payment. Includes:

1) Outpatient (emergency) medical expenses;

2) Medical expenses for hospitalization**;

3) Outpatient medical expenses for radiation and chemistry of malignant tumors, kidney dialysis, kidney transplantation, and liver transplantation.

Social health insurance reimbursement is reimbursed after discharge or transfer.

Settlement procedures for inpatient and special disease outpatient**:

Before the 10th of each month, the designated medical institutions shall report the cost statement, hospitalization statement and relevant information of the discharged patients in the previous month to the medical insurance agency, and the medical insurance agency shall review and use it as the basis for monthly pre-allocation and year-end accounts;

The medical insurance agency pre-allocates the overall expenses of the previous month's inpatient and special disease outpatient clinics** every month;

Insured persons who have been identified as having special diseases should go to a designated medical institution designated by the labor and social security department to seek medical treatment and purchase medicines, and the medical expenses incurred shall be directly billed and settled immediately;

Emergency settlement procedures: insured personnel due to emergency rescue to the city's non-designated medical institutions and non-local medical institutions hospitalized**, the medical expenses incurred, first paid by the individual or unit, after the end of the emergency rescue, with the hospital emergency medical records, examinations, laboratory reports, invoices, detailed medical charges to the medical insurance agency according to the provisions of the reimbursement procedures.

Legal Analysis: Reimbursable Available. The medical expenses incurred by the insured persons in line with the city's basic medical insurance and the drug catalogue, diagnosis and treatment project catalogue, and medical service facilities of the city's basic medical insurance for students and children shall be paid by the basic medical insurance for urban residents according to the regulations.

Including: (1) outpatient (emergency) medical expenses; 2) Medical expenses for hospitalization**; 3) Outpatient medical expenses for radiation and chemistry of malignant tumors, kidney dialysis, kidney transplantation, and liver transplantation.

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 **.

Hello dear, depending on the situation. Biologics are included in the reimbursable catalogue and are reimbursable. Legal basis:

Article 24 of the Social Insurance Law of the People's Republic of China provides that the State shall establish and improve a new type of rural cooperative medical system. The management measures for the new type of rural cooperative medical care shall be stipulated by ***.

Summary. Dear, yes.

Biologics can be covered by medical insurance. Biologics are reimbursable, so they are reimbursable. The law stipulates that medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses can be reimbursed. Legal basis:

Article 28 of the Social Insurance Law stipulates that 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.

Pro, you can apply for medical insurance with biologics. Biologics are reimbursable, so they are reimbursable. According to the law, medical expenses that meet the requirements of the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses can be reimbursed.

Legal basis] Article 28 of the Social Insurance Law, in line with the basic medical insurance drug list, medical treatment items, medical service facility standards, emergency and rescue medical expenses, in accordance with national regulations from the basic medical insurance **.

Legal analysis: Biologics are reimbursable and reimbursable.

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

Article 24: The State is to establish and improve a new type of rural cooperative medical system.

The management measures for the new type of rural cooperation and medical care shall be stipulated by ***.

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 60 years old and minors from low-income families, etc., will be carefully divided and subsidized by **.

Article 31 According to the needs of Changhu management services, social insurance agencies may sign service agreements with medical institutions and drug business units to standardize medical services.

Medical institutions shall provide reasonable and necessary medical services to insured persons.

Biologics are not covered by medical insurance, so they cannot be reimbursed. However, biological agents are not reimbursed for daily medication, because biological agents are not basic drugs, they are new special drugs, so they are not reimbursed, and they cannot be bought or prescribed in hospitals.

Rural cooperative medical care can reimburse biological agents, but only for inpatient drugs, and biological agents will be reimbursed in proportion to the total cost when they are used as inpatient drugs.

Medicare reimbursement schemes

With the increase in the number of pilot projects and the improvement of the level of subsidies, all localities should carefully calculate and scientifically formulate and adjust the compensation plan for farmers' medical expenses on the basis of analyzing and summarizing the cooperative medical system and the best situation. The formulation and adjustment of the plan should grasp the following principles: First, on the basis of establishing risks, we should insist on achieving a balance between revenue and expenditure of cooperative medical care and a slight surplus.

Second, the new and local financial subsidy funds should be mainly used for the overall planning of serious diseases, and can also be appropriately used for small medical expenses subsidies to improve the subsidy level of cooperative medical care.

Fourth, the adjustment of the compensation plan should be carried out in the new year to maintain the continuity and stability of the policy.

Legal analysis: Biologics are reimbursable and reimbursable. The State shall establish and improve a new type of rural cooperative medical system.

The management measures for the new type of rural cooperative medical care shall be stipulated by ***. The State shall establish and improve a 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 **.

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

Article 4 Employers and individuals within the territory of the People's Republic of China who pay social insurance premiums in accordance with law have the right to inquire about payment records and records of individual rights and interests, and to request social insurance agencies to provide social insurance consultation and other related services.

Individuals enjoy social insurance benefits in accordance with the law, and have the right to supervise their own units' contributions for them.

Article 5: The people at or above the county level shall include social insurance undertakings in their national economic and social development plans. The state raises social insurance funds through multiple channels. The people at or above the county level shall give necessary financial support to the social insurance undertakings.

The state supports social insurance through preferential tax policies.

Biologics can be covered by medical insurance. Biologics are reimbursable, so they are reimbursable. The law stipulates that medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses can be reimbursed.

Legal basis: Article 28 of the "Social Insurance Law", in line with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and medical expenses for emergency and rescue, in accordance with national regulations from the basic medical insurance **.

Biologics are reimbursable, so they are reimbursable. The law stipulates that medical expenses that meet the standards of basic medical insurance drug lists, diagnosis and treatment items, medical service facilities, and emergency and rescue can be reimbursed. The law is based on the law

Article 28 of the Social Insurance Law stipulates that 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.

Can biologics be reimbursed?

Kiss, biologics aggroms can be reimbursed. As long as all drugs specified in the medical insurance list can be reimbursed (including biological agents).

Hello, can biologics be covered by medical insurance? Biologics are reimbursable, so they are reimbursable. The law has changed and covered the medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses.

Legal basis] Article 28 of the "Social Insurance Law" stipulates that 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.

Summary. Hello dear, glad to answer for you. Biologics medical insurance reimbursement process1

The doctor submits an application, and the hospital goes through the process of self-purchase of drugs to provide drugs to patients. 2.The doctor applies to the medical insurance office, and the medical insurance office can purchase it at a designated pharmacy and reimburse it at the hospital.

Hello dear, glad to answer for you. Biologics Fu Honghu medical insurance reimbursement process 1The doctor submits an application, and the hospital goes through the process of self-purchase of drugs to provide drugs to patients.

2.The doctor applied to the medical insurance office, and the medical insurance office could designate a pharmacy to purchase it and reimburse it at the hospital.

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**, the insured personnel after the medical expenses incurred by the medical expenses, by the medical insurance institutions to give them a certain amount of economic compensation. The establishment and implementation of the basic medical insurance system gathers the economic strength of the units and members of the society, coupled with the financial support, 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".

In November 2019, the first batch of 422 diseases and payment methods in Anhui Province were announced, and from January 1, 2020, there will be a unified payment standard for urban and rural residents when they seek medical treatment in 18 hospitals in the province.