1, the patient sees a doctor in a designated medical institution, and pays the Qifubiaozhun 300 yuan for chronic diseases;
2. Adult residents pay according to the low standard, and the reimbursement ratio is 50%; For underage residents and adult residents who pay according to high-grade standards, the reimbursement rate is 60%;
3, malignant tumor radiotherapy and chemotherapy, uremia dialysis treatment, tissue and organ transplantation after taking anti-rejection drugs outpatient treatment costs have no deductible, according to the low standard to pay the reimbursement rate of adult residents is 70%, underage residents and according to the high standard to pay the reimbursement rate of 80%;
4, uremia dialysis treatment, tissue and organ transplantation after taking anti-rejection drugs annual expense reimbursement standard, adult residents according to the low standard payment limit of 60000 yuan, minor residents according to the high standard payment limit of 80000 yuan. Eligible medical expenses shall be paid from the basic medical insurance fund in accordance with state regulations.
Management and prevention of chronic diseases;
1, the definition of chronic diseases: refers to those diseases with slow course and long duration, which are difficult to be completely cured;
2. Common types of chronic diseases: including cardiovascular diseases, diabetes, chronic respiratory diseases, cancer, etc.
3. Preventive measures for chronic diseases: including healthy diet, regular exercise, smoking cessation and alcohol restriction, regular physical examination, etc.
4. Self-management of chronic diseases: patients need to learn to monitor their condition, use drugs rationally, follow the doctor's advice and adjust their lifestyle;
5. Medical services for chronic diseases: usually including outpatient treatment, long-term medication, regular follow-up, health education, etc.
6. Psychological support for chronic diseases: Patients can cope with the psychological pressure caused by diseases through psychological consultation, participation in support groups, family and social support.
To sum up, there is a deductible line in the reimbursement process of chronic medical expenses, and the reimbursement ratio is different. Adult residents and minor residents enjoy 50%-80% reimbursement according to the payment standard. There is no deductible for the treatment expenses of certain diseases such as malignant tumor and uremia, and there is an annual reimbursement limit to ensure that the eligible expenses are paid by the basic medical insurance fund, which reflects the national safeguard measures for patients with chronic diseases.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations. Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.