医保甲类和乙类的区别

1年前 (2021-08-11) 0 点赞 0 收藏 0 评论 154 已阅读

医保的甲乙类药品有何区别?

甲类药品是全额报销,为何还要自付一部分?

 

提问

&

解答

老友问

什么是甲类药品?什么是乙类药品?

 答 

医保药品目录分为“甲类”和“乙类”。甲类药品是临床治疗必需、使用广泛、疗效好,同类药品中价格低的药品;乙类药品是可供临床治疗选择使用、疗效好,同类药品中比甲类药品价格高的药品。

老友问

甲乙类药品在医保报销上有何不同?

 答 

“甲类”“乙类”所对应药品的报销方式有所不同。   

参保人使用“甲类”药品时,可以全额纳入报销范围,然后按基本医疗保险规定的支付比例报销;

参保人使用“乙类”药品时,先由参保人自付一定比例后,再按基本医疗保险规定的支付比例报销。其中,未标注个人负担比例的,需由个人先负担10%的药品费用,其余部分列入医疗保险基金支付范围;已经标注个人负担比例的,先由个人按标注的比例负担,其余部分列入医疗保险基金支付范围。

医保甲类和乙类的区别

假设

一种医保药品价格为10元

基本医疗保险支付比例为90%

医保甲类和乙类的区别

■ 如果是甲类药品,10元药价全部进入医保报销范围,按照90%的支付比例来报销,10*90%=9元。也就是说,医保基金报销了9元钱,个人负担1元。

■ 如果是乙类药品,10元药价中,个人先行自付10%,10*10%=1元,余下9元进入医保报销范围,9*90%=8.1元。也就是说,医保基金报销了8.1元,医保报销后个人自付0.9元,加上之前个人先行自付的1元,自付费用合计1.9元。

总有人说我帅

我笑了

因为我笑起来更帅

医保甲类和乙类的区别
 

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钦业扫码支付盒子扫码枪条码扫描器超市健康码药店医院电子医保卡手机收钱机器一维二维码扫码器收银扫描平台 券后价¥39.9 天猫 优惠券¥6 立即领券
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