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Chengdu: It’s burden! Medical security is up to reimbursement of 400,000 yuan

Original title: The burden is reduced: the medical insurance can be reimbursed for a 400,000 yuan of drug fees for rare patients and their families. They have always oppressed a heavy mountain, not only is difficult, but the difficulties of drugs often become their treatment road. A threshold. Today, good news has finally come: On March 23, the website of Chengdu Municipal People’s Government announced the "Chengdu Medical Saving Bureau, Chengdu Finance Bureau, Chengdu Health Committee on the Issue of Rare Disease Protection".

According to this notice, in order to promote the construction of multi-level medical security system, resolve rare diseases on the risk of disastrous expenditure in the family of insured personnel, and Chengdu has established a rare disease prevention mechanism for "cost control, responsibility".

The notice is valid for 5 years, and the annual drug cost limit is up to 460,000 yuan, and the maximum medical insurance can be reimbursed by 400,000 yuan. So, which rare patient will be guaranteed? What is the scope of protection? What is the guaranteed fund? Applying for rare disease prevention needs to meet these conditions this "notice" clearly clarified the safeguards of rare diseases – the first application for rare diseases, one of the two conditions: 1, age 5 years old (including 5 The patients with the ages should be in Chengdu, medical mutual assistance supplementary insurance benefits, and the number of insured payments is 60 months. 2, patients who are less than 5 years of age 爱上海419论坛 should be in Chengdu, medical mutual assistance supplement insurance treatment, and their parents have participated in the medical mutual assistance supplement insurance, and the accumulated insured payment is over 60 months. It has already enjoyed the treatment of rare diseases to protect the treatment, and the application should be in Chengdu, the medical mutual assistance supplementary insurance treatment. The "Notice", which has been launched in the country, can be applied to the scope of use of the medication: a rare drug drug that has been approved in China has been included, and can be applied to the scope of this medication.

The so-called compliance, that is, 3 conditions: First, the drug indication is a disease described in the national rare disease catalog; the second is a rare disease-innovative 上海工作室外卖 medicine that is in combining breakthrough treatment drug characteristics; three is to pay 400,000 in medical insurance Yuan / year, the patient can obtain continuous normative medication under the limited conditions of 60,000 yuan / year. Pharmaceuticals in accordance with the above conditions, if their adaptation is included in the second case, the national basic medical insurance, work injury insurance and birth insurance drug catalog payment range, the corresponding drug indication is not included or exited from this medicinal security Scope. The rare disease drugs approved in the country, while meeting the above conditions, and is not higher than those with the adaptive drug year drug costs, which can be applied to the scope of use.

  Safeguard funds from major illness medical mutual help supplement insurance 阿拉爱上海同城论坛 rare disease drug protection funds from? It is reported that the guarantee is mainly derived from Chengdu major illness medical mutual assist supplement insurance funds, and the account accounting separately, and the balance is clear. 2% of the total number of major illness medical mutual assistance supplement insurance in accordance with the previous year, raising rare diseases. The Municipal Medical Insurance Bureau will adjust the proportion of funding in accordance with the operation of funding funds.

When the annual guarantees are expected to use the safeguards amount, the medical mutual help supplement insurance funds and drug production enterprises (or suppliers) are shared together. Safeguard the balance of the balance of the funds. The patient’s drug burden has a small annual fee to 460,000 yuan in this notice, which has clear requirements for rare disease guarantee standards: patient use of drug costs specified in the "Notice", accumulating calculation within one treatment year, segmentation reimbursement .

The annual drug cost limit is 460,000 yuan, of which there is 400,000 yuan for medical insurance payment limits, and personal burden is 60,000 yuan. The ratio of reimbursement ratios of 200,000 yuan (including 200,000) within a treatment year is 70%, 200,000 -46 million yuan (including 460,000 yuan), the drug cost is settled by the guarantee fund.

  In addition, this notification also emphasized rare disease management services: rare diseases should be medical in the unspeakable medical institutions in rare diseased drugs to purchase medicines and settlement in rare diseased drugs.

The Municipal Medical Insurance Center shall sign an agreement with rare disease manufacturers (or suppliers), and the agreement has been signed for 2 years.

Drug production enterprises (suppliers) may not be moved to subtract or release protocols (except for the except for the drug withdraw from the Chinese market). The Municipal Medical Security Affairs Center has developed relevant management methods and organizes and organizes. (Chengdu Daily Reporter Deng Xiaofang) (Editor: Gao Hongxia, Luo Wei).