In order to further provide more convenient medical insurance services for the insured, the WeChat official account of the National Health Insurance Administration has launched the query function of the national basic medical insurance drug list. Welcome to pay attention to the WeChat official account of the National Health Insurance Administration to conveniently query the drugs in the medical insurance catalog.
What is the National Essential Medical Insurance Drug List?
What do Categories A and B mean in the reimbursement categories?
Which drugs are not included in the National Basic Medical Insurance Drug List?
How to check the information of drugs in the medical insurance list?
Let's find out
01
What is the National Essential Medical Insurance Drug List?
In order to ensure the basic medical needs of the insured and standardize the management of basic medical insurance drugs, the state has formulated a list of drugs for basic medical insurance. The medical insurance fund shall pay the relevant medical expenses incurred by the insured persons in the designated medical institutions in accordance with the provisions of the medical insurance drug catalog.
Since its establishment in 2018, the National Health Insurance Administration has established and improved the dynamic adjustment mechanism of the medical insurance drug list. In principle, the list of medical insurance drugs will be adjusted once a year, and drugs that meet the basic conditions of clinical necessity, safety and effectiveness, and reasonable price will be included in the medical insurance drug list.
02
What do Categories A and B mean in the reimbursement categories?
The Western medicines and proprietary Chinese medicines in the NRDL are divided into two categories: A and B.
"Class A drugs" refer to drugs that are necessary for clinical treatment, widely used, have definite efficacy, and have a lower price or treatment cost among similar drugs. When the insured person uses this type of drug, it can be fully included in the reimbursement scope, and then reimbursed according to the prescribed proportion.
"Category B drugs" refer to drugs that can be used for clinical treatment, have definite efficacy, and have a slightly higher price or treatment cost than "Class A drugs" in the same category. When the insured person uses this kind of drug, he needs to pay a certain percentage of himself, and the remaining part is included in the reimbursement scope, and then reimbursed according to the prescribed proportion.
03
Which drugs are not included in the National Reimbursement Drug List?
(1) Drugs that mainly play a tonic role;
(2) Drugs containing national precious and endangered wild animal and plant medicinal materials;
(3) health care drugs;
(4) Preventive vaccines and contraceptives;
(5) Drugs that primarily play the role of enhancing sexual function, treating hair loss, weight loss, cosmetology, quitting smoking, and stopping alcohol;
(6) Drugs that cannot be charged separately due to being included in the diagnosis and treatment items or other reasons;
(7) Wine preparations, tea preparations, all kinds of fruit-flavored preparations (except for children's drugs under special circumstances), oral inhalants and oral effervescent agents (except for special provisions), etc.;
(H) other drugs that do not meet the provisions of basic medical insurance.
04
How to check the information of drugs in the medical insurance list?
Step 1: Enter the WeChat official account of the "National Health Insurance Administration", click on the microservice → the National Medical Insurance Drug Catalogue query, and enter the query page.
Step 2: Enter the specific drug name and click search to find out whether the drug is within the scope of the medical insurance catalog, the drug classification and the specific reimbursement category.
You can also select "Drug Classification" or "Medical Insurance Reimbursement Category" to filter according to your own needs.
Source: National Health Insurance Administration