Can chronic diseases and medical insurance be reimbursed together?

The answer is of course, but you must first clarify what kind of protection you are referring to by "chronic disease reimbursement". In the past few years that I have been working at a grassroots medical insurance agency, I have encountered an average of three or four people asking this question every day. Most of them are elderly people who have just obtained the qualification for chronic disease certification. They are afraid that the two reimbursements will conflict and the trip will be in vain.

First of all, the reimbursement for chronic diseases (that is, outpatient chronic diseases) that we often talk about at the national level is itself one of the benefit modules of the basic medical insurance. It is not two independent systems at all. It is equivalent to the medical insurance package you buy including the rights of general outpatient service, hospitalization, and special chronic disease protection. As long as you have passed the chronic disease qualification certification, when you go to a designated institution to prescribe drugs corresponding to chronic diseases and do relevant examinations, the system will automatically give priority to the chronic disease reimbursement channel. The reimbursement ratio is higher than that of ordinary outpatient clinics, and the cap line is also higher. There is no question of "can they be used together"? It is originally integrated.

If the "chronic disease reimbursement" you are talking about refers to the additional Huimin Insurance, commercial medical insurance, or special chronic disease subsidies provided by the local civil affairs or the Disabled Persons' Federation, then it can indeed be reimbursed in conjunction with the basic medical insurance. Take Aunt Zhang who came to do business last month as an example. She is a member of the residential medical insurance. She has been diagnosed with type 2 diabetes for 3 years. She has just obtained the qualification for chronic disease. She also bought the local Huimin Insurance before. Last week, she went to the community hospital to prescribe hypoglycemic drugs for 200 yuan. She has been diagnosed with chronic disease. The coordinator first reported 140 and paid 60 out of her own pocket. The 60 yuan will be accumulated into her Huiminbao deductible for this year. When the deductible exceeds 18,000 by the end of the year, she can still claim half of it through the Huiminbao, which is equivalent to saving another sum of money she paid out of her own pocket.

Of course, not all situations can be added up casually. Our medical insurance follows the principle of loss compensation. The total amount of all reimbursements will definitely not exceed the actual medical expenses you spent, and there will not be a situation where "the reported amount is more than the amount spent". The special subsidy for chronic diseases in a few places is a fixed amount of medicine purchase allowance. If you have already reported the cost through medical insurance, you cannot use the subsidy to repeatedly deduct the same expenditure. When buying medicines, you can ask the medical insurance settlement staff at the pharmacy to avoid wasting money.

There are also many differences in the chronic disease catalog and reimbursement rules in different places. For example, in some places, only 10 high-incidence chronic diseases can be included in the reimbursement, while in some places, more than 40 types can be covered. If you seek medical treatment in another place, you must register a chronic disease in another place in advance, otherwise you may not be able to settle the bill directly. If you are not sure, just call the 12393 medical insurance hotline to ask about the local rules, so as to avoid unnecessary trips. If you have just been diagnosed with a chronic disease and have not yet applied for qualification certification, you can bring your medical records and diagnosis certificates for the past six months to the medical insurance agency in the insured place, or the medical insurance department of a designated hospital. After completing the process, you can directly enjoy the benefits for your next prescription. You do not have to advance money yourself and come back for reimbursement, which is very convenient.