三甲医院 医保对 甲类和乙类药 报销比例是多少啊?谢谢!!

2025-03-15 21:44:37
推荐回答(2个)
回答1:

对药品的医保支付,哪个级别的分类都一样,计算方式都一样,只是最终三级医院的总费用的(不单只药费)享受的统筹支付比例要低于一二级医院。

不论是治疗费、检查费、化验费、药费都分有自费、甲类和乙类等,住院时,一起算统筹比例,乙类药先自付10%。

医保住院,总费用除开自费部分、乙类费用先自付10%之后,超过医院医保门槛费的部分,享受统筹支付比例。医院级别不同门槛费不同,享受统筹支付的比例也不同。职工医疗保险的比例百分之八十几(武汉市82%/84%/87%,三级医院82%),居民医疗保险的比例70%左右(武汉市80%/65%/50%,三级医院50%)。

这样看来,医保住院不能单独算药品,甲类统筹比例,乙类药品统筹比例的。

很复杂吧!其实电脑系统会自动算的。医保住院时,出示医保卡,读卡进医保系统,交押金(一般都是门槛费),发生费用录入系统,系统自动分类为自费、甲类、乙类等,乙类先自付10%,再进入基本医疗,按照年度住院次数(大于1次门槛费减半)、医院级别(门槛费不同、统筹比例不同),由电脑计算因该自己付多少钱,医院再向社保的医保中心结算多少钱。

回答2:

不同药品的报销比例是不同的,甲类药都是100%报销,乙类药从10%到30%不等。

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