l l Which diseases under the Employees' Health Insurance can I apply for Special Disease (long-term chronic disease) Clinic?
Class I Special Diseases
(1) Radiotherapy, chemotherapy and analgesic treatment for malignant tumors; (2) Dialysis treatment for patients with renal failure; (3) Anti-rejection treatment after kidney, heart valve, hematopoietic stem cell, liver and lung transplantation; (4) Hemophilia.
Class II Specific Diseases
(1) systemic lupus erythematosus; (2) hypertension (hypertension complications: hypertensive heart disease, hypertensive eye disease, hypertensive nephropathy); (3) diabetes mellitus (diabetes complications: nephropathy, peripheral neuropathy, retinopathy, podiatry); (4) rheumatoid cardiac valvulopathy; (5) cerebrovascular accidents; (6) bronchial asthma, chronic bronchitis with obstructive emphysema, chronic pulmonary heart disease (7) liver cirrhosis (decompensated stage); (8) aplastic anemia; (9) schizophrenia, mood disorders (depressive mania), paranoid mental disorder, schizoaffective disorder, epilepsy-induced psychiatric disorders, mental retardation with psychiatric disorders; (10) tuberculosis; (11) severe prostatic hyperplasia; (12) coronary heart disease; (13) rheumatoid arthritis (rheumatoid arthritis) complications: vasculitis, interstitial lung disease, peripheral neuropathy, osteoporosis); (14) Parkinson's disease; (15) amyotrophic lateral sclerosis; (16) myeloproliferative disorders (true erythrocytosis, primary thrombocythemia, primary myelofibrosis); (17) hepatitis C; (18) chronic hepatitis B virus (HBV) infection; and (19) Alzheimer's disease. .
l What is the procedure for employees to apply for special diseases (long-term chronic disease)?
Where to apply:Submit the information to the Beibei District Special Disease Identification Hospital. The Beibei District Special Disease Identification Hospitals are Chongqing Ninth People's Hospital (68203424) and Beibei Traditional Chinese Medicine Hospital (60310616), and you can choose anyone of them.
Required materials: Special Disease Declaration Form (available on site), 1 copy of passport main page, 2 recent 1-inch color photographs (blue or red background), and medical records related to the type of disease being applied for (to be stamped with the hospital seal).
l Special disease reimbursement policy:
Deductible: ￥200 at Primary hospital, ￥440 at Secondary hospital, ￥880 at Tertiary hospital.
Reimbursement rate (Coinsurance) : 90% coved by medical insurance for radiotherapy, chemotherapy, analgesic treatment for malignant tumors, dialysis treatment for patients with renal failure, and anti-rejection treatment after kidney, liver, lung, heart valve, and hematopoietic stem cell transplantation, and 100% for those whose annual cumulative medical insurance payment is less than ￥37,000, and between ￥37,000 and ￥47,000. The reimbursement rate for other specialized diseases is 80%, and above ￥47,000, 100% is reimbursed by the large medical insurance fund.
Reimbursement Maximum: ￥547,000 in total when combined with hospitalization, of which￥ 47,000 is the limit for reimbursement by the medical insurance and ￥500,000 is the limit for reimbursement by the large medical insurance fund.
The special disease are covered by outpatient insurance,that means outpatient coverage will continue after reimbursement by special medical insurance.