哪些进入医疗保险目录的抗癌药，实质都能报销吗
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Alisa这两天在学习<span style="color: black;">医疗保险</span>知识，在<span style="color: black;">科研</span>了<span style="color: black;">医疗保险</span>目录后，<span style="color: black;">发掘</span><span style="color: black;">这儿</span>面学问还挺大的！</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">原来，<span style="color: black;">药品</span>进了<span style="color: black;">医疗保险</span>目录，病人在医院治疗<span style="color: black;">时期</span><span style="color: black;">运用</span>了，<span style="color: black;">亦</span>不<span style="color: black;">必定</span>是<span style="color: black;">所有</span>都<span style="color: black;">能够</span>报销的。不是报销比例的问题，而是<span style="color: black;">医疗保险</span>在对<span style="color: black;">药物</span>进行支付时，就做了<span style="color: black;">有些</span>规则限定。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic1.zhimg.com/80/v2-3ae9796b9219a0cca79874bba6645ec4_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 限定<span style="color: black;">疾患</span>类型</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">例如精氨酸谷氨酸注射剂仅限肝性脑病治疗<span style="color: black;">运用</span>，<span style="color: black;">倘若</span>用于其他<span style="color: black;">疾患</span>，则<span style="color: black;">必须</span>自费。像抗肿瘤的靶向<span style="color: black;">药品</span>奥拉帕利，仅限用于“铂<span style="color: black;">敏锐</span>的复发性上皮性卵巢癌、输卵管癌或原发性腹膜癌”，<span style="color: black;">倘若</span>用于其他癌症治疗，就<span style="color: black;">必须</span>自费。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic1.zhimg.com/80/v2-3ae9796b9219a0cca79874bba6645ec4_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 限定某些症状或状态</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">例如艾普拉唑注射剂限定有说明书标明的<span style="color: black;">疾患</span>诊断且有禁食医嘱或吞咽困难的<span style="color: black;">病人</span>；治疗糖尿病的艾塞那肽注射剂，则限二甲双胍等口服降糖药或胰岛素<span style="color: black;">掌控</span>效果<span style="color: black;">不良</span>的BMI≥25的<span style="color: black;">病人</span>，且首次处方时需由二级及以上医疗<span style="color: black;">公司</span>专科医师开具处方。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic1.zhimg.com/80/v2-3ae9796b9219a0cca79874bba6645ec4_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 限定<span style="color: black;">必定</span>的<span style="color: black;">疾患</span>治疗进程</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">例如参一胶囊，限原发性肺癌、肝癌化疗<span style="color: black;">时期</span><span style="color: black;">运用</span>。例如口服的瑞戈非尼，限肝细胞癌二线治疗、转移性结直肠癌三线治疗以及胃肠道间质瘤三线治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">什么是肿瘤的“N线治疗”：一线治疗<span style="color: black;">通常</span><span style="color: black;">指的是</span>诊断后的首轮治疗，二线治疗是指一线治疗后，肿瘤<span style="color: black;">显现</span><span style="color: black;">发展</span>后的治疗，三线治疗<span style="color: black;">指的是</span>二线治疗后，肿瘤<span style="color: black;">显现</span><span style="color: black;">发展</span>后的治疗。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic1.zhimg.com/80/v2-3ae9796b9219a0cca79874bba6645ec4_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 限<span style="color: black;">必定</span>搭配</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">例如水溶性维生素单独<span style="color: black;">运用</span>不报销，<span style="color: black;">协同</span>脂肪酸、氨基酸等肠外营养<span style="color: black;">药品</span><span style="color: black;">运用</span>时才报销。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic1.zhimg.com/80/v2-3ae9796b9219a0cca79874bba6645ec4_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 限支付时间</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">例如注射用丹参多酚酸，单次住院最多支付14天。利妥昔单抗在治疗淋巴瘤时，<span style="color: black;">不可</span>超过8个疗程。超出时间范围，则不报销。类似的<span style="color: black;">药品</span>还有<span style="color: black;">非常多</span>种，就不一一举例了。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic1.zhimg.com/80/v2-3ae9796b9219a0cca79874bba6645ec4_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 限<span style="color: black;">疾患</span>病因</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">例如门冬氨酸钾镁注射剂限洋地黄中毒<span style="color: black;">导致</span>的<span style="color: black;">心率</span>失常，<span style="color: black;">倘若</span>是其他<span style="color: black;">原由</span><span style="color: black;">导致</span>的<span style="color: black;">心率</span>失常，则不在报销范围。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Alisa说</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">看到<span style="color: black;">医疗保险</span>原来还有这些限制，<span style="color: black;">大众</span><span style="color: black;">第1</span>时间肯定是想“怎么会<span style="color: black;">这般</span>，这么......"其实，<span style="color: black;">咱们</span>从一个正面的<span style="color: black;">方向</span>来看，<span style="color: black;">医疗保险</span>的资源是非常<span style="color: black;">宝贵</span>的，<span style="color: black;">咱们</span>要把把钱用在刀刃上，<span style="color: black;">因此</span>限制是为了节约与公平。<span style="color: black;">另一</span>，这些限制<span style="color: black;">亦</span>是<span style="color: black;">思虑</span>到<span style="color: black;">有些</span><span style="color: black;">疾患</span>的<span style="color: black;">状况</span>来制定的，咱们只要谨遵医嘱就好。再看回<span style="color: black;">咱们</span>的<span style="color: black;">商场</span>保险，<span style="color: black;">亦</span>会有赔付条款<span style="color: black;">需求</span>，不是所有的医药费都能赔偿，而<span style="color: black;">非常多</span>业务员和客户都不会去琢磨条款，这就<span style="color: black;">导致</span><span style="color: black;">非常多</span>误会。<span style="color: black;">因此</span><span style="color: black;">咱们</span><span style="color: black;">科研</span>条款，不是为了找”坑“，而是为了变得更加专业，让保险更符合<span style="color: black;">大众</span>的期待。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">作者 Alisa</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">参考资料：2019国家版<span style="color: black;">医疗保险</span>目录</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在G棕号回复”<span style="color: black;">医疗保险</span>目录“可<span style="color: black;">得到</span>完整版<span style="color: black;">医疗保险</span>目录表格下载链接</p>
可以发布外链的网站 http://www.fok120.com/ 楼主听话，多发外链好处多，快到碗里来！外链论坛 http://www.fok120.com/
页:
[1]