医疗保险能够报销的救命药、靶向药，为么医院买不到？
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">医疗保险</span>目录，关乎着全国人民的用药问题。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">纳入<span style="color: black;">医疗保险</span>目录，即<span style="color: black;">寓意</span>着“平价”，<span style="color: black;">寓意</span>着<span style="color: black;">医疗保险</span><span style="color: black;">能够</span>报销，<span style="color: black;">寓意</span>着<span style="color: black;">非常多</span>家庭逃脱了“因病返贫”的命运。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这<span style="color: black;">始终</span>是国家<span style="color: black;">奋斗</span>的方向。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2020年<span style="color: black;">医疗保险</span><span style="color: black;">药物</span>目录扩容至2800种，<span style="color: black;">药物</span>价格平均降幅达50.64%。</p>2021年，共计74种<span style="color: black;">药物</span>新增进入目录。67种目录外独家<span style="color: black;">药物</span>谈判成功，平均降价61.71%。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">一盒万来块靶向药降价到几千<span style="color: black;">乃至</span>几百。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic1.zhimg.com/80/v2-1b6d75e613d75effee46348a9f63c054_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;">虽然这是个大好事，但在<span style="color: black;">看病</span>的"最后一<span style="color: black;">千米</span>"，依旧有<span style="color: black;">非常多</span>问题。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">例如</span>买不到报销药的<span style="color: black;">状况</span>。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">1、</span>买不到的<span style="color: black;">医疗保险</span>报销药</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">央视《财经半小时》曾记录了<span style="color: black;">这般</span>一个病患家庭：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">身患</span>非小细胞癌的王先生，<span style="color: black;">已然</span>进入了危险期。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">治疗最有效的药是“克唑替尼”靶向药，这种药<span style="color: black;">已然</span>纳入了<span style="color: black;">医疗保险</span>报销范围。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">但家人跑遍了大部分医院都买不到，这就<span style="color: black;">寓意</span>着<span style="color: black;">医疗保险</span><span style="color: black;">没</span>法报销。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">每盒克唑替尼花了5万，<span style="color: black;">一月</span>一盒的频率，对一个普通家庭<span style="color: black;">来讲</span><span style="color: black;">没</span>异于“天价”。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">医院<span style="color: black;">倘若</span>能买到，价格只要5千，还有<span style="color: black;">医疗保险</span>报销，天壤之别。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic2.zhimg.com/80/v2-e511b4c82ff2e10eec32d8f067eb13f5_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;"><span style="color: black;">源自</span>：财经半小时</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">事实上，<span style="color: black;">非常多</span>纳入<span style="color: black;">医疗保险</span>的<span style="color: black;">药物</span>，在医院却买不到的<span style="color: black;">状况</span><span style="color: black;">非常</span><span style="color: black;">平常</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">按照</span>中国药学会对1420家<span style="color: black;">2、</span>三级样本医院的统计数据，2018-2019年纳入国家<span style="color: black;">医疗保险</span>目录的肿瘤创新药，<span style="color: black;">截止</span>2020年第三季度，进院比例仅为15%-25%。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic3.zhimg.com/80/v2-376837266afd10fff7e255c224f4e34e_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;"><span style="color: black;">源自</span>：中国药学会（CPA）1420家样本医院谈判<span style="color: black;">药物</span>进院数据</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">先前，有个肺移植手术的<span style="color: black;">病人</span>家属将医院告上法庭。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">便是</span><span style="color: black;">由于</span><span style="color: black;">大夫</span>开的药都是<span style="color: black;">医疗保险</span>内<span style="color: black;">能够</span>报销的药，<span style="color: black;">然则</span>医院让家人直接去医院一楼的药店自费购买。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这些<span style="color: black;">药物</span>加起来自费了524955元。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">本来<span style="color: black;">能够</span>报销，却白白花去一大笔钱，<span style="color: black;">因此</span>将医院告上了法庭。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">这般</span>的<span style="color: black;">状况</span>，是医院和<span style="color: black;">大夫</span>太<span style="color: black;">暗中</span>？其实<span style="color: black;">她们</span><span style="color: black;">亦</span>有<span style="color: black;">非常多</span><span style="color: black;">没</span>奈。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">2、</span>算着钱治病的医院</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">医疗保险</span>新目录执行，<span style="color: black;">非常多</span>靶向药纳入报销范围。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">但抗癌药、创新药等价格<span style="color: black;">昂贵</span>动辄几千上万的<span style="color: black;">药物</span>，最后<span style="color: black;">亦</span>很可能需自费购买。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">但站在医生的<span style="color: black;">方向</span>，他<span style="color: black;">亦</span>不愿意<span style="color: black;">这般</span>折腾病患。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">最后</span><span style="color: black;">显现</span>这种<span style="color: black;">状况</span>，<span style="color: black;">暗地里</span><span style="color: black;">亦</span>有许多<span style="color: black;">原由</span>：</p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">1、<span style="color: black;">医疗保险</span>的总额预付制度</h3>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">医疗保险</span><span style="color: black;">分部</span>每年会给医院<span style="color: black;">必定</span>数额的<span style="color: black;">医疗保险</span><span style="color: black;">运用</span>额度，超过这个额度的<span style="color: black;">花费</span>，就<span style="color: black;">必须</span>医院自己<span style="color: black;">包袱</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">而<span style="color: black;">医疗保险</span>报销的这部分花费，<span style="color: black;">通常</span>是医院先垫付，之后再向<span style="color: black;">医疗保险</span><span style="color: black;">分部</span>申请结款。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">假如医院今年垫付了1000万，但额度<span style="color: black;">仅有</span>800万，剩下的200万就<span style="color: black;">没</span>法结算，等于医院贴钱给病人看病。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这种方式的初衷是让<span style="color: black;">大夫</span>有足够动力<span style="color: black;">掌控</span>医疗<span style="color: black;">花费</span>、<span style="color: black;">恰当</span><span style="color: black;">运用</span>医疗资源，<span style="color: black;">亦</span>确实在<span style="color: black;">必定</span>程度上减轻了<span style="color: black;">医疗保险</span>资金压力和<span style="color: black;">病人</span><span style="color: black;">看病</span><span style="color: black;">包袱</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">但这种简单粗暴的方式，直接<span style="color: black;">引起</span>了<span style="color: black;">大夫</span>不敢给<span style="color: black;">病人</span>开高价药，生怕<span style="color: black;">医疗保险</span>超额。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">亦</span><span style="color: black;">便是</span>说，<span style="color: black;">大夫</span>除了治病救人，还要<span style="color: black;">每日</span>花心思计算<span style="color: black;">医疗保险</span><span style="color: black;">花费</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">治疗<span style="color: black;">有些</span><span style="color: black;">严重</span>病人，其实基本等同于在赔钱。</p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">2、药占比考核</h3>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">药占比<span style="color: black;">便是</span><span style="color: black;">大夫</span>开出处方时，<span style="color: black;">药品</span><span style="color: black;">花费</span>占病人所有<span style="color: black;">花费</span>的百分比。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">例如</span>说一个病人看病，拍片子花了100，又开了100块钱的药，<span style="color: black;">那样</span>药占比<span style="color: black;">便是</span>50%。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">设计药占比的初衷是监督<span style="color: black;">大夫</span><span style="color: black;">恰当</span>用药，减轻病人医疗<span style="color: black;">花费</span><span style="color: black;">包袱</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">但<span style="color: black;">实质</span>操作中，<span style="color: black;">引起</span><span style="color: black;">非常多</span><span style="color: black;">大夫</span>不敢开药，尤其是<span style="color: black;">有些</span>高价药，一开，药占比就直线<span style="color: black;">上升</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">另一</span>药占比本身<span style="color: black;">便是</span>医院一个考核细则，哪个<span style="color: black;">大夫</span>药占比过高是要罚款的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2019年单一药占比考核被<span style="color: black;">恰当</span>用药综合指标取代。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">然则</span>，紧箍咒依然在。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">大夫</span><span style="color: black;">亦</span><span style="color: black;">必须</span>挣钱养家，<span style="color: black;">不可</span><span style="color: black;">始终</span>被扣钱。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">病人</span>又不得<span style="color: black;">不消</span>药，怎么办呢？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">结果<span style="color: black;">便是</span>让<span style="color: black;">病人</span>去医院外自费买药。</p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">3、<span style="color: black;">能够</span>避免的高价自费药支出</h3>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">除了以上两个<span style="color: black;">原由</span>外，医院还有<span style="color: black;">药物</span>品规限制、<span style="color: black;">药物</span>零加成等<span style="color: black;">需求</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这<span style="color: black;">亦</span>间接<span style="color: black;">引起</span>了癌症特效药等高价<span style="color: black;">药物</span>，很难在医院上买到。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">看似是<span style="color: black;">医疗保险</span>的锅，但其实它<span style="color: black;">亦</span>很难。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">医疗保险</span>基金结余年年递减，人口老龄化加剧，用药的人越来越多。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">不<span style="color: black;">掌控</span>着点，<span style="color: black;">基本</span><span style="color: black;">不足</span>花。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在<span style="color: black;">医疗保险</span>来看，让尽可能多的人享受到<span style="color: black;">保证</span><span style="color: black;">便是</span>最大的KPI。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">小病<span style="color: black;">能够</span>指望<span style="color: black;">医疗保险</span>，但面对大病真的够呛。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这几年越来越多人<span style="color: black;">起始</span>关注<span style="color: black;">商场</span>保险，生了病保险<span style="color: black;">机构</span>赔一笔，总比自己掏钱强。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">去年，有个肺癌理赔案，<span style="color: black;">病人</span>的治疗费、<span style="color: black;">药物</span>费等等，一份医疗险就报销了13万，靶向药<span style="color: black;">亦</span>都报了，减轻了很大<span style="color: black;">包袱</span>。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic1.zhimg.com/80/v2-dbe1c5501c652a6e36dc59ddcbd1acbc_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;"><span style="color: black;">倘若</span><span style="color: black;">将来</span>还在续保，以后的住院、治疗等<span style="color: black;">花费</span><span style="color: black;">同样</span><span style="color: black;">亦</span>能报销。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">另一</span>，这个<span style="color: black;">病人</span>之前还买了30万保额的重疾险，直接赔了30万。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">患病</span><span style="color: black;">时期</span>都<span style="color: black;">无</span>工作收入，这笔钱<span style="color: black;">亦</span>弥补了收入损失，<span style="color: black;">将来</span>几年生活费、营养费都<span style="color: black;">不消</span>愁了。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">和前面<span style="color: black;">必须</span>自费付56万的人相比，她<span style="color: black;">没</span>疑幸运的多。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此</span>说，<span style="color: black;">医疗保险</span>是社会福利托底的一部分，并<span style="color: black;">不可</span><span style="color: black;">处理</span>所有的<span style="color: black;">看病</span>问题。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">配齐<span style="color: black;">商场</span>保险，<span style="color: black;">才可</span>最大程度减少财务损失。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">意见</span>买一份百万医疗险，<span style="color: black;">例如</span>太平洋健康的医享<span style="color: black;">没</span>忧，</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">它能<span style="color: black;">保准</span>续保20年，<span style="color: black;">时期</span><span style="color: black;">生病</span>了<span style="color: black;">亦</span>能续保，<span style="color: black;">看病</span>过程产生的<span style="color: black;">恰当</span>医疗<span style="color: black;">花费</span>都能报销。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">保证</span>期限内最高可报销800万，进口药，自费药，靶向药，院外特药，都能报。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">非常多</span>抗癌药虽然进了<span style="color: black;">医疗保险</span>目录，但始终供<span style="color: black;">不该</span>求，很可能会遇到<span style="color: black;">大夫</span>开了处方、医院没药，买不到的<span style="color: black;">状况</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">应对这种<span style="color: black;">状况</span>，医享<span style="color: black;">没</span>忧有【特定<span style="color: black;">药物</span><span style="color: black;">名单</span>】：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">目录中<span style="color: black;">包括</span>了88治疗恶性肿瘤的靶向药，就连用于细胞疗法的120万一针的阿基仑塞注射液都能保。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">针对</span>这些药，<span style="color: black;">倘若</span>医院买不到，在院外的<span style="color: black;">医疗保险</span><span style="color: black;">选定</span><span style="color: black;">药店</span>买到，<span style="color: black;">亦</span><span style="color: black;">能够</span>报销。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">再买一份重疾险，如达尔文6号。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">保证</span>扎实，可选责任实用，灵活性很强，</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">基本</span><span style="color: black;">保证</span>之上，再送一份重疾复原<span style="color: black;">保证</span>（即重疾二次赔），还<span style="color: black;">不消</span>额外加费，非常划算。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">达尔文6号还有一个<span style="color: black;">优良</span>，它癌症多次赔责任，不限制次数。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">附加上这个责任， 保费会高不少，赔付两次后，虽然癌症再次赔付只保新发和转移，但<span style="color: black;">亦</span>要好过其他重疾险的癌症二次责任，</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">有预算且看重癌症多重<span style="color: black;">保证</span>的<span style="color: black;">伴侣</span>，<span style="color: black;">能够</span>按需<span style="color: black;">选取</span>附加。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;">大白小结：</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">患病</span>了没钱治，是人生中最绝望的时刻。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">医疗保险</span>是社会福利托底的一部分，并<span style="color: black;">不可</span><span style="color: black;">处理</span>所有的<span style="color: black;">看病</span>问题。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">有份<span style="color: black;">商场</span>保险<span style="color: black;">能够</span>让你不被<span style="color: black;">医疗保险</span>限制，<span style="color: black;">亦</span>能更有底气的享受更好的医疗资源。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">我是大白，致力于用大白话说清保险，<span style="color: black;">帮忙</span><span style="color: black;">大众</span>明明白白买保险，</p>
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<div style="color: black; text-align: left; margin-bottom: 10px;"><a style="color: black;"><span style="color: black;"><span style="color: black;">大白读保-APril：大白保：保险科普<span style="color: black;">文案</span>汇总，含重疾险/医疗险/意外险/寿险等选品攻略，看完省下70%保费！22 赞同 · 2 评论<span style="color: black;">文案</span>22 赞同 · 2</span></span></a> 评论<span style="color: black;">文案</span>26 赞同 · 2 评论<span style="color: black;">文案</span><span style="color: black;">41 赞同 · 2 评论<span style="color: black;"><span style="color: black;">文案</span></span></span><span style="color: black;"><img src="https://pica.zhimg.com/v2-15da0580f0fa932609b2e124de93f9dc_r.jpg?source=172ae18b" style="width: 50%; margin-bottom: 20px;"></span></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">如你想定制<span style="color: black;">方法</span>、咨询<span style="color: black;">制品</span>、测算保费、理赔询问，<span style="color: black;">能够</span>直接找大白。</p>
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