How does Wenzhou Yikangbao Insurance apply for claims?

One-stop reimbursement: medical expenses incurred by the insured within the validity period of the insurance contract that meet the claim conditions can be settled through Wenzhou medical insurance information system.

Sporadic reimbursement: if the expenses incurred by the insured in the process of medical treatment do not meet the one-stop reimbursement conditions, they can directly bring their valid ID card and hospitalization summary and other related materials to the designated branch window of the insurance company for reimbursement.

The above is the claim method of Wenzhou Yikangbao.

1. Medical expenses do not enjoy medical insurance reimbursement: if the insured can enjoy medical insurance reimbursement for the expenses incurred in the medical process, but the insured does not choose to enjoy medical insurance reimbursement, then the contractor of Yikangbao will not make claims for it;

2. See a doctor in a hospital or pharmacy outside the insurance contract: According to the contents of the Yikang insurance contract, the insured needs to see a doctor in Chinese mainland, and the qualification of the hospital needs to meet the standards of the second-class and above public hospitals stipulated by Wenzhou Medical Insurance before reimbursement can be made. In addition, Wenzhou Yikangbao also has certain regulations on the place of drug purchase, and the insured needs to buy drugs in these five designated pharmacies before reimbursement;

3. Other contents agreed in the exemption of insurance liability.

Wenzhou Yikangbao is actually a national commercial supplementary medical insurance product, which is underwritten by commercial insurance companies and guided by government departments. Its insurers include PICC P&C Insurance, China Life Insurance, Pacific Life Insurance, Ping An Pension and Dida Insurance. The guiding units are Wenzhou Medical Insurance Bureau, Wenzhou Finance Bureau, Wenzhou Agriculture and Rural Bureau, Wenzhou Finance Bureau, Wenzhou Municipal Government Finance Office, Wenzhou Taxation Bureau of People's Republic of China (PRC) State Taxation Bureau, and Wenzhou Supervision Branch of China Banking Supervision Administration.

Yi Kangbao can reimburse medical expenses inside and outside the medical insurance catalogue, and the specific protection is as follows:

After medical insurance reimbursement, Yikangbao can also reimburse some inpatient medical expenses and special outpatient medical expenses that are not listed in the medical insurance catalogue. Details are as follows:

Within the medical insurance catalogue: after medical insurance reimbursement, 80% of the part that the individual pays more than 25,700 yuan can be reported, and the highest reimbursement is 1.8 million yuan.

Outside the medical insurance catalogue: If the expenses are out of the scope of medical insurance, you can reimburse 60% after paying more than 20,000 yuan, with a maximum reimbursement of1.20,000 yuan.