Is Shanghai medical insurance automatically reimbursed if it exceeds 1500?

Shanghai medical insurance exceeds 1500 yuan automatic reimbursement.

Shanghai medical insurance emergency reimbursement ratio is as follows:

1. If there is a deductible for hospitalization, the deductible for on-the-job employees is 1500 yuan. Generally speaking, if the first hospitalization does not exceed 1.500 yuan, the money will be paid by myself (which can be deducted from the account funds over the years), and 85% of the excess (but below the maximum amount of 70,000 yuan) will be reimbursed by medical insurance (that is, 15% will be paid by myself). If you have already paid this 1500 yuan for the second hospitalization, you don't need to pay it again, and the medical insurance will directly reimburse 85%.

2. If it exceeds the maximum limit, medical insurance will only reimburse 80%.

The provisions of Shanghai Municipality on the use of the balance of personal accounts of medical insurance are as follows:

1. The balance of personal account of medical insurance can be used to pay the medical expenses borne by individuals;

2. The balance of personal account of medical insurance can be used for the payment of drugs for chronic diseases in outpatient department. In Shanghai, outpatient chronic disease drugs can be paid by medical insurance personal account and medical insurance pooling fund, of which the proportion of medical insurance personal account payment is 50%;

3. The personal account balance of medical insurance can be transferred. If an individual is transferred for medical treatment or the insured unit changes, the balance of his personal account of medical insurance can be transferred to a new insured unit or medical treatment place to pay the medical expenses borne by the individual.

The specific usage of medical insurance card is as follows:

1. Scope of use of medical insurance card: When insured employees buy medicines in designated hospitals and pharmacies, they can swipe their cards on POS machines with their passwords, but they cannot withdraw cash or transfer money;

2. Inquire about the balance of medical insurance card: Insured employees can inquire about the balance by telephone, or at the Bank Savings Office of China or the designated hospitals and pharmacies in the urban area. You can also log in to the social security inquiry system online;

3. For the inquiry of medical insurance card transactions, the insured employees can print the medical insurance card transaction records, including the expenditure records and consumption records of personal account funds, with their ID cards and medical insurance. If you have any questions about the transaction records, you can go to the retail business department of Bank of China for enquiry.

4. Medical insurance card password: The insured employees can change their passwords by phone or bring their ID cards to the Bank of China Savings Office. If the insured employee forgets the password, he can report the loss of the original password and change the password with his ID card at China Bank Savings Office;

5. Custody of medical insurance card: Insured employees should keep the medical insurance card properly. If they accidentally lose it, please immediately issue a letter of proof to the unit and stamp it in the medical insurance office for confirmation. Then, they will take their ID cards to China Bank Savings Office to report the loss and go through the formalities. After 7 days, they can get a new card.

To sum up, when using medical insurance to settle accounts, medical insurance will give priority to the funds in personal accounts. If the funds in personal accounts are insufficient, medical insurance foundation will pay. The use of personal account funds includes outpatient and inpatient medical expenses, purchase of drugs and medical devices, etc.

Legal basis:

Article 58 of People's Republic of China (PRC) Social Insurance Law

The employing unit shall, within 30 days from the date of employment, apply to the social insurance agency for social insurance registration for its employees. If the social insurance has not been registered, the social insurance agency shall verify the social insurance premium it should pay.

Employees-free individual industrial and commercial households who voluntarily participate in social insurance, part-time employees who do not participate in social insurance in the employing unit and other flexible employees shall apply to the social insurance agency for social insurance registration.

The state establishes a national unified personal social security number. Personal social security number is a citizen's identity number.

Article 59

The people's governments at or above the county level shall strengthen the collection of social insurance premiums.

Social insurance premiums shall be uniformly collected, and the implementation steps and specific measures shall be stipulated by the State Council.