Does Shenzhen's first-class medical insurance brush the medical insurance card and directly do surgery reimbursement?

The first-class medical insurance in Shenzhen is not directly reimbursed by the medical insurance card.

The reimbursement of medical expenses of the first-class medical insurance participants in Shenzhen is not completed by directly swiping the medical insurance card. The insured person needs to pay the expenses first, and then bring the relevant materials to the local social security agency for reimbursement. The staff will review the information to confirm whether the expenses meet the reimbursement conditions. If it meets the requirements, the insured person can get the corresponding reimbursement. In addition, the hospitalization expenses of the first-class medical insurance participants can be reimbursed by the designated institutions, and the general outpatient expenses are paid by the medical insurance pooling fund according to regulations, and the reimbursement ratio is over 50%.

Rules for the use of medical insurance cards:

1, medical insurance card concept: medical insurance card is an electronic card used by people who participate in medical insurance to enjoy medical insurance benefits;

2. Basic functions: the medical insurance card is mainly used for personal information identification, medical expenses settlement, medical insurance treatment enjoyment, etc.

3. Use process: when seeking medical treatment in designated medical institutions, identity verification and expense settlement are carried out through medical insurance cards;

4. Reimbursement method: Medical insurance cards usually support instant settlement, but in some special cases, it may be necessary to pay in advance before reimbursement;

5. Fund management: the funds in the medical insurance card are managed by the medical insurance management department to pay medical expenses.

To sum up, the first-class medical insurance participants in Shenzhen need to pay in advance for surgery reimbursement, and then bring relevant materials to the social security agency to apply, and they can get the corresponding reimbursement after they meet the requirements. In addition, the hospitalization expenses of the first-class medical insurance participants can be reimbursed by the designated institutions, and the general outpatient expenses are paid by the medical insurance pooling fund, and the reimbursement ratio is above 50%.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 28

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.