The Second Reimbursement Process of Shanghai Serious Illness Medical Insurance

Legal analysis: "Second reimbursement" refers to the residents of urban residents' medical insurance or the new rural cooperative medical system. If there were high expenses for seeing a doctor last year, you can apply for critical illness insurance again in addition to normal reimbursement, and there is no capping line. The second reimbursement process is as follows: 1, and the application is accepted; 2. Accepting institution; 3. Application results; 4. Cost accounting; 5. Payment of expenses.

Legal basis: Article 30 of the Social Insurance Law of People's Republic of China (PRC), the following medical expenses are not included in the payment scope of the basic medical insurance fund:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(3) borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.