How to reimburse hospitalization medical insurance in Shanghai

Shanghai inpatient medical insurance reimbursement process:

1. When seeking medical treatment, show the medical insurance card to the designated hospital to prove the identity and registration of the insured. The part of medical insurance reimbursement is settled by medical insurance and hospitals, and individuals do not need to pay in advance before reimbursement. At the time of checkout, the part paid by the individual is paid by the balance of the medical insurance card and cash;

2. After receiving the reimbursement materials, the window staff will issue the Receipt of Hospitalization Medical Expenses of Shanghai Insured Persons to the insured persons;

3. After receiving the information, the audit will be completed within 15 working days, and the bank branch will transfer the reimbursement payment from the basic medical insurance pooling fund into the financial account of the insured person's smart ic card, and the insured person will withdraw cash from the bank branch with the IC card;

4, 15 working days later, according to the need, the hospitalized insured can receive the social medical insurance medical reimbursement calculation form from the business hall window of the Municipal Social Security Bureau with the Receipt of the hospitalization medical expenses of the urban insured. The form should be properly kept, and it will not be replaced if it is lost;

Hospitalization expenses incurred by foreign employees in designated medical institutions of medical insurance in this Municipality (including emergency observation room for hospitalization observation); Due to special circumstances such as work, emergency hospitalization expenses incurred in designated medical institutions in other provinces and cities may be applied for settlement with the approval of district and county medical insurance centers.

Handling materials:

1, original charge receipt;

2. Detailed list of expenses;

3. Outpatient medical records;

4. Proof of disease diagnosis;

5. Social security card;

6. Identity card;

7. Bank account.

To sum up, the reimbursement of hospitalization medical insurance in Shanghai can be made at the medical insurance office of the Social Insurance Fund Administration in each district of the insured's territory.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

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.