How to reimburse Shanghai medical insurance card for medical treatment

1. If the medical insurance card is social security, the outpatient service will not be reimbursed. If you use the medical insurance card every month, you should bear it yourself. If you are hospitalized, {hospitalization expenses-deductible-self-paid drugs (nutrition drugs and imported drugs) }*85% will be reimbursed, and the rest will be borne by yourself. 2. When reimbursing medical insurance, you need to go to the local medical insurance management center or the medical insurance settlement window of designated medical institutions for reimbursement. Procedures include: my ID card, medical insurance card, original invoice, medication list, medical records and other materials. 3. Medical insurance reimbursement is carried out in proportion, generally floating around 70%. The proportion and amount of reimbursement are related to their own examination and medication, medical level and other factors. For example, it is clear that Class A drugs can enjoy full coverage, Class C drugs need to bear all the costs, and Class B drugs will report 80% and bear 20% of the costs. Take the urban medical insurance in Shanghai as an example. If the amount is less than 70,000 yuan, more than 85% of the social security will be reported, and the individual will pay 15%. There is a deductible for reimbursement of medical insurance cards. In order to take care of the interests of the insured, Ji 'nan now implements the deductible standard, with the first-level medical institution 400 yuan, the second-level medical institution 700 yuan, and the third-level medical institution 1 1,000 yuan, 400 yuan. 200 yuan, designated community hospital. For example: Jinan Ethnic Community Health Service Center, Luoyuan Community and Qilishan Community. 1000- 10000 yuan (including 10000 yuan), 85% of the overall fund burden and 0/5% of the individual burden; 10000 yuan -90000 yuan, 88% of the overall fund burden, personal burden 12%. 90,000-200,000 yuan, 90% for the overall fund and 10% for the individual. 4. By the way, all drugs that can be reimbursed should be drugs within the scope of medical insurance. If it is drugs outside the scope of medical insurance, they are all self-funded drugs and cannot be reimbursed.

Legal objectivity:

According to the provisions of Article 28 of the 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.