How to reimburse Shanghai medical insurance

It aims to facilitate the insured to obtain medical expenses compensation in time.

First, prepare the reimbursement materials.

Before applying for medical insurance reimbursement, you need to prepare the following related materials: valid identity documents (such as ID cards and social security cards), medical vouchers such as medical expense invoices, prescriptions and inspection reports, and medical insurance statements or medical insurance electronic certificate. Ensure the authenticity and completeness of these materials in order to successfully pass the reimbursement review.

Second, choose the reimbursement method.

Shanghai Medical Insurance provides a variety of reimbursement methods for the insured to choose from, including online reimbursement and offline reimbursement. Online reimbursement can be made through medical insurance official website and mobile APP, which is convenient and fast; Offline reimbursement needs to go to the designated medical insurance service window. The insured can choose the appropriate reimbursement method according to his actual situation.

Third, submit an application for reimbursement

After selecting the reimbursement method, the insured shall submit the reimbursement application as required. Online reimbursement needs to fill in relevant information and upload the required materials; For offline reimbursement, you need to bring relevant materials to the designated window. When submitting the application, please ensure the accuracy and completeness of the information so as not to affect the reimbursement progress.

Fourth, waiting for review and resolution.

After submitting the reimbursement application, the medical insurance department will review the application materials. After the approval, the expenses will be settled, and the reimbursement will be credited to the bank account designated by the insured or cash will be distributed. Insured persons can check the reimbursement progress and results through medical insurance official website or mobile APP.

Verb (abbreviation of verb) matters needing attention

When applying for medical insurance reimbursement, the insured should pay attention to the following points: ensure that medical expenses occur within the validity period of medical insurance; Abide by medical insurance policies and regulations, and shall not falsely report or impersonate medical expenses; Keep relevant medical vouchers and reimbursement materials properly for future inquiry and verification.

To sum up:

Shanghai medical insurance reimbursement process includes preparing reimbursement materials, selecting reimbursement methods, submitting reimbursement applications, waiting for review, settlement and other steps. When applying for medical insurance reimbursement, the insured shall abide by relevant policies and regulations to ensure the authenticity and legality of the application. By understanding and following these procedures, the insured can get compensation for medical expenses more conveniently.

Legal basis:

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

Article 28 provides that:

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.

Measures of Shanghai Municipality on Basic Medical Insurance for Employees

Article 14 stipulates:

Employees purchase medicines from designated retail pharmacies with prescriptions issued by designated medical institutions. The expenses incurred by employees in designated medical institutions and retail pharmacies that meet the requirements of basic medical insurance shall be paid by the basic medical insurance fund according to regulations.