Reimbursement policy of medical insurance for retired employees in Shanghai

The reimbursement policies of medical insurance for retired employees in Shanghai are as follows:

1. You need to choose a designated hospital to see a doctor and show your medical insurance card when you see a doctor;

2. After hospitalization, the hospital usually requires that some hospitalization expenses be paid in advance, and this payment invoice will be kept at this time;

3. During the hospitalization, the hospital will print a list of treatment expenses every day, which will clearly indicate which social security can be reported, which are self-funded and which can only be reimbursed;

4. After discharge, the hospital system will directly settle accounts, and the part that can be reimbursed by medical insurance will be directly reimbursed, and the part that cannot be reimbursed needs to be paid at its own expense;

5. If the retirees are institutions or state-owned enterprises, they can also submit all the invoices during hospitalization to the financial department of the unit, and at this time, they can also reimburse some expenses.

Medical insurance card processing flow:

1. Prepare application materials, original and photocopy of ID card, one-inch photo, resignation procedures, photocopy of household registration book, renewal of medical insurance card and medical records;

2. Then go to the old-age insurance institution where the account is located to receive the social insurance financial subsidy form, fill it out and submit it, and submit all the prepared materials;

3. The staff will review the information provided, and the day can be ended, and a payment voucher will be issued; According to the bank information on the payment document, you can transfer money regularly; Take the first payment slip to the medical insurance hall to apply for a medical insurance card. In some places, there will be medical records. The medical record has photos and seals, so you can take it with you when you see a doctor.

To sum up, after retirement, you will no longer pay the basic medical insurance premium and enjoy the basic medical insurance benefits in accordance with state regulations.

Legal basis:

Article 30 of People's Republic of China (PRC) Social Insurance Law

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.