Job Recruitment Website - Social security inquiry - Can Siyang use Shanghai medical insurance?
Can Siyang use Shanghai medical insurance?
Medical insurance reimbursement conditions:
1. In order to obtain medical insurance reimbursement for medical behavior in designated institutions, first of all, the insured person needs to see a doctor or buy medicine in designated medical institutions and pharmacies stipulated by the basic medical insurance in order to obtain reimbursement, otherwise it cannot be reimbursed;
2. If it belongs to the social security catalogue, it is necessary to have medical treatment items or purchased drugs in the social security catalogue to be reimbursed, otherwise it cannot be reimbursed;
3. To reach the deductible standard, medical insurance reimbursement is required. First, the medical expenses incurred by the insured reach the deductible line stipulated by social security, and the part exceeding the deductible line can only be reimbursed within the limit, and the unified proportion is paid by the basic medical pooling fund.
The required materials are as follows:
1, the original valid identity certificate or social security card of the insured;
2, outpatient medical records, inspection, test results report and other original medical information;
3. If it is an agent, you need to provide the original ID card of the agent;
4, the original certificate of disease diagnosis issued by the designated medical institutions;
5. The detailed list of outpatient expenses printed by the hospital computer or the original payment of prescriptions issued by doctors;
6. Original receipt of outpatient charges of medical institutions with unified finance and taxation.
To sum up, the materials needed for medical insurance reimbursement include hospital medical records, which need doctors to fill in and issue discharge certificates; You also need a general ledger of medical expenses, including medical expenses, hospitalization expenses, operation expenses, nutrition expenses, visits and other expenses that can be reimbursed by medical insurance regulations. In addition, it also includes the original and copy of the party's ID card.
Legal basis:
Article 10 of People's Republic of China (PRC) Social Insurance Law
An insurance contract is an agreement between the applicant and the insurer on the relationship between insurance rights and obligations. The applicant refers to the person who has entered into an insurance contract with the insurer and has the obligation to pay the insurance premium according to the contract.
An insurer refers to an insurance company that has entered into an insurance contract with the applicant and is liable for compensation or payment of insurance benefits according to the contract.
Article 28
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.
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