Shanghai children's hospitalization fund insurance is a social welfare undertaking that helps each other. Mainly to provide some medical expenses for children hospitalized due to illness. The establishment of children's fund insurance institutions can reduce the family burden of sick children, promote their healthy growth and maintain social stability.

First, the characteristics:

1, non-profit social welfare undertakings;

2. Low cost and high degree of protection;

3. Convenient settlement procedures;

4. Children who are already sick can also participate;

5, serious illness specialist outpatient service can also be paid by the fund according to regulations.

Second, the object of protection

1, all students registered in primary and secondary schools (including technical secondary schools, technical schools, vocational schools and special schools);

2. Preschool children (0-5 years old) with permanent residence in this city (including residence permit valid for more than one year);

3. Children under the age of 18 with permanent residence in this city and a disabled card;

4. Eligible preschool children of "foreign daughter-in-law";

5, approved by the district education administrative department to migrant children as the main body of school students.

Third, the charging standard

Participants are charged according to the academic year (September of that year 1 to August of the following year1);

1, 0-5 years old 60 yuan/school year;

2, 6- 18 years old 50 yuan/school year;

3. 60 yuan, a disabled child who did not attend school/school year;

Fourth, enjoy the treatment.

Once the participant is hospitalized due to illness or injury, he/she shall present the medical certificate of children's hospitalization fund and the hospitalization settlement certificate:

1, 50% hospitalization advance payment can be exempted when admission.

2. The medical expenses that exceed the Qifubiaozhun for each hospitalization (the standard refers to the medical insurance policy) shall be paid by the children's hospitalization pooling fund for 50%.

Qifubiaozhun is: 50 yuan, a first-class medical institution; 100 yuan, a secondary medical institution; 300 yuan, a tertiary medical institution. The expenses below Qifubiaozhun (including Qifubiaozhun) will not be paid by the overall fund.

3, for leukemia, hemophilia, aplastic anemia, malignant tumor children after discharge specialist outpatient treatment costs, as well as dialysis costs before kidney transplantation and postoperative anti-rejection drug costs, temporarily no Qifubiaozhun, children's hospitalization pooling fund in accordance with the provisions to pay 50%, with the "serious illness specialist outpatient medical record" for payment procedures. Specialist clinics should be treated in the original hospital, limited to one hospital.

4. The maximum cumulative payment per person per academic year is 654.38+10,000 yuan.