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

First, prepare 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, as well as 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, including online reimbursement and offline reimbursement. Online reimbursement can be carried out through the official website of medical insurance 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 their actual situation.

iii. submitting an application for reimbursement

after selecting the reimbursement method, the insured shall submit an application for reimbursement 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.

iv. Waiting for review and settlement

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 progress and results of reimbursement through the official website of medical insurance or mobile APP.

V. Precautions

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 the relevant medical vouchers and reimbursement materials properly for future inquiry and verification.

To sum up:

The reimbursement process of Shanghai Medical Insurance includes the steps of preparing reimbursement materials, selecting reimbursement methods, submitting reimbursement applications, waiting for review and settlement, etc. 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 medical expenses compensation more conveniently.

Legal basis:

Article 28 of the Social Insurance Law of the People's Republic of China

stipulates:

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations.

Article 14 of the Measures of Shanghai Municipality on Basic Medical Insurance for Employees

stipulates:

Employees shall purchase medicines at 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 in accordance with the regulations.