Handling of primary school students' medical insurance:

(1) Children in school (excluding children from poor families with minimum living allowances)

1. Children who are insured receive insurance application materials from the school (including insurance instructions and forms, the same below).

2. The guardians of the insured children fill in the relevant forms carefully according to the requirements of enrollment, and declare the enrollment information online (the first batch of applications in 27 did not need to declare information online), and return the required materials to the school after preparing them.

3. The school will review and collect relevant information and submit it to the social security agency.

4. The social security agency accepts the insured information, reviews the insured information, enters the insured information, establishes a social security collection account and collects the application fees in the bank through the computer system.

5. After the collection of children's medical insurance fees is successful, the school can apply to the social security agency for making children's medical insurance certificates, print the certificate making list in the children's insurance collection window, pay the certificate making fees at the social security certificate making window and go through the certificate making procedures.

6. After 2 working days from the acceptance of the certificate-making procedures, the school will go to the social security institution to receive the children's medical insurance certificate and distribute it to the insured.

(2) Children under the age of 18 who have not enrolled in the park or settled outside the city

1. The guardians of the insured children go to the social security agency where the household registration is located to obtain the application materials for insurance.

2. The guardians of the insured children should fill in the relevant forms according to the insurance requirements and declare the insurance information online (the first batch of applications in 27 did not need to declare the information online), and prepare the required insurance information to declare to the social security agency where the household registration is located.

3. The social security agency accepts the insured information, reviews the insured information, enters the insured information, establishes a social security collection account and collects the application fees in the bank through the computer system.

4. After the collection of children's medical insurance fees is successful, the insured children's guardians can apply to the social security agency for making children's medical insurance certificates, print the certificate-making list in the children's insurance collection window, pay the certificate-making fees at the social security certificate-making window and go through the certificate-making procedures.

5. 2 working days after accepting the certificate-making procedures, the insured children's guardian will go to the social security collection agency to receive the children's medical insurance certificate and issue it to the insured.

(III) Children from low-income families in deep households

1. The insured children ask the civil affairs department of the district where the household registration is located for insurance application materials, print and confirm the insurance list, seal it, fill in the insurance form, prepare the insurance materials and return them to the civil affairs department.

2. The civil affairs department shall review the enrollment forms and materials, and report to the social security agency.

3. The social security agency accepts the insured information, reviews the insured information, enters the insured information, establishes a social security collection account and collects the application fees in the bank through the computer system.

4. After the collection of children's medical insurance fees is successful, the civil affairs department can apply to the social security agency to make a children's medical insurance certificate, print the certificate making list in the children's insurance collection window, pay the certificate making fee at the social security certificate making window and go through the certificate making procedures.

5. 2 working days after accepting the certificate-making procedures, the civil affairs department will collect the children's medical insurance certificate from the social security collection agency and issue it to the insured.

Guidelines for handling children's medical insurance

1. Children's medical insurance and social/medical insurance cards

1. Required materials: the original household registration book+the first page of the household registration book and a copy of the baby's own page, and the original and copy of the agent's ID card

2. Handling place: the social security center where the household registration is located

3. Handling fee: 25 social/medical insurance cards. Get the card+medical record book 1 working days after registration, and take the card book with you when you see a doctor in the future.

2. Children's Hospitalization Medical Mutual Fund (blue medical certificate)

1. Required materials: household registration book

2. Handling place: the street where the household registration belongs, community health service center (district hospital)

3. Handling fee: 6 yuan every year (from September 1 to August 31 of the following year)

4. Enjoy treatment: The maximum payment per person per academic year is 1, yuan

5. Note: the baby will be processed in 3-6 days. Shanghai Children's Hospital Medical Mutual Fund Hotline: 52122999 Consultation time: Monday to Friday, 9: -17: < P > III. One-child insurance (Shanghai)

1. Required materials: Shanghai Household Registration Book or Shanghai Residence Permit of the only-child parents, and Honor Certificate of the only-child parents.

2. Handling place: insurance plan service points set up in the street of residence, and neighborhood committees where residence is located.

3. Insurance cost: 6 yuan is equivalent to the one-child parents' incentive fee for a couple in Shanghai every year

4. The maximum amount of protection: 4, yuan for illness death, 4, yuan for accidental death, 2, yuan for serious illness, and 5, yuan for accidental medical treatment (first visit to a first-class hospital (inclusive), and second visit to a second-class hospital). Pay 8% after deducting 1 yuan every time)

5. Note: The object is the only child who has been born for 3 days to 16 years old; After purchase, you need to activate the medical insurance for primary school students online

The benefits you can enjoy:

I. Hospitalization benefits:

Insured residents must seek medical treatment in designated hospitals with vouchers, and the hospitalization expenses that meet the admission criteria shall be borne by the individual first, and the part above the Qifubiaozhun shall be paid by the residents' medical insurance fund according to the regulations, and the reimbursement ratio is as follows:

First-class hospitals: the Qifubiaozhun is all in 1 yuan in the same insurance year, and the expenses above the Qifubiaozhun are reimbursed for Class A expenses.

secondary hospital: in the same insurance year, the minimum threshold for the first hospitalization is 3 yuan, and the minimum threshold for the second and above hospitalization is 15 yuan. Above the minimum threshold, 6% of the expenses of Class A and 45% of the expenses of Class B will be reimbursed.

tertiary hospitals: in the same insurance year, the qifubiaozhun for the first hospitalization is 5 yuan, and the qifubiaozhun for the second and above hospitalizations is 25 yuan. Above the qifubiaozhun, 5% of Class A expenses and 4% of Class B expenses will be reimbursed.

II. Treatment of serious illness outpatient service:

Insured residents suffering from malignant tumor, Parkinson's syndrome, severe mental illness, systemic lupus erythematosus, aplastic anemia, hemophilia, and in the anti-rejection treatment period after organ transplantation and uremia period of chronic renal function can apply for serious illness outpatient service of medical insurance for urban residents. The serious illness outpatient service is subject to fixed cost management, and the expenses within the fixed amount are reimbursed by 5%.

what materials do I need to bring when I apply for reimbursement?

medical bills, expense details, disease diagnosis, copies of cases (stamped with the official seal of the hospital), medical insurance cards, original ID cards of patients, original and copies of XX bank passbook (card), and the Application Form for Remote Referral of Basic Medical Insurance for Urban Residents in XX City is also required for patients who are referred to other places.

note: if the reimbursement materials need to be copied, please copy them before handling the reimbursement business, and the medical insurance department will not be responsible for finding the reimbursement materials after accepting the business.

Further reading: How to buy insurance, which is better, and teach you how to avoid these "pits" of insurance.