First, prepare relevant materials and certificates.
1. Original and photocopy of hospitalization invoice: This is the basic basis for reimbursement and must be kept.
2. Original and photocopy of diagnosis certificate: the diagnosis certificate issued by the hospital proves that the child really needs hospitalization.
3. Original and photocopy of the child's identity certificate: to prove the child's identity, usually an ID card or household registration book.
4. Original and photocopy of Shenzhen Children's Medical Insurance Card: It proves that the child has participated in Shenzhen Children's Medical Insurance.
5. Original and photocopy of the identity certificate of the parent or guardian: As the legal representative of the child, the identity certificate is required.
Second, fill out the reimbursement application form.
1. Download and print the reimbursement application form on the official website of Shenzhen Social Insurance Fund Administration.
2. Fill in the child's basic information, hospitalization information and medical expenses as required in the form.
3. Ensure that the information filled in is accurate, so as not to affect the reimbursement progress.
Third, submit an application for reimbursement
1. Submit the completed reimbursement application form and related materials to the designated window of Shenzhen Social Insurance Fund Administration or mail it to the designated address.
2. When submitting the application, ensure that the materials are complete and complete to avoid omissions.
Fourth, waiting for review and reimbursement.
1. Shenzhen Social Insurance Fund Administration will review the submitted materials after receiving the application.
2. After the approval, the reimbursement shall be made according to the prescribed proportion and standard, and the reimbursement shall be directly credited to the bank account designated by the child or parent.
To sum up:
The process of reimbursement for children's medical insurance in different places in Shenzhen needs to prepare relevant materials and certificates, fill in the reimbursement application form and submit it to Shenzhen Social Insurance Fund Administration for review and reimbursement. In the whole process, it is very important to ensure the completeness and accuracy of the materials, so as not to affect the reimbursement progress and results.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28 provides that:
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.
Measures of Shenzhen Municipality on Social Medical Insurance
Article 57 provides that:
The insured fails to handle the basic medical expenses and local supplementary medical expenses incurred in designated medical institutions outside the city according to the provisions of these measures, and is reimbursed according to 90% of the payment standards stipulated in these measures; The insured fails to go through the referral and filing procedures according to the provisions of these measures, and the basic medical expenses and local supplementary medical expenses incurred in non-settlement hospitals outside the city are reimbursed according to 70% of the payment standards stipulated in these measures, with the deductible line of 1000 yuan.