brief introduction
During the insurance period, if the insured is diagnosed and prescribed by a specialist in a designated hospital, and purchases medicines from hospitals and pharmacies agreed in the insurance contract in advance and uses medicines in the specific drug list agreed in the insurance contract, he can apply for reimbursement and claim for special drugs afterwards in the official account of "Zhao Yan Medical Insurance" WeChat, and upload the application materials for reimbursement and claim for special drugs afterwards according to the prompts. After passing the examination, the insured will be paid according to the proportion agreed in this insurance contract.
Claim process
Reimbursement application entrance: Click Enter, then click Service Center → Claims Service → Special Medicine Afterwards Reimbursement Application, and upload video claims data according to the prompts.
Apply for reimbursement of claim materials afterwards.
1. Identity certificate of the insured
2. In-patient medical records/discharge summary
3. Pathological diagnosis report
4. Drug prescription
5. Immunohistochemical/genetic test report
6. Original invoice
Second, special drugs are directly reimbursed.
brief introduction
During the insurance period, the insured needs to buy drugs from hospitals and pharmacies agreed in the insurance contract after being diagnosed and prescribed by designated hospital specialists, and use the drugs in the specific drug list agreed in the insurance contract, he can first apply for the direct payment service for special drugs in the official account of "Zhao Yan Medical Insurance" WeChat, and the staff will review the rationality of drug use within one working day. After approval, qualified professionals will be arranged to contact the insured to choose a designated pharmacy to take medicine.
Claim process
Reimbursement application entrance: Click Enter, click Service Center → Claims Service → Special Medicine Direct Payment Application in turn, and upload video claims data according to the prompts. The insured person applies for direct payment of special drugs online, and after the rationality of drug use in the specific drug list is approved, the professional contacts the insured person by telephone to choose the method of drug collection.
1. Go to the store to get the medicine. If the insured chooses to go to the designated pharmacy for special drugs to collect the drugs by himself, he will contact the insured by telephone to confirm the address of the pharmacy and send the drug receipt. The insured should bring prescriptions, drug receipt and other related materials to the "Zhao Yan Medical Insurance" special pharmacy to receive.
2. Send medicine to the door If the insured chooses to send medicine to the door, the professional will contact the insured by phone to confirm the relevant information of delivering medicine to the door and send the medicine receipt certificate. The insured shall submit relevant materials when receiving medicines.
Application materials for direct payment of special drugs
Identity documents of the insured.
Inpatient medical record/discharge summary
Pathological diagnosis report
Drug prescription
Immunohistochemical/genetic test report
Three. Direct reimbursement of overseas special drugs
brief introduction
During the insurance period, if the malignant tumor insured needs to purchase drugs from hospitals and pharmacies agreed in the insurance contract and use overseas drugs in the specific drug list agreed in the insurance contract, he can first apply for the direct payment service of overseas special drugs in the official account of "Zhao Yan Medical Insurance" WeChat, and the staff will arrange specialized experts to conduct objective analysis according to the patient's medical record, and provide accurate diagnosis and reliable treatment plan. After the introduction of the scheme, the insured can use imported drugs in Hainan Boao Super Hospital, Boao International Hospital, Lecheng Campus of Hainan Provincial People's Hospital or Lecheng Branch of Hainan Provincial Women and Children Hospital Center. The insured only needs to pay the remaining expenses after the claim is settled.
Claim process
Reimbursement application entrance: Click Enter, click Service Center → Claims Service → Application for Direct Payment of Overseas Special Drugs in turn, and upload video claims data according to the prompts. The insured applies for direct payment of overseas special drugs online. After the specially appointed experts pass the examination, the professionals will contact the insured by telephone and refer them to the designated hospitals in Hainan for medication.
Apply for overseas special drugs to directly pay claims materials.
Identity documents of the insured.
Inpatient medical record/discharge summary
Pathological diagnosis report
Immunohistochemical/genetic test report
Four. Reimbursement of medical expenses for Fosun Automobile.
brief introduction
During the insurance period, the insured meets the requirements of Fosun CAR-T treatment, and the medical expenses incurred by using Fosun CAR-T treatment in designated hospitals will be reimbursed at the rate of 80%, with no deductible, and the maximum annual compensation will be 6,543,800 yuan. If the insured suffers from the drug indications listed in the Catalogue of Specific Self-funded Drugs before the start of insurance, the insurer is not responsible for paying the insurance premium for automobile treatment expenses.
Claim process
1. Application method
Reimbursement application entrance: Click Enter, click Service Center → Claims Service →CAR-T Service Application in turn, and upload video claims data according to the prompts;
After the rationality of CAR-T drug use is approved, professionals will contact the insured by phone to order offline;
The insured carries a doctor's prescription to the designated pharmacy to order Yikaida;
Pharmacy pharmacists review prescriptions, explain product information to the insured, and sign drug purchase contracts with the insured;
After the insured pays part of the drug fee at his own expense, the pharmacy issues a receipt, and the insured returns to the medical institution for leucocyte apheresis;
After about 17 days of factory production, Yikaida will be sent to the designated pharmacy after delivery.
At the appointed time, Yikaida was sent to a certified treatment center for the insured to take medicine.
2. Fosun CAR-T treatment expense reimbursement application.
Identity documents of the insured.
Inpatient medical record/discharge summary
Pathological diagnosis report
Drug prescription
Immunohistochemical/genetic test report