The insured person of Shanghai Federation of Trade Unions Mutual Aid Medical Insurance "Special Serious Illness Group Mutual Aid Medical Insurance Plan" is diagnosed with uremia, malignant tumor, severe disease for the first time 180 days after the effective date of the policy (within the three-year protection period) One of nine major diseases, including hepatitis, heart valve replacement surgery, coronary artery bypass surgery, aplastic anemia, intracranial tumor surgery, major organ transplant surgery, and aortic surgery, can receive mutual medical insurance of 10,000 yuan each. gold.
From 90 to 119 days after the effective date of the policy, the consolation payment is 500 yuan; from 120 to 149 days, the consolation payment is 1,000 yuan; from 150 to 179 days, the consolation payment is 2,000 yuan.
The "Shanghai Employee Hospitalization Supplementary Medical Mutual Aid Insurance Plan" for the first time is subject to a 30-day exemption period. After the exemption period, individuals who fall within the reimbursement scope of basic medical insurance are responsible for part of their medical expenses, and supplementary medical treatment will be paid according to the following standards Security fund:
(1) 50% of the outpatient treatment for serious illness will be paid;
(2) Treatment of the other three conditions: 60% of the part above the threshold line and below the cap line will be paid; The portion above the cap line is paid at 70%.
Extended information:
Insurance procedures for the Shanghai Supplementary Medical Mutual Aid Insurance Plan for In-service Employees:
(1) Fill in the application form (in triplicate);
(2) Provide a computer disk with the list of participants (name, ID number), and print two copies of the same list;
(3) Provide the unit with a list of participants this month or last A copy of the monthly "Medical Insurance Premium Payment Settlement Form";
(4) Pay the full premium.
The payment procedures for the Shanghai Supplementary Medical Insurance Mutual Assistance Plan for In-service Employees:
(1) Fill in the "Application Form for Hospital Supplementary Medical Insurance Benefit for Active Employees";
< p>(2) Provide the following materials:A. Original and copy of the special receipt for medical expenses;
B. Discharge summary or outpatient serious illness registration certificate, home bed construction certificate;
C. Copy of ID card;
D. When applying for the first time, a copy of the "Account Name" page of the Shanghai Bank's medical insurance special account passbook must be provided.
Official website of Shanghai Federation of Trade Unions-Employee Mutual Aid Supplementary Insurance