1. Take photos on the official account of "Huhuibao" WeChat and the "self-service claim portal" and upload all kinds of documents (including the function of submitting applications with relatives) through the mobile terminal to apply for claims.
2. In the specialty pharmacy attached to the product manual, customers can assist the insured (including the elderly) to apply for claims and upload various documents through the mobile terminal in the official account of "Huhuibao" WeChat and the "self-service claims portal";
3. Request assistance in claim settlement through the counters of service outlets of nine commercial insurance companies.
II. The calculation method of compensation amount for several types of expenses within the scope of guarantee responsibility is as follows:
1, the compensation amount of out-of-pocket medical expenses for specific hospitalization = (specific drug expenses, surgical materials and examination expenses in invoices settled by basic medical insurance during hospitalization (excluding medical expenses of individual and classified out-of-pocket part of basic medical insurance-deductible line of 20,000 yuan) x70%, and the reimbursement rate of patients with previous diseases is 50%. The annual limit is 6,543.8+0,000, including 300,000 single-product drugs, 200,000 materials for a single hospitalization operation, and PET-CT only once a year.
2. The compensation amount for certain high-cost drugs =(2 1 kind of high-cost special drugs (purchased at the outpatient department of Shanghai public second-class and above hospitals or designated pharmacies and meeting the compensation conditions) -0 yuan deductible line) x70%, and the reimbursement rate for patients with previous diseases is 30%; The annual limit is 6,543,800+0,000.
3. The compensation amount of proton heavy ion medical expenses = (reasonable and necessary positioning and radiotherapy planning expenses, proton heavy ion radiotherapy expenses (proton heavy ion therapy is accepted in a medical institution with proton heavy ion therapy qualification in Shanghai for malignant tumor, excluding bed fees and chemotherapy fees) -0 yuan deductible) ×70%, and the reimbursement rate of previous patients is 30%; The annual limit is 300,000.
Finally, it should be noted that if the insured person is hospitalized in the general department of the second-level and above medical insurance designated hospital in Shanghai and uses the Shanghai medical insurance card for real-time settlement, he can claim compensation; If you don't use the Shanghai medical insurance card for real-time settlement, you need to settle the Shanghai basic medical insurance before you can apply for compensation. Certain high-cost drug insurance premiums and proton heavy ion medical insurance premiums do not accept claims for foreign/off-site expenses.