Since its launch, "Zao Huibao 2024" has won high recognition from the majority of insured people by virtue of its characteristics of "low threshold and high protection"!
However, there are some friends who have some questions about the claim, can the following scenario "Jujube Huibao 2024" be compensated?
Under what circumstances will it affect a claim?
Let's take a look
Scenario 1: If I have been diagnosed with a sick illness when I enroll in the insurance, can I still make a claim for Zao Huibao?
Of course, you can!
The medical expenses incurred by the insured within the scope of insurance liability during the insurance period shall be paid according to the compensation ratio of the pre-existing disease group agreed in the insurance contract after the settlement of the basic medical insurance and the deduction of the annual deductible corresponding to the insurance liability. Note: Historical data marks outpatient chronic diseases and those who have enjoyed reimbursement treatment for serious illnesses (residents' serious illnesses, employees' major illnesses, and employees' serious illnesses) during this time period (hospitalization date) from 0:00 on November 1, 2020 to 24:00 on October 31, 2023 will be defined as pre-existing conditions.
Scenario 2: My father is sick and is admitted to a private hospital closer to home, can I be reimbursed for "Zao Huibao 2024"?
Zao Huibao 2024 stipulates that the diagnostic hospital must be a designated medical institution for basic medical insurance, regardless of public or private. Therefore, as long as you live in a designated hospital for medical insurance, you can apply for a claim for "Zao Huibao 2024".
Scenario 3: I went to travel to other places and was accidentally injured and hospitalized, will this cost be reported in "Jujube Huibao 2024"?
You can apply for a claim for medical treatment in other places! Non-local medical treatment shall be subject to the provisions of Zaozhuang Basic Medical Insurance for remote medical treatment. The medical expenses incurred by the insured in other places for medical treatment in accordance with the provisions of this insurance (excluding the medical expenses that need to be borne by the individual first as stipulated in the basic medical insurance of Zaozhuang City) are included in the scope of "Zaozhuang Huibao".
For settlement and reimbursement of medical treatment in other places, you need to submit the following reimbursement materials to the designated window of Zaohuibao:
A copy of the insured's ID card;
If the insured person is a minor, the legal guardian's identity document and proof of relationship must be provided at the same time; If it is a trustee, the identity document of the trustee and the power of attorney must be provided at the same time;
Medical insurance statements, medical records (home page, admission records, discharge records), medical expense invoices, hospitalization expense lists and other relevant certificates;
The insured's or beneficiary's bank account (card number, bank account, mobile phone number);
If there is a third-party payment in advance, the third-party settlement information must be provided.
Scenario 4: I accidentally fell while riding a bicycle and spent a lot of money on the fracture and hospitalization, can I make a claim?
You can make a claim!
Whether it is hospitalization for injuries caused by accidents, home burns, falls, or hospitalization medical expenses due to illness, as long as they meet the liability agreement of "Zao Huibao 2024" and are reimbursed by basic medical insurance, you can apply for "Zao Huibao 2024" claims.
Jujube Huibao 2024".
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