Legal analysis: Shanghai college students' medical insurance reimbursement policy includes that hospitalized students must pay a certain deposit to pay the expenses that need to be borne by individuals, and refund more and make up less when they leave the hospital. College students' medical insurance is temporarily kept by the hospital medical insurance office during hospitalization. After the discharge formalities are completed, the hospital medical insurance office is responsible for filling in the overall payment form on the homepage of college students' medical insurance as required, and returning the college students' medical insurance to me. The scope of medication, diagnosis and treatment items and service facilities for college students to participate in the basic medical insurance for urban residents shall be temporarily implemented in accordance with the relevant provisions of the basic medical insurance for urban employees. 1. The medical expenses that should be borne by the individual shall be settled by the individual at one time when leaving the hospital. 2. Maternity expenses shall be subsidized in a fixed amount. The quota standard is: normal delivery in 800 yuan, cesarean section 1600 yuan. If the birth cost is lower than the limit standard, the subsidy shall be given according to the actual expenditure; Higher than the quota standard, according to the quota standard subsidies. 3. The scope of accidental injuries in outpatient service includes three diseases: fracture, joint dislocation and foreign body in respiratory tract. Suicide, self-mutilation (except mental illness), traffic accidents, fights, alcoholism, drug abuse and other diseases caused by crimes or violations of the Law on Public Security Administration Punishment will not be reimbursed by the overall fund. 4. The scope of outpatient emergency rescue includes coma, severe shock, massive hemorrhage, poisoning, severe dehydration, febrile convulsion, severe dyspnea caused by severe trauma, spontaneous or traumatic pneumothorax, hemopneumothorax, laryngeal infarction, tracheobronchial obstruction, severe arrhythmia, life-threatening internal and external bleeding caused by various reasons, acute heart failure, respiratory failure, renal failure and other major changes in vital signs. 5. Students who need to be hospitalized in different places due to critical illness during holidays, internships and suspension from school can go to the local designated medical institutions or public hospitals nearby, and the medical expenses incurred will be paid in full by individuals first. Collect and summarize college bills and report them to the municipal medical insurance agency for settlement.
Legal basis: People's Republic of China (PRC) Social Insurance Law.
Twenty-seventh individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with state regulations; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.
Article 33 Employees shall participate in work-related injury insurance, and the employer shall pay the work-related injury insurance premium, while employees shall not pay the work-related injury insurance premium.
Thirty-sixth employees who are injured by accidents or suffer from occupational diseases due to work reasons and are recognized as work-related injuries shall enjoy work-related injury insurance benefits; Among them, those who lose their ability to work after the appraisal of their ability to work enjoy disability treatment.
Work injury identification and labor ability appraisal should be simple and easy.