Retroactive Medical Insurance Billing Procedures for General Illnesses

(Applicable to both outpatient and inpatient services)Prepare all required documents: payment invoice, outpatient medical records, social security card and ID card.Submit documents to the Medical Insurance Service E-Station on the 1st Floor, Building 3 for eligibility review, complete formalities and sign documents as required.Bring all reviewed materials to the manual billing counter on the 1st F...

2026-06-18

Full Online Operation Guidelines for Special Outpatient Disease Certification

 I. Application Guidelines for Special Outpatient Disease Certification (Government Service Portal) (1) System LoginInsured persons may submit applications for special outpatient disease certification via the Personal Online Service System on the official website of Shenzhen Municipal Medical Security Bureau or the WeChat official account "Shenzhen Medical Insurance". The opera...

2026-06-18

Medical Treatment Guidelines for Work Injury Patients

1. For accidental injuries confirmed to be work-related, clearly inform the attending physician at the time of consultation. Work injury identification application shall be submitted within 30 days after the injury. Applications submitted beyond the time limit will not be reimbursed by work injury insurance, and all relevant medical expenses shall be borne by the employer. All medical expenses inc...

2026-06-18

Medical Guidelines for Insured Patients with Injuries Caused by Liable Third Parties

1. Truthfully inform the attending physician of the exact time, location, cause and specific condition of the injury.2. If a liable third party is confirmed, go through liability identification procedures at relevant government departments such as traffic police stations in a timely manner. All medical expenses shall be paid out of pocket in advance; reimbursement will be processed in accordance w...

2026-06-18

Guidelines for Accessing and Purchasing Dual-Channel Drugs Under Shenzhen Basic Medical Insurance

I. Policies Governing Dual-Channel DrugsThe dual-channel mechanism covers nationally negotiated drugs and chronic disease medications (excluding narcotic drugs, psychotropic drugs and toxic medical substances). Such medicines are accessible via two authorized channels: designated medical institutions and designated retail pharmacies, and are simultaneously eligible for medical insurance reimbursem...

2026-06-18

Procedures for Binding Designated Community Health Center via Shenzhen Medical Insurance

1. Scan the QR code of "Medical Insurance Assistant" with WeChat to enter the service page of Shenzhen Municipal Medical Security Bureau. Click "Consult & Handle Services", enter the keyword "designated community health center" to view the binding steps and complete the operation as prompted.2. Scan the designated QR code with WeChat to activate the medical insura...

2026-06-18

Operating Procedures for Family Mutual-aid Account Setup

Launch the WeChat Mini Program "Guangdong Medical Insurance" and tap Login. The system will prompt to open the "Yuexinqian" Mini Program; select Allow to jump to it. After logging in via facial recognition verification, tap Return to Medical Insurance Service Platform to enter the homepage. Set the insured region to Shenzhen City, then follow the steps below:1. Locate the Senio...

2026-06-18

Medical Treatment Guidelines for Insured Patients with Accidental Injuries Not Attributable to Third Parties

1. Truthfully inform the attending physician of the exact time, location, cause and injury condition of the accident.2. Inpatients shall truthfully fill out the Commitment Letter Confirming No Third-party Liability (hereinafter referred to as the Commitment Letter) before completing medical insurance registration procedures. The Commitment Letter with the injured party’s fingerprint shall be filed...

2026-06-18

Off-site Medical Treatment Filing Procedures

For participants enrolled in medical insurance outside Shenzhen who need reimbursement for outpatient treatment in Shenzhen, off-site medical treatment filing must be completed at the insurance-participating region first. Afterwards, medical services can be received at nationally networked designated medical institutions in Shenzhen with direct settlement by presenting a social security card or me...

2026-06-18

Registration Procedures for Special Outpatient Diseases Under Shenzhen Social Medical Insurance

I. Category I Special Outpatient Diseases(1) Category I Diseases Recognizable and Treatable in Our HospitalMalignant tumor (chemotherapy including biotargeted therapy and endocrine therapy); chronic renal insufficiency (hemodialysis); six major types of mental illnesses.(2) Benefit Entitlements for Category I Special Outpatient Diseases1. Medical treatment is available at designated municipal medi...

2026-06-18

Operation Guidelines for Newborn Insurance Registration with Birth Medical Certificate (Shenzhen Medical Insurance WeChat Official Account)

1. Follow the WeChat official account "Shenzhen Medical Insurance", click menu items Online Medical Insurance Services and Mobile Services.2. Log in with the parent’s identity credentials.3. Click Children’s Insurance Enrollment Management.4. Select Newborn Enrollment via Birth Medical Certificate.5. Tap Apply Now to start registration.6. Fill in newborn enrollment information: input the...

2026-06-18

Process for Retroactive Medical Insurance Billing for Newborns

Newborns with local household registration who complete resident basic medical insurance enrollment within 6 months after birth may pay premiums retroactively starting from the month of birth and enjoy resident medical insurance benefits as stipulated herein from the date of birth.Required Documents for Retroactive Billing1. Documents of the newborn: Birth Certificate, ID Card / Household Register...

2026-06-18

Scope of Personal Account for Shenzhen Tier 1 Medical Insurance

1. The threshold for flexible utilization of personal medical insurance accounts has been abolished.2. Expenses eligible for payment via personal accounts are listed below:(1) Out-of-pocket medical expenses incurred by the enrollee, spouse, parents, children, grandparents, maternal grandparents, grandchildren, great-grandchildren, elder brothers, younger brothers, elder sisters and younger sisters...

2025-08-01

Special Outpatient Diseases Covered by Shenzhen Medical Insurance

Quantity & Scope of DiseasesThe scope and total number of special outpatient diseases remain unchanged, totaling 52 plus 1 disease, with province-unified disease codes.Classification of Special Outpatient DiseasesDivided into Category I Special Outpatient Diseases and Category II Special Outpatient DiseasesCategory I (23 + 1 diseases)1. Anti-rejection therapy after heart, lung, liver and kidne...

2025-07-01

General Outpatient Pooled Medical Insurance Benefits Under Shenzhen Medical Insurance

Pool Fund Reimbursement Ratios- Primary and lower-level medical institutions: 75% covered by the pooled fund- Secondary hospitals: 65% covered by the pooled fund- Tertiary hospitals: 55% covered by the pooled fundFor retirees and resident medical insurance participants aged 60 and above, the above reimbursement ratios will be increased by 5 percentage points respectively.The remaining out-of-pocke...

2025-06-02

Shenzhen Medical Insurance Benefits & Treatment: Catalogue Coverage

1. Catalogue and Payment StandardsThe unified national catalogue and payment standards for basic medical insurance drugs, diagnosis and treatment items, and medical consumables shall be implemented.For medical consumables priced above RMB 1,000 per unit, no distinction will be made between imported and domestic products, and no separate general price brackets will be formulated independently.2. Ad...

2025-05-05

Shenzhen Medical Insurance Medical Treatment & Benefits: Effective Date of Benefit Entitlement

General Rules1. Medical insurance benefits take effect on the 1st day of the month following the completion of insurance enrollment and full premium payment.2. For children and student enrollees who pay the annual premium covering September of the current year to August of the next year in a lump sum, medical benefits are available from October of the current year to September of the next year.Spe...

2025-04-01

Circumstances Not Covered by Basic Medical Insurance

1. Injuries Caused by Third PartiesMedical expenses incurred from personal injuries attributable to third parties shall be borne by the liable third party and shall not be reimbursed by medical insurance.2. Work-related InjuriesExpenses for injuries identified as work-related accidents shall be covered by work injury insurance under social insurance, and no duplicate reimbursement will be provided...

2025-03-03

Notes on Prescribing Dual-channel Drugs

On-site Registration and Drug Dispensing Process in Hospital Outpatient DepartmentStep 1: Complete on-site medical insurance registration at the specialist outpatient clinic (for Shenzhen Medical Insurance participants).Step 2: Consult the specialist, who will complete diagnosis and medical record information. Participants shall pay the consultation fee in advance with medical insurance credential...

2025-02-03

Full Process Guide for Outpatient Treatment with Off-site Medical Insurance

I. Filing for Record: The "Passport" for Off-site Medical Treatment1. Long-term Off-site Residence FilingApplicable to retirees settling with children, long-term off-site workers and other similar groups. The filing remains permanently valid upon completion, allowing dual access to medical benefits in both the filed location and the participant’s insurance enrollment region.2. Temporary ...

2025-01-06