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4. What are the documents required to apply for medical expense reimbursements?

If the insured goes to a National Health Insurance special hospital or clinic for an occupational injury or disease, for reasons not attributable to the insured, the insured fails to submit the occupational injury and disease outpatient form or application for hospitalization within 10 days from the date of medical treatment or before discharge from the hospital, and those who first seek medical treatment under the identity of health insurance may, within 6 months from the date of outpatient treatment or the date of discharge (5 years for special reasons), fill in the following application form and apply to the Bureau for reimbursement of medical expenses.

(1)Labor Insurance Occupational Accident Insurance Up-front Medical Expense Reimbursement Application Form and benefit receipt
(2) Original medical expense receipts and expense details. (In case the receipt and expense detail are lost or used for other purposes, the photocopies of the receipt and expenses details shall be sealed by the issuing medical institution to prove that they are identical to the originals.)
(3) Medical diagnosis report or other proof documents. (If the documents are in a foreign language, the Chinese translation shall also be submitted.)
(4) For any accident on the way to and getting off work or on a business trip, please fill in the " Labor Occupational Accident Insurance Insured Person Report of Injury Resulting from an Accident on the Way to or from Work or during Business Trip", and submit a copy of the front and back of the driver's driver's license. If handled by the police and other relevant agencies, please submit a copy of the relevant records.
(5) If the insured has any disease due to the occupational injury or disease resulting from the injury, if the physician determines that there is a medical need and chooses the special materials and items stipulated in Paragraph 1 of Article 45 of the National Health Insurance Act, after the out-of-pocket payment is paid in advance, a consent form for out-of-pocket payment that complies with the provisions of the National Health Insurance Medical Service Institution's Special Contract and Management Regulations shall be submitted.
(6) If the insured suffers an occupational injury or disease abroad, he/she shall first be treated in a local hospital or clinic, and a copy of the entry-exit permit and a certificate of assignment or business trip issued by the insured unit shall be submitted.
(7) For those who want to apply for reimbursement of medical expenses for their more than 5 day hospitalization in mainland China area, their medical proof documents (original copy of the medical expense receipt, details of expenses, medical diagnosis report or other proof documents) must be notarized by a Public Notary Office in mainland China area, and then they should apply for verification to Strait Exchange Foundation with the original copy of the Notary certificate. After the documents are verified, then they could be used to apply for the reimbursement.
Last Update:2022-09-13