Guest
Zhao Li, Zhang Yan, and Shi Jingyi
Interview Background
During this event, Zhao Li, Director of the Jing'an District Medical Insurance Center, will address hot topics in medical insurance policies and provide strategic tips for seeking medical treatment. Zhang Yan, Deputy Director of the Outpatient Department at Huadong Hospital affiliated to Fudan University, and Shi Jingyi, Deputy Director of the Outpatient and Emergency Management Office at Children's Hospital of Shanghai, will also answer frequently asked questions about medical insurance policies and medical service access. The event seeks to help raise public awareness of health management and improve the overall health literacy level of the population.
Host:
Hello, everyone. Welcome to this health education event jointly organized by the Shanghai Jing'an Media Center and West Nanjing Road Sub-district. Today, we are joined by Zhang Yan, Deputy Director of the Outpatient Department at Huadong Hospital affiliated to Fudan University, and Shi Jingyi, Deputy Director of the Outpatient and Emergency Management Office at the Children's Hospital of Shanghai. Welcome. The two experts here today are the most authoritative voices on this matter. We would like to take this opportunity to invite them to discuss the details and unique features of their hospitals. Let's first hear from Huadong Hospital, and then Director Shi will introduce the Children's Hospital of Shanghai.
Zhang Yan:
Thanks for having me. Hello, everyone. Huadong Hospital was established in 1951 and is affiliated to Fudan University. As the host mentioned, many people's first impression of Huadong Hospital is our excellence in medical care and health services. Huadong Hospital is a Grade-A tertiary hospital specializing in geriatric medicine. The Department of Geriatrics is a national key clinical specialty. However, beyond geriatrics, internal medicine departments, such as cardiology, gastroenterology, and respiratory medicine, as well as hematology, nephrology, endocrinology, and rheumatology and immunology, have always been among our leading specialties. In recent years, with the continuous recruitment of top professionals and ongoing talent development efforts, our surgical departments—including general surgery, thoracic surgery, urology, vascular surgery, plastic surgery, and neurosurgery—have also achieved a leading position in the field. Another advantage of our hospital is our extensive collection of advanced diagnostic and treatment equipment. We have state-of-the-art operating rooms, da Vinci surgical robots, Varian linear accelerators, and large-bore 3.0T MRI machines. Recently, we've also put into operation the Parker MRI systems. Beyond the internal medicine and surgical departments I just mentioned, Huadong Hospital has many other distinctive specialties. For instance, you might not know that our Traditional Chinese Medicine nursing is also a specialized department with many outstanding professionals.
Shi Jingyi:
Thanks for having me. Hello, everyone. I joined the Children's Hospital of Shanghai over thirty years ago, and many parents have told me they were also treated at our hospital when they were children. Our philosophy is that serving children brings happiness, so even though we've worked very hard, we always feel there's room for improvement. Today, I'd like to introduce the new technologies we've adopted for children's health.
Host:
You might wonder why today's hospital representatives are from the emergency management departments. This is because our topic today focuses on current medical insurance policies and strategies for seeking medical treatment. Through today's introduction and sharing, we hope to help everyone better understand relevant policies, including specific details about the medical treatment process. Today, we are also delighted to welcome Director Zhao Li from the Jing'an District Medical Insurance Center as a guest to share her insights. Welcome!
Zhao Li:
Hello to the host and the two experts. The Medical Insurance Center serves as the agency for implementing health insurance policies in Jing'an District. We have multiple service windows where a variety of health insurance matters can be processed. You are welcomed to visit our center at 363 Yuanping Road to process any medical insurance-related business, and we will serve you with our utmost dedication.
Host:
Today, we're here to help resolve any pain points, challenges, and questions you have. Speaking of medical insurance, in today's era, while people are still accustomed to carrying their medical record books with insurance cards when seeking medical treatment, unexpected situations can arise. For instance, sometimes you might plan to get certain examinations done, and while passing by a hospital, you want to take advantage of the opportunity, but you don't have your medical record book or card with you. You might now know about the electronic medical insurance code or card, but how exactly do we use it? How do we activate it, how do we use it, and what do we do in emergencies? Let's start with some basic knowledge. First, let's hear from Director Zhao about how to handle this from a policy perspective. What are the details of the actual operation?
Zhao Li:
Well, if you suddenly develop an acute condition during work and need emergency medical treatment without having your physical card or medical record book with you, you can easily solve this problem by using the electronic medical insurance credential. The electronic medical insurance credential, also known as the medical insurance code, is a unified digital identifier issued by the National Healthcare Security Administration on a nationwide information platform for insured individuals. It enables convenient services throughout the entire process. With the electronic medical insurance credential, we can easily complete medical insurance payments at hospitals by scanning the code, eliminating the need to carry a physical card. Besides, the activation process is also very simple and convenient. For online activation, we can use the China Healthcare Security App or third-party platforms—we commonly use Sui Shen Ban Citizen Cloud. It can also be activated through Alipay or WeChat. You can follow the step-by-step prompts to complete real-name authentication and face recognition activation. After activation, you just need to access the electronic medical insurance credential portal, and then scan the code at the hospital or pharmacy windows to make payments.
Host:
Let's now talk with Director Shi. Actually, using the Children's Hospital of Shanghai as an example is a bit special. In fact, whether we're young or old, we can all use this method. I'm curious about what credentials are used for children's medical treatment. Also, since parents usually bring their children to see doctors and handle these procedures, how have you streamlined this process?
Shi Jingyi:
I can really relate to that. Some parents come to refill prescriptions during their lunch break, but nowadays, with grandparents from both sides taking care of children and sometimes living separately, requiring a physical card to be present can indeed be challenging. I often encounter situations where people arrive first and then have to wait for someone to bring the medical insurance card from home, which is really inconvenient. As a child-friendly hospital, being parent-friendly means being child-friendly. Many elderly people who come here are under a lot of pressure, often in a hurry, and unfamiliar with the specific procedures. Strategically, we've arranged many staff members to help—I sometimes assist personally—and we've also arranged volunteers. But I think young people should do as much preparation as they can.
Host:
Thank you, Director Shi. Now I'll pass the microphone to Director Zhao. I'm curious, Director Zhao—children now have their own medical insurance cards and can use their own accounts, but we often hear about "family accounts". As I understand it, this allows family members to help complete these processes for other family members. Speaking of family accounts, there's also something called a "supply account". There are many accounts like this. How should we handle them? For example, after binding, can grandparents use family accounts when taking grandchildren for medical treatment? Can aunts and uncles also complete this process? What types of accounts are available?
Zhao Li:
Let me explain. A "family account" is a sub-account linked to an individual's medical insurance account for family members. What does this mean? If you bind a family account, you can use the related benefits of family members' electronic medical insurance credentials. For example, if I bind my parents' family accounts to my phone, when accompanying them for medical treatment, I can use my phone to display their medical insurance credentials. In this way, I can help them make appointments, collect medicine, and make payments. This makes it much easier for them to receive medical treatment.
Zhao Li:
One more detail—in recent years, there were online complaints about how to prove parent-child relationships when binding accounts. What are the procedures for binding family accounts?
Zhao Li:
It works like this: family accounts can be bound through the China Healthcare Security App, as well as through Alipay and WeChat. They all have a family account binding function. The binding process requires real-name authentication and submission of materials proving the parent-child relationship. The binding process for children has become relatively simpler. We've now integrated with the big data center, so we no longer need to upload children's birth certificates or household registration books as we did in the past. For binding children under 16 years old, we only need to enter the child's name and ID number on the Alipay platform.
Host:
Given this level of convenience, I believe it won't be long before we can match parents and ourselves together. We just raised another question: Exactly what kind of familial relationships are included in this so-called "family account"?
Zhao Li:
There are specific regulations governing the binding of family accounts. You can bind accounts with your parents, children, and spouse. Grandparents cannot bind accounts with grandchildren, and binding with aunts and uncles is currently not possible.
Host:
But I believe this reflects the rigor of our policy.
Zhao Li:
People often mix up the two, which are actually completely different medical insurance services. The family account we just discussed mainly solves the problem of elderly people and children seeking medical treatment without physical cards. The settlement still uses the patient's own account, and cannot access the family mutual aid account. What is mutual aid? Family mutual aid refers to the shared use of personal accounts within a family. What does this mean? If I am enrolled in Shanghai's employee medical insurance and have surplus funds in my account from previous years, I can establish a family mutual aid network. After my family members join the family mutual aid network, I can include my family members in my annual account.
Host:
Can I understand it this way: we have a kind of medical insurance pool within our family, right? During use, family members can draw funds from this pool or network for the core family members.
Zhao Li:
When creating a medical insurance network for sharing, you can only include spouses, children, or parents. Other members are not eligible. When using this system, for instance, if my network includes both a network organizer and family members, there can only be one network organizer. Three conditions must be met: the first is that the organizer must be a participant in the Shanghai employee health insurance scheme. Second, they must have surplus funds in their accumulated account—as without funds they cannot be used. The third one is the insurance account. The urban employee insurance account must be in normal status, not suspended or in any other irregular state. As for family members, they need to meet two requirements: they must be the network organizer's children, spouse, or parents, and they must have Shanghai medical insurance, which can be either urban employee medical insurance or resident medical insurance.
Host:
That's right. In this internet era, online and offline channels have been integrated, making it convenient for everyone to understand how to use their medical insurance accounts and access various platforms for medical treatment, consultations, and other health needs. Having invited these experts here today to share and communicate with everyone, I want to return to the principle I mentioned at the beginning. Jokingly speaking, I hope you won't mind if I say that I actually wish for our center and our hospitals to become increasingly less busy with fewer cases, as this would indicate that everyone's health is improving. While we entrust our health to our hospitals and our center, and while we need to know these policies and information for when we might need them, I believe it's actually a positive sign if we use these services less frequently or not at all. I'd like to thank everyone again for listening to the knowledge we've shared today, and thank our representatives from the center and both hospitals for sharing these details. I wish everyone good health. This concludes our program. Thank you all, goodbye.
Shi Jingyi:
Thank you.
Zhao Li:
Thank you.
Zhang Yan:
Thank you.