Is Guangzhou social security card only available in designated hospitals?

Is Guangzhou social security card only available in designated hospitals?

Social security generally refers to social insurance. Social insurance refers to a social and economic system that provides income or compensation for people who lose their ability to work, are temporarily unemployed or suffer losses due to health reasons. Next, I sorted out the relevant contents of whether Guangzhou social security card can only be used in designated hospitals. I hope you like this article!

Is Guangzhou social security card only available in designated hospitals?

Guangzhou social security card can be used not only in designated hospitals. If you want to apply for reimbursement, you can only use social security cards in designated hospitals. If you use a social security card in a non-designated hospital, you can only deduct money from your personal medical insurance account.

There are two ways to handle medical insurance designated hospitals in Guangzhou.

First, through WeChat, employees' medical insurance participants can pay attention to the official WeChat of "Guangzhou Medical Insurance" and complete real-name authentication, so they can apply for online number selection in real time.

Second, through on-site processing, that is, before the insured person registers for medical treatment in the outpatient department of a designated medical institution in Guangzhou, he/she needs to show his/her social security card or medical insurance card, valid ID card and one-inch small color photo at the relevant window of the hospital to go through the procedures for selecting points for the outpatient department.

It can be changed after handling, and the specific change requirements are as follows

1. For the insured who have selected points in the previous year and want to change the selected points in the new year, they can go directly to the newly selected hospital for re-selection procedures at the beginning of the new year with medical insurance vouchers and valid identity documents.

2. If you have had general outpatient consultation (emergency consultation) in the original selected hospital in the new year, but want to transfer to another hospital, the insured must meet certain conditions for change, including: the insured's household registration changes, the place of residence changes, the work unit changes, or the "selected hospital" needs to be changed due to the change of the qualification of the designated hospital.

The insured person shall go through the formalities of change with the above-mentioned diagnosis certificate and related materials to any one or two medical insurance agencies of the municipal medical insurance.

3. The change of the selection point takes effect immediately, and the insured person can enjoy the overall treatment of general outpatient service in the newly selected hospital according to regulations.

Why buy medical insurance?

Medical insurance is the most basic insurance given by the state to the people.

Dad felt that this made every insured person feel the beauty of life in China.

Even though my dad said before that medical insurance is insufficient-there is reimbursement online, and there is a reimbursement ratio.

But it is undeniable that medical insurance also has incomparable advantages over commercial medical insurance:

1, guarantee renewal

Most of the commercial medical insurance on the market is 1 year, and a few are 6 or 20 years. The renewal conditions are strict.

However, medical insurance is that everyone can renew their insurance all the time, regardless of occupation or age, and there is basically no requirement for renewal.

2. You can insure against illness.

There are many restrictions on buying commercial medical insurance, as well as health notification.

The health information of commercial medical insurance will ask about habits, hobbies, past medical history and so on.

Many partners with minor problems can't buy suitable commercial medical insurance, or even be refused insurance directly.

However, medical insurance will not. As a' welfare' given by the state to the public, medical insurance not only has no health notice, but can even be insured in spite of illness.

3. Lifetime guarantee

Medical insurance stipulates that after paying a certain number of years, you can enjoy medical insurance benefits for life after retirement.

I have to say that the first-tier cities are good here, and Guangzhou only needs to pay 15 years. Many cities need at least 20 years.

Payment of medical insurance in Guangzhou

Guangzhou medical insurance is also divided into urban employee medical insurance and urban and rural residents medical insurance.

Medical insurance for urban workers: enterprise workers, migrant workers, retired workers and flexible employees participate in this medical insurance.

Medical insurance for urban and rural residents: minors, students at school and urban and rural residents can participate in the insurance.

Flexible employees, if they are registered locally in Guangzhou, can choose one of two kinds of medical insurance.

Both employee medical insurance and resident medical insurance can enjoy benefits such as outpatient service and hospitalization, but there are some differences.

1, different payment standards

Employees' medical insurance is paid once a month and residents' medical insurance is paid once a year;

2. Enjoy different treatment

Employees pay more medical insurance than residents and enjoy better treatment than residents' medical insurance.

For example, the proportion of medical insurance reimbursement for employees is higher, and personal accounts can be used for outpatient treatment and pharmacy purchase.

3. The payment period is different.

Employees can enjoy retirement exemption after paying the prescribed number of years of medical insurance; Residents' medical insurance payment is one year and guaranteed for one year.

Speaking of payment, how much should Guangzhou medical insurance pay?

Take the payment base from July 20 19 to June 30, 2020 as an example.

The payment ratio (unit 5.5%, individual 2%) is the standard. Payments for each income stage are as follows:

Payment in different income stages

If the income is higher than 27,960 yuan, it will be paid according to the highest standard of 27,960 yuan.

In addition, you need a monthly medical subsidy for major diseases.

Based on the average monthly salary of employees in Guangzhou in that year, the current monthly contribution rate per person is 0.26%.

In addition, employee medical insurance also has a personal account, which will be paid every month. The older you get, the higher the proportion.

Personal accounts pay money every month. It can be seen that most migrant workers with incomes of 5,000 to 6,000 yuan almost put 2% of their monthly expenses into their personal accounts.

The money in the personal account can be used to buy medicine and see a doctor, so the medical insurance fee paid is finally used back to yourself.

Where did the rest of the money go?

Social security is taken from the people and used by the people, and the rest of the money will enter the social pooling account and be uniformly distributed by the state.

This money is also for us in the end.

After talking about Guangzhou occupational medical insurance, how much does Guangzhou urban and rural residents pay for medical insurance every year?

Medical insurance for urban and rural residents is paid once a year, and the annual cost is different.

Payment time is generally from September 1 to February 20th 1 every year.

If you don't pay the fee on time, you can't pay the fee that year, so you can only insure it next year.

In 2020, the medical insurance payment standard for urban and rural residents in Guangzhou will be per person 104 1 yuan, of which:

Students bear 3 14 yuan per person, and the government subsidizes 727 yuan per person.

Other insured individuals bear 366 yuan/person, and the government subsidies 675 yuan/person.

Guangzhou medical insurance reimbursement

Guangzhou medical insurance should also choose the corresponding designated hospitals for medical treatment, commonly known as "one small and one large".

Small hospitals are generally primary medical institutions, such as community hospitals and first-class hospitals.

Larger hospitals are generally secondary and tertiary hospitals, such as district and municipal hospitals.

Employees of enterprises participating in employee medical insurance, employees participating in employee medical insurance as flexible employees, students and minors participating in resident medical insurance need to choose "small points" first, and then decide "big points":

Elderly residents, non-employees and other urban and rural residents can only choose 1 "Xiaodian" as the designated medical institution.

1. Proportion of medical insurance reimbursement for employee medical insurance outpatient service in Guangzhou:

The proportion of medical insurance reimbursement for employee medical insurance clinics in Guangzhou; Generally speaking, doctors in small hospitals are fully capable of treating minor ailments and pains. In addition, the reimbursement rate of small hospitals is high, and my father suggested that minor illnesses and pains should be treated in small hospitals as much as possible.

2. Proportion of hospitalization reimbursement of medical insurance for employees in Guangzhou:

Proportion of hospitalization reimbursement for medical insurance for employees in Guangzhou; It can be seen that the proportion of hospitalization reimbursement for retired employees will be higher and the self-funded part will be less.

Therefore, the care of retired employees by Guangzhou Medical Insurance is still in place. There are also more than 590,000 yuan of serious illness medical subsidies. The excess will be reimbursed by Medicaid for major diseases, with a maximum subsidy of 295,000 yuan per year, and the reimbursement ratio is as high as 95%! Therefore, migrant workers in Guangzhou, remember to pay employee medical insurance.

3 Guangzhou residents medical insurance outpatient reimbursement ratio:

Proportion of reimbursement for medical insurance outpatient service of Guangzhou residents; It is worth noting that if you are not a student or a child, you can only go to a designated small hospital for reimbursement, and you can't go to other medical institutions for reimbursement.

4 Guangzhou residents medical insurance hospitalization reimbursement ratio:

Proportion of hospitalization reimbursement for residents' medical insurance in Guangzhou; Obviously, the deductible line for hospitalization reimbursement of residents' medical insurance is much lower than that of employees' medical insurance. But correspondingly, the total annual reimbursement is much lower, and the proportion of reimbursement for non-employees and elderly residents has also declined.

In addition, residents' medical insurance can also enjoy the treatment of serious illness insurance.

Personal out-of-pocket expenses within the scope of the policy, if the annual total exceeds 6.5438+0.8 million yuan, can be reimbursed 60%; Those who exceed the medical insurance cap line for urban and rural residents throughout the year can be reimbursed 90%, and the current maximum payment limit is 450,000 yuan. Social medical assistance recipients are not limited by the maximum payment limit, which is an important guarantee for those low-income families.

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