Guangzhou medical insurance in 2023

It is understood that the reimbursement rate of general outpatient medical insurance for employees in Guangzhou is 80%. After the success of the designated big hospital, the reimbursement rate after referral to the big hospital is 55%, and the payment limit of the overall fund is 300 yuan/month. For details, please refer to the following contents: The latest medical insurance policy for employees in Guangzhou: 1. After April of 1 year, employees only designated 3A hospitals but not designated community hospitals, and did not enjoy the treatment of overall medical insurance. Clarify the medical insurance in this city: 2. Employees who have chosen "big point" but not "small point" a few days ago on 20 18 can still settle accounts at "big point" after April 20 1 8, but they will not be referred according to the proportion of outpatient payment (45%) and will be selected. Third, the insured went to community hospitals (commonly known as "small hospitals", corresponding to "small points") for medical treatment, and the proportion of outpatient reimbursement for employees with medical insurance in Guangzhou increased to 80% simultaneously; If you go to other selected medical institutions (commonly known as "big hospitals", corresponding to "big hospitals") within 30 days after the first referral, the reimbursement rate (55%) will increase by 10% compared with that of the insured who goes to the big hospitals directly (45%). Fourth, hospitalization is not limited by the location. The reimbursement rate and payment limit of medical insurance for employees in general outpatient clinics are 1, and that of basic hospitals is 80%. 2. After the success of designated large hospitals, the reimbursement rate after referral to primary hospitals is 55%. 3. Without referral from primary hospitals, the reimbursement rate is 45%. 4. Referral procedures shall be handled in primary hospitals, and each referral shall be valid within 30 days. After the expiration of the referral period, it can be handled again. There is no need for a paper referral form, and the Guangzhou medical insurance system will automatically record it. 5. Overall fund payment limit: 300 yuan/month, neither cumulative nor cumulative.

Legal objectivity:

Introduction: It is very simple to apply for a designated hospital for medical insurance: bring two ID cards, medical insurance cards and color photos and go to the hospital of your choice to handle the affiliated business. Call two hospitals at a time: 1. Hospitals above Grade II (50% reimbursement) 2. Grassroots community hospitals (65% reimbursement); How to handle the designated hospital of Guangzhou medical insurance? Can I change it after I handle it? In one case, in the new social security year, if the general outpatient (emergency) consultation is not carried out in the original selected hospital, the insured person can bring the medical insurance card to the designated handling department of the proposed selected hospital and fill in the registration form to handle the change procedures. The insured person can also carry the medical insurance card directly to any of the eight branches directly under the Municipal Medical Insurance Bureau 1 branch. There is another situation. In the new social security year, you have done general outpatient (emergency) treatment in the hospital you originally chose, but you want to change to another hospital. In this case, if you need to change to another hospital, you must meet the following conditions before you can change: the insured person's household registration changes, the residence changes, the work unit flows, or the "selected hospital" needs to be changed because of the changes in the qualifications of designated medical institutions. The insured must hold the medical insurance card, "Registration Card" and the relevant information of the above changes to the Municipal Medical Insurance Bureau as a branch to handle the change procedures. 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 medical institution according to the regulations. Extension of relevant medical insurance knowledge: designated medical insurance hospitals refer to the list of hospitals with social security medical qualifications in the area under the jurisdiction of social security departments. The insured person chooses the hospital for medical treatment according to the published list, and then issues the medical insurance card to the medical insurance insured person after passing the examination by the social security department. With the medical insurance card, he can go to a designated hospital for medical treatment, and he can reimburse medical expenses according to relevant regulations, otherwise he will not be able to reimburse medical expenses. Hospitals are divided into Class A hospitals and Class B hospitals. Class A hospitals are divided into first, second and third levels. In general, each designated medical insurance hospital can choose 4 hospitals, including 1 compulsory community hospital.