Can Guangzhou Medical Insurance Set Up Two 3A Hospitals?

Guangzhou's medical insurance policy allows the insured to choose designated medical institutions within a certain range, including 3A hospitals.

First, Guangzhou medical insurance designated medical institutions policy

Guangzhou's medical insurance policy stipulates which medical institutions the insured can enjoy medical insurance benefits. Under normal circumstances, the insured can choose designated medical institutions within the scope permitted by the medical insurance policy according to their own needs and actual conditions. These designated medical institutions include hospitals of different levels, among which the top three hospitals, as medical institutions with high medical service level, are usually within the scope of choice.

Second, matters needing attention in choosing designated medical institutions

When choosing designated medical institutions, the insured should pay attention to the following points:

1. Understand the medical insurance policy: Insured personnel need to know the specific provisions of Guangzhou medical insurance policy on designated medical institutions, including the scope of selection and reimbursement ratio.

2. Choice according to personal circumstances: Insured persons can reasonably choose designated medical institutions according to their own health status, medical needs and place of residence.

3. Confirm the qualification of medical institutions: When choosing a designated medical institution, the insured should confirm whether the medical institution has the designated qualification of medical insurance to ensure that it can enjoy medical insurance benefits.

Third, can Guangzhou medical insurance deny two top three hospitals?

Whether Guangzhou Medical Insurance can deny the two 3A hospitals actually needs to be judged according to the personal situation of the insured and the specific provisions of the medical insurance policy. Generally speaking, if the medical insurance policy allows the insured to choose multiple designated medical institutions, and the insured has actual needs, then two 3A hospitals can be selected as designated medical institutions. However, it is necessary for the insured to communicate with the medical insurance agency to confirm whether it can be realized.

To sum up:

Whether Guangzhou medical insurance can deny two top-three hospitals depends on specific medical insurance policies and personal circumstances. Insured personnel need to understand the provisions of the medical insurance policy on designated medical institutions, reasonably choose designated medical institutions according to their personal circumstances, and confirm the medical institutions' medical insurance designated qualifications when choosing. If necessary and in line with the policy, the insured can choose a number of 3A hospitals as designated medical institutions.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 23 provides that:

Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

Measures of Guangzhou Municipality on Social Medical Insurance

Article 12 stipulates:

The insured chooses 1 primary medical institutions (referred to as "small points") as the designated medical institutions for general outpatient treatment (referred to as "designated primary medical institutions") within the scope of the designated medical institutions for social insurance in this Municipality. After the primary medical institutions are selected, 1 other medical institutions (referred to as "Big Point") can be selected as the selected medical institutions for general outpatient treatment within the scope of the designated medical institutions for social insurance in this Municipality.