1, the insured went to the community hospital (commonly known as a small hospital, corresponding to a small point) for medical treatment, and the reimbursement rate of the insured employees in Guangzhou medical insurance 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 your first visit, the reimbursement rate (55%) will increase 10% compared with the insured's direct visit to big hospitals (45%).
2. Hospitalization is not limited by location. The reimbursement ratio and payment limit of general outpatient service of employee medical insurance, and the reimbursement ratio and payment limit of general outpatient service of employee medical insurance are 80% in primary hospitals. After the success of designated large hospitals, the reimbursement rate after referral to large hospitals is 55%. Without referral from primary hospitals, the reimbursement rate is 45%.
Referral procedures are handled in primary hospitals, and each referral is 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.
Medical insurance reimbursement scope:
Medical expenses, auxiliary examination, electrocardiogram, X-ray fluoroscopy, filming, laboratory tests, physical therapy, acupuncture, CT, nuclear magnetic resonance, etc. Limited 200 yuan.
Surgical expenses (refer to the national standard, if it exceeds 1 1,000 yuan, it will be reimbursed 1 1,000 yuan). The elderly over 60 years old are hospitalized in health centers, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan.
All inpatients who participate in cooperative medical care, whose medical expenses exceed 5,000 yuan at one time or for the whole year, should be compensated by stages, that is, 500 1- 10000 yuan is 65%, and1-18000 yuan is 70%.
The annual compensation limit of town-level cooperative medical system hospitalization, uremia outpatient hemodialysis and tumor outpatient radiotherapy and chemotherapy is 1. 1 ten thousand yuan.