What should I do if I need medical treatment for an elderly person who is living in a different country from my children?
What if a patient with a chronic illness needs frequent prescriptions? In the country's unified deployment and the efforts of the Guangdong Provincial Health Protection Department, currently all cities in Guangdong Province have opened the direct settlement of outpatient and inpatient medical expenses within the province, the insured person filed in the medical institutions that have opened the direct settlement of outpatient medical expenses, you can realize the direct settlement of it!
Participants in the foreign medical
Process in three steps
Participants in the foreign medical, there are mainly the following steps:One of the Participants to complete the foreign medical record;
Participants to complete the foreign medical records;
The second is selected to have access to the settlement platform of the designated medical institutions (hospitalization does not need to select the point, only need to select the city);
The third is participants in the selected medical institutions for the settlement of the medical treatment.
First Steps
First Steps
The first step in the process of filing for the record
The first step in the process of filing for the record
The second step in the process of filing for the record
Using the "Guangdong Health Insurance" app
Using the "Guangdong Medical Insurance" applet
to quickly apply for the record!
Step 1: Long press scan or click on the image below, you can enter the "粤医保 "小程序.
Step 2: After entering the "Guangdong Medical Insurance" app, follow the prompts to log in successfully, and then find the "Different Place Medical Record" function.
Note: The first time you use the program, you will need to activate your e-voucher in advance.Step 3: For example, if you click on the Different Place Medical Record icon, the program will bring up the Record Information, and you will need to read it carefully. Please read the information carefully, wait for 5 seconds and then check "I have read the information and agree" to enter the filing interface.
Step 4: Fill in the contact number of the person who needs to file as well as choose the type of filing and the filing start date.
Tips: Different types of filing, you need to provide relevant materials and fill in the corresponding filing content according to the requirements of the "filing notice", after submitting, you can complete the online medical record.
Five types of people meet the conditions of the province's foreign medical record:(a) the foreign settlement of retirees: refers to the retirement in the foreign settlements and household registration moved to the settlement of the people. The record is valid for a long time.
(2) Long-term residents of other places: refers to those who intend to reside or have resided in the same area of other places for more than half a year in the near future. The validity period of the record is determined according to the validity period of the certificate of residence or the personal commitment.
(3) Resident staff in a different place: refers to the personnel who are sent by the employer to work in a different place and comply with the relevant regulations of the place of insurance. The validity period of the record is determined according to the certificate of the work unit in the place of insurance, or the certificate of the work unit in a different place, or the work contract, or the personal commitment.
(4) Referrals from other places: refers to those who meet the requirements of referrals to hospitals in the participating places. The validity period of the record is determined by the participating places in the light of local practice.
(E) Temporary foreign medical personnel:
1. Outpatient emergency personnel. Due to emergency treatment and rescue needs, in the insurance place outside the medical institutions to receive emergency outpatient treatment of the person, can be the first visit to the hospital and then make up for the record procedures, the record is valid for 10 days, the starting time for the first outpatient date. The record is valid for 10 days, starting from the date of the first outpatient visit. If you are admitted to the hospital within the validity period of the record, the hospitalization will be valid. 2. Other people. Other people who meet the requirements of the insured place of foreign medical treatment, in accordance with the provisions of the insured place of implementation.The second step: choose a point
If there are relevant regulations in the place of participation, the participant must choose a designated medical institution that meets the required level or number of hospitals in the place of participation as the designated medical institution for direct settlement of medical expenses for general outpatient treatment or outpatient treatment of specific illnesses in the place of participation.The designated medical institutions selected by the insured for medical treatment in a different place must have opened the direct settlement service for medical treatment in a different place, and the insured can use their social security cards and electronic vouchers for medical treatment and need to abide by the procedures and service standards of the designated medical institutions in the place of medical treatment.
How do I find out what the designated medical institutions are?
Participants can check the designated medical institutions for direct settlement of medical expenses for medical treatment in other places through the "Guangdong Medical Insurance" app.The third step: medical settlement
After selecting a hospital, you can go to this hospital with your card. You can hold a social security card, ID card, health insurance electronic voucher (need to be activated in advance in the Guangdong health insurance public number), electronic voucher activation to take the phone to the hospital after medical treatment.The main reimbursement policy can be summarized as follows: Catalog of the place of residence, the policy of the place of participation.
When a participant goes through the direct settlement of medical expenses for medical treatment in a different place, the national medical insurance information platform will divide the cost of each expense detail according to the provisions of the catalog of the place of medical treatment, and then calculate the cost of the individual burden of the participant and the cost of the medical expenses according to the provisions of the policy of the place of participation. The amount of money to be paid by the participant and the various health insurance funds will be calculated in accordance with the provisions of the "policy of the place of insurance". The participant only needs to settle the costs that should be borne by the individual according to the bills provided by the designated medical institutions. The expenses paid by the medical insurance fund will be paid by the medical insurance organization and the designated medical institution in accordance with the regulations.The records of settlement for medical treatment in other places can be queried through the "Guangdong Medical Insurance" app.
Can outpatients with specific outpatient illnesses settle on-site?
What if the settlement fails?
There are two ways to deal with this situation.The first is to apply for a replacement account. The participant is not able to settle the bill directly due to objective reasons such as abnormalities in the health insurance information system, the designated medical institution should guide the participant to go through the procedure of making up for the bill, and should not refuse to provide the participant with the service of making up for the bill.
The second is to handle sporadic reimbursement. Participants who do not go to the designated medical institutions for reimbursement procedures, the medical expenses incurred in accordance with the provisions of the place of participation, you can apply for reimbursement of incidental reimbursement to the local health insurance agency.