Information on medical treatment in other places (applicable to urban workers' basic medical insurance participants) I. Who can apply for long-term medical treatment in other places? The following participants who participate in the city's urban workers' basic medical insurance in the form of an employing organization can apply for long-term medical treatment in a different place: 1. Retirees of the organization who reside in the same place within the country for more than half a year; 2. Employees of the employing organization who work in a different place within the country for more than half a year. How to apply for long-term medical treatment in a different place? (A) the insured unit by the person holding the unit certificate, or the applicant with the health insurance card to the municipal health insurance secondary agency to apply for "Guangzhou social medical insurance record book" (referred to as "medical record book", (the first time to apply for the record book for free, due to loss, damage to the need to make up for and replacement of the "medical record book" shall be in accordance with the pricing department to approve the purchase of the fee standard). (b) the insured unit or the insured person in the same place of residence in accordance with the provisions of the basic medical insurance to choose 1 ~ 3 designated medical institutions (local basic medical insurance is not implemented, you need to choose the township level or above the public health care institutions), and by the selected medical institutions (need to indicate the level of the medical institutions) and the local social (medical) insurance agencies in the "medical records of different places" review and stamp, with the following information to the city of the second level of health insurance Confirmation procedures. The information required to carry the procedures for medical treatment in a different place No. personnel category to carry the information location to carry special information (corresponding to the category) basic information and related procedures 1. unit employees ① "work unit proof of medical treatment in a different place" ② business license of the branch in a different place (copy) or issued by the government agencies in foreign institutions related to the materials ③ insured unit and the participant's labor contract (validity period of half a year or more) ① recent small One-inch crownless color photo ② "Guangzhou Social Medical Insurance Record Book of medical treatment in other places," the Guangzhou Health Insurance secondary agency 2. retirees ① "medical treatment in other places proof of residence form" or the local police station (streets, neighborhood committees, village committees) issued more than half a year's proof of temporary residence or a copy of temporary residence permit or apply for medical treatment in other places with the same place of residence ② copy of the unit to prove that the city's labor dispatch agencies ① labor Dispatching agency and the dispatched agency of the relevant labor dispatch agreement (copy) ② dispatched agency operating in Guangzhou business license (copy) ③ declaration of cross-location medical treatment of the participant's branch of the relevant cross-location business license (copy) ④ labor dispatch agency and the participant of the labor contract (valid for more than two years) ⑤ dispatched agency issued by the fact that the labor relationship with the participant certificate ⑥ "work units Work unit medical certificate form" ⑦ business license of the employment intermediary (copy) and other relevant certificates 4 City employment intermediary ① "work unit medical certificate form" ② foreign branch business license (copy) ③ insured unit and the participant's labor contract (valid for more than half a year) ④ employment intermediary's business license (copy) and other relevant certificates Note: the unit applying for medical treatment in a different location need to provide the "medical electronic bulk importation Note: Units applying for cross-location medical treatment need to provide the report file of "Batch Import Form of Electronic Version for Medical Treatment in a Different Place", which can be downloaded from the Guangzhou Health Insurance Website or obtained from the service window of the second-tier municipal health insurance organization. How to add the selected designated medical institutions which are less than 3 when applying for medical treatment in a different place for the first time? If the selected designated medical institutions are less than 3 when applying for medical treatment in a different place for the first time, and you need to add 1 or 2 designated medical institutions, you have to follow the regulations and requirements of the procedure for applying for medical treatment in a different place for the first time (see Question 2 for details) and attach the original "Record Book of Medical Treatment in a Different Place" of the original application procedure. Under what circumstances can the selected medical institution for medical treatment in a different place be changed? How to change the procedures? (A) If you have selected a designated medical institution in a different place, you cannot change the selected medical institution within half a year under normal circumstances. In one of the following cases, the relevant change procedures can be changed: 1. After half a year of applying for and approving the procedures for medical treatment in a different place due to medical condition, the regulations and requirements of the initial application for medical treatment in a different place can be applied for (see question 2 for details); if it is less than half a year, if there is a need to change the hospital due to the medical condition, the change procedures must be accompanied by the relevant case data issued by the replacement medical institution and the original application procedures for the original change procedures for the original "Record of medical treatment in a different place"; 2. Relocation of the new After half a year of applying for and approving the procedures for medical treatment in a different place, the applicant can apply for the procedures for medical treatment in a different place for the first time in accordance with the regulations and requirements of the procedures for medical treatment in a different place (for details, please see Question 2), and attach the "Certificate of Residence for Medical Treatment in a Different Place" of the new place of residence, or a copy of the proof of temporary residence for more than half a year or a copy of the certificate of temporary residence issued by the local police station (street, neighborhood, village), and the original application for procedures for the original "Record Book for Medical Treatment in a Different Place" to the municipal health insurance agency to change the procedures. (2) Change of the name or level of the medical institution with the original and a copy of the valid certificate of change issued by the original selected medical institution, and the original of the "Record Book of Medical Treatment in a Different Place" of the original application procedure to the secondary municipal health insurance agency to change the procedure. (c) Change of personal information or the name of the insured unit in accordance with the regulations and requirements for the initial application for medical treatment in a different place (see Question 2 for details), and change of procedures at the secondary municipal health insurance agency with the certificate of change issued by the social security agency to which the insured belongs, as well as the original copy of the "Record Book of Medical Treatment in a Different Place" of the original application. V. How to enjoy the medical insurance treatment after long-term medical treatment in a different place? After confirming the procedures of medical treatment in a different place, the following medical expenses incurred in the selected medical institution in a different place confirmed by the secondary medical insurance agency shall be paid by the individual and then apply for sporadic reimbursement from the secondary medical insurance agency: (1) inpatient hospitalization and emergency hospitalization medical expenses; (2) specific outpatient projects (radiotherapy and chemotherapy of malignant tumors, anti-rejection treatment after liver and kidney transplantation, etc.) which are approved by the secondary medical insurance agency of the city and are carried out within the validity period of the approval. (radiotherapy and chemotherapy for malignant tumors, anti-rejection treatment after liver and kidney transplantation, blood and peritoneal dialysis for uremia) and medical expenses incurred in the treatment of designated outpatient chronic diseases. Can the insured person who has applied for the procedure of medical treatment in other places enjoy the medical insurance treatment when he/she goes back to the designated medical institutions in the Guangzhou Municipal Medical Insurance Coordination Zone? Yes. After the individual cash advance, within 1 month from the date of discharge (or settlement of medical fees), the participant shall apply for reimbursement of the relevant medical fees paid by the integrated fund to the secondary medical insurance organization of the city in accordance with the relevant regulations on the management of the review and reimbursement of basic medical insurance of Guangzhou City. What are the conditions and procedures for canceling the application for medical treatment in a different place? Participants who have applied for medical treatment in a different place can cancel their medical treatment in a different place if they return to the Guangzhou Municipal Health Insurance Coordination Zone for long-term residence, work and medical treatment. They cannot apply for medical treatment in a different place again within half a year after the cancellation. Participants with their own application, with the original application procedures of the original "medical record book" to the city of medical insurance secondary agencies to cancel the medical procedures; after the participants should be paid by the integrated fund of the basic medical expenses incurred by the designated medical institutions can be directly accounted for. VIII. How to deal with the original application for medical treatment in a different place after suspending or terminating the insurance and changing the insurance unit? For participants who have been approved for medical treatment in a different place, the original approval for medical treatment in a different place will be invalidated if the participant suspends his/her participation in the insurance program (active), terminates his/her participation in the insurance program (active/retired), or changes his/her participation unit (active); and if the participant changes his/her participation unit (retired), and does not change the approval procedures for medical treatment in a different place in a timely manner, the original approval for medical treatment in a different place will be invalidated. In the above cases, the medical insurance fund will no longer pay for the medical expenses incurred thereafter. Note: The report files of "Workplace Medical Treatment in a Different Place Certification Form", "Medical Treatment in a Different Place Certification Form for Place of Residence" and "Medical Treatment in a Different Place Electronic Batch Import Form" can be downloaded from the Guangzhou Municipal Health Insurance Website or obtained from the service window of the municipal health insurance secondary agency. (Website: ). There is no need to go to the Municipal Medical Insurance Center on Meidong Road for medical services, as long as you go to the nearest secondary agency in each district.
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