Guangzhou: New crown hospitalization continues full coverage and outpatient implementation of special coverage!

Read Time:4 Minute, 27 Second

On January 8, in order to do a good job of medical coverage for the treatment costs of patients insured after the implementation of the “Class B B” management of new coronavirus infection, according to the requirements of the relevant national and provincial documents, the city issued the “Guangzhou Municipal Medical Security Bureau Guangzhou Municipal Finance Bureau Guangzhou Municipal Health and Health Commission forwarded on the implementation of the “Class B B” management After the implementation of the new coronavirus infection patients treatment cost optimization of medical security related policy notice” (Sui medical insurance hair [2023] No. 1), since the implementation of the new coronavirus infection “Class B B management” date, optimize the adjustment of medical security related policy.

A. Continuation of full coverage for hospitalization expenses

The medical expenses (including the treatment of underlying diseases, comorbidities and complications) incurred by patients with the new coronavirus infection during emergency observation and hospitalization in all hospitals in the city will continue to be covered by the previous special medical insurance policy, with the initial payment line abolished, the reimbursement ratio based on the first-class hospital, and the annual maximum payment limit not included, and the portion of the individual’s burden will be subsidized by the government after the basic medical insurance, major medical insurance and medical assistance are paid in accordance with the regulations. After the basic medical insurance, major medical insurance, medical aid and other payments are made according to the regulations, the individual burden is subsidized by the financial institutions, and the full amount is guaranteed. The policy is calculated by the time of admission of the insured patients, first implemented until March 31, 2023.

Second, outpatient expenses to implement special protection

The medical expenses incurred by patients with new coronavirus infection and suspected symptoms in outpatient and emergency medical institutions (Level 2 and below) of the city’s primary medical insurance, which are in line with the medical insurance medical treatment items, medical insurance medical consumables catalog and the “Guangdong Province basic medical insurance outpatient drug catalog for the treatment of new coronavirus infection”, are specially covered, with no starting line and no ceiling line. The 85% ratio is paid by employees’ medical insurance and urban and rural residents’ medical insurance funds. The outpatient special protection policy will be implemented until March 31, 2023.

The outpatient and emergency expenses for the treatment of neocoronavirus infection incurred by the participants in the designated medical institutions of the tertiary medical insurance will be covered in accordance with the current general outpatient coordination policy of the city.

III. Temporary expansion of the medical insurance drug catalog

New coronavirus infection treatment program in the new coronavirus treatment drugs to continue the medical insurance temporary payment policy, first implemented until March 31, 2023.

In addition, according to the national regulations, the Guangdong Provincial Medical Security Bureau formulated and issued the “Guangdong Province basic medical insurance outpatient drug catalog for the treatment of new coronavirus infection”, including 215 kinds of Western drugs, 460 kinds of proprietary Chinese medicines and 75 kinds of hospital preparations, in the second level and the following designated medical institutions for outpatient use, the drugs in the catalog with reference to the management of Class A drugs, the first implementation until March 31, 2023.

IV. Temporary expansion of the scope of medical insurance designated points

According to the need, non-medical insurance designated medical institutions that have the ability to treat new coronavirus infection will be temporarily included in the scope of medical insurance designated hospitals, and sign a “temporary special agreement on medical insurance fee settlement for medical institutions treating patients with new coronavirus infection” to guide all types of medical institutions to do a good job of diagnosis, settlement and other information collection and uploading, medical insurance fee settlement and other work related to new coronavirus infection.

V. Smooth medical insurance Internet consultation services

During the epidemic period, patients with new coronavirus infections will be paid by the medical insurance fund for the consultation and drug expenses incurred in the first consultation and prescription at the designated medical institutions (including Internet hospitals and medical institutions providing Internet medical services) for “Internet+” medical services, and the reimbursement standard will be the same online and offline.

New coronavirus infection-related symptoms of follow-up services, still in accordance with the current Internet reimbursement policy.

Sixth, optimize the operation of convenient services

In response to the development of the epidemic and the new situation of the public’s medical insurance needs, continue to provide convenient medical insurance services, implement the policy of long prescription medical insurance payment, expand and optimize the “no need to do”, “online do”, “do it now” and “do it near”. The company will continue to provide convenient medical insurance services, implement the policy of long prescription medical insurance payment, expand and optimize the service modes of “no need to do”, “online”, “do it now” and “do it near”, build the joint business mode of “medical insurance + bank, medical insurance + postal service, medical insurance + taxation”, promote the realization of zero-run medical insurance business, and make every effort to ensure that the insured units, insured persons and The company is also committed to providing efficient and convenient medical insurance services to all kinds of service recipients, including insured persons and designated medical institutions, without having to leave home.