At the moment, there are 17 types of designated chronic disease in Guangzhou:Diabetes, hypertension, coronary heart disease, Parkinson's disease, rheumatoid arthritis, systemic lupus erythematosus, schizophrenia, chronic heart failure (cardiac function above grade III), Anticoagulation therapy after heart valve replacement operation, epilepsy, chronic active hepatitis (hepatitis B), liver cirrhosis (decompensation), chronic glomerulonephritis, chronic renal insufficiency (non-dialysis) Chronic obstructive pulmonary disease, Alzheimer's disease, affective disorder (manic episodes, depressive episodes and bipolar disorder).If the insured was diagnosed by the qualified designated health care organization with the designated chronic disease, the medical expenses can be reimbursed. If the medical expenses are within the specialist out-patient drug directory for designated chronic disease, according to medical insurance pooling fund, the reimbursement proportion of the expenses at local community health service Institution is 85% (excluding secondary and tertiary hospitals), the expenses at the other health care organization is 65%. The maximum payment for each designated chronic disease is RMB 100 per month, valid in current month with no accumulation. The insured can choose 3 of the entities at the maximum for health insurance benefits.
2014-06-05Part I::Receive treatment at a designated hospital1. Designated hospitals are the hospitals which are designated by social security, or school clinic, except the foreign guests ward, priority ward and special treatment ward.2. The insurance company refuses to compensate if receiving treatments at a non designated hospital in a non emergency situation.3. For accessing health service in other regions, the insured should go to a secondary or above public hospital.Part II:Range of compensation for supplementary medical insurance:1. Outpatient for accidental injuries;2. Hospitalization for accidental injuries;3. Hospitalization for illness (only for the disease occurred after admission to school).Part III: Operation standard for supplementary medical insurance:1. Guangzhou Basic Medical Insurance Drug Directory2. Guangzhou Basic Medical Insurance Treatment Items Range3. Guangzhou Basic Medical Insurance Service Facility Range and Payment Standard for Urban EmployeesClaims has to be within the reimbursement range according to the abovePart IV:Compensation regulations for outpatient for accident1. The medical expenses should be reimbursed at school first; the insurance will compensate the insured students of basic social medical insurance with the remaining balance.2. For the uninsured students of basic social medical insurance, insurance company will compensate them under the standard of medical insurance, which is the total expenses deduct the payment from basic social medical insurance that is calculated based on compensation standard. The remaining balance will be paid by insurance company.3. Medical expenses (including the domestic vaccine cost) is caused by accidental injuries by cats, dogs, rats and etc. that are fitted into the payment range.Part V:Compensation regulations for hospitalizationThe insured students of Guangzhou resident medical insurance is required to pay the expenses with social security card or medical insurance card, otherwise insurance company refuses to compensate. For the uninsured students of basic social medical insurance, insurance company will compensate them under the standard of medical insurance, which is the total expenses deduct the medical cost of social pool that is calculated based on compensation standard. Insurance company will pay the remaining balance.Part VI:Note for settlements1. The following documents are needed for settlements on outpatient for accidental injuries:1.1. Student identity card, copy of bank card (both sides are needed)1.2. Invoice and invoice list1.3. Copy of outpatient medical record (including the cover)1.4. Medical record of medical insurance (apply at school clinic)2. The following documents are needed for settlements on hospitalization for accidental injuries:2.1. Student identity card, copy of bank card (both sides are needed)2.2. Original invoice of hospitalization and original statement of hospitalization fee by medical insurance.2.3. List of particular items for hospitalization fee2.4. Copy of outpatient medical record (include the cover, admission record and summary of discharge)2.5. Discharged aegar (with hospital chop)3. The following documents are needed for settlements on hospitalization for illness:3.1. Student identity card, copy of bank card (both sides are needed)3.2. Original invoice of hospitalization and original statement of hospitalization fee by medical insurance.3.3. List of particular items for hospitalization fee3.4. Copy of outpatient medical record (include the cover, admission record and summary of discharge)3.5. Discharged aegar (with hospital chop)Part VII:Special Instructions1. Insurance company collects information for claims every week (that means your information for claims may takes maximum 5-7 business days at school for summarizing)2. For the claims with complete documents and within the coverage, CLIC will send the compensation to the banks within 10 business days, the amount will be transfer to corresponding student accounts by the banks (it may takes 2-10 business days for the banks to transfer). Notice will be sent out to students for the claims that are rejected if they are not in coverage. If information for claims is missing, students will be noted to reclaim after they have the complete documents.3. China Life Insurance Company Ltd. service personnel/ telephone/mobile phoneGao Jie/020-86380493/13826486662 Fax:020-86375909
2014-06-05地址:广州市黄埔大道西601号 |邮编:510632|联系电话:85220116
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