First, the difference between fixed and non-fixed social security in Guangzhou
Guangzhou social security designated medical institutions refer to medical institutions that have signed service agreements with social security departments. Insured people can usually enjoy a higher reimbursement rate and more convenient services when they seek medical treatment in these institutions. Non-designated medical institutions refer to medical institutions that have not signed a service agreement with the social security department. When the insured person goes to these institutions for medical treatment, the reimbursement ratio and limit may be reduced.
Second, the social security reimbursement in Guangzhou.
Emergency and rescue: Guangzhou Social Security usually allows the insured to enjoy a certain degree of reimbursement for medical treatment in non-designated medical institutions for emergency or rescue. This is because emergency treatment and rescue are urgent medical needs, and insured people often cannot choose designated medical institutions in advance.
Special diseases and medical items: For some special diseases or medical items, Guangzhou Social Security may also allow reimbursement in non-designated medical institutions. These special diseases and medical items are usually determined according to the national and local social security policies.
Personal account payment: In Guangzhou, the social security personal account funds of the insured can be used to pay the medical expenses of non-designated medical institutions. This means that even if the expenses of non-designated medical institutions cannot be fully reimbursed, the insured person can use the funds in his personal account to pay.
It should be noted that the reimbursement ratio and limit of Guangzhou Social Security to non-designated medical institutions may be different, and the specific reimbursement ratio and limit need to refer to the provisions of local social security policies. In addition, the insured should try to keep relevant invoices and medical records when seeking medical treatment, so as to apply for reimbursement in the future.
To sum up:
Whether Guangzhou social security can be reimbursed mainly depends on individual participation and specific types of medical expenses. Under normal circumstances, the insured can enjoy a certain degree of reimbursement in non-designated medical institutions, but the specific reimbursement ratio and limit need to refer to the provisions of local social security policies. Insured personnel should understand and abide by relevant policies and regulations in order to better enjoy social security benefits.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28 provides that:
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Measures of Guangzhou Municipality on Social Medical Insurance
Article 14 stipulates:
The insured shall seek medical treatment in the designated medical institutions. Except for first aid and rescue, the basic medical insurance fund will not pay the expenses incurred in non-selected designated medical institutions.