Medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate for the economic losses caused by the risk of illness to workers. Through the payment of premiums by employers and individuals, a medical insurance fund is established, and when insured individuals fall ill and incur medical expenses, the medical insurance institution provides them with certain economic compensation.
医疗保险一般指基本医疗保险,是为了补偿劳动者因疾病风险造成的经济损失而建立的一项社会保险制度。通过用人单位与个人缴费,建立医疗保险基金,参保人员患病就诊发生医疗费用后,由医疗保险机构对其给予一定的经济补偿。
In order to attract more foreign talents to develop in Guangzhou, Guangzhou has fully deepened and implemented nine medical insurance measures that are convenient and beneficial to the public, allowing insured people in Guangzhou (including foreign nationals in Guangzhou) to fully enjoy these favorable measures.
为了吸引更多外籍人才留穗发展,广州全面深化落实九项的医保便民惠民措施,让广州市参保人(包含身处广州的外籍人士),全面享受这些利好措施。
01 Eligible Foreign Nationals for Medical Insurance
01可参加医保的外籍人士
● Foreign nationals legally working in China who hold a foreigner's work permit and a work residence permit.
● 持有外国人工作许可证和工作居留许可,在中国合法工作中的外籍人士。
● Foreign nationals legally working in China who hold a Chinese permanent residence ID card.
● 持有中国永久居留身份证,在中国合法工作中的外籍人士。
● Foreign nationals without employment who hold a Chinese permanent residence ID card.
● 持有中国永久居留身份证,无工作的外籍人士。
02 Guangzhou Medical Insurance Promotes One-Stop Service of Internet Medical Insurance + Pharmacy
02广州医保推动互联网医保+药店一站式服务
● Increase in Traditional Chinese Medicine (TCM) Designated Points
● 增加中医选点
Insured individuals can handle the designated point procedures through the "Guangzhou Medical Insurance" WeChat public account or on-site at TCM medical institutions. After designation, insured individuals can enjoy medical insurance reimbursement when seeking treatment at the designated TCM medical institution.
参保人可通过“广州医保”微信公众号或在中医医疗机构现场办理选点手续,选点后参保人在该中医医疗机构就医可享受医保报销。
● Expansion of the Scope of Internet Medical Insurance Services
● 扩大医保互联网诊疗服务范围
Insured individuals can have follow-up consultations for common diseases, chronic diseases, and specific outpatient diseases (excluding emergency hospital observation and home care beds) at designated internet medical institutions as per regulations. Currently, 43 designated medical institutions in the city have signed agreements with internet medical insurance designated institutions.
参保人可按规定在选定的互联网定点医疗机构进行常见病、慢性病、门诊特定病种(急诊留院观察和家庭病床除外)的复诊。目前全市已有43家定点医疗机构签订了互联网医保定点医疗机构协议。
● Internet Medical Insurance + Pharmacy One-Stop Service
● 互联网医保+药店一站式服务
Designated retail pharmacies are organized to provide consultation services for insured individuals, assisting insured patients to choose medical insurance internet hospitals for medical treatment and settlement through the internet as per regulations. Currently, there are 265 designated retail pharmacies offering this service across 11 districts in the city.
组织定点零售药店为参保人提供导诊咨询服务,协助参保患者通过互联网途径,按规定选择医保互联网医院进行就医结算。目前全市共有265家定点零售药店开展此项服务,遍布11个区。
● Implementation of the "Dual-Channel" Mechanism for Medications
● 实施药品“双通道”机制
Guangzhou City has now included 291 types of drugs under the "dual-channel" mechanism, allowing insured individuals to truly enjoy the medical insurance pooling reimbursement benefits of nationally negotiated drugs.
广州市目前已将291种药品纳入“双通道”范围,让参保人切实享受国家谈判药的医保统筹报销待遇。
When insured individuals seek medical treatment at a designated "dual-channel" medical institution in the city, if the institution does not have the "dual-channel" drugs required for treatment, they can use the "dual-channel" prescription issued by the medical insurance physician to purchase the drugs at a designated "dual-channel" retail pharmacy within 72 hours from the time the prescription is issued, and enjoy the medical insurance reimbursement benefits.
参保人在本市的“双通道”定点医疗机构就医时,如果该定点医疗机构暂未配备治疗所需的“双通道”药品,参保人可以凭借医保医师开具的“双通道”药品外配处方,在处方开具时间起72小时内到本市的“双通道”定点零售药店购药,并享受医保报销待遇。
As of the end of January, there are 16 "dual-channel" hospitals and 30 "dual-channel" pharmacies in the city providing this service to insured individuals.
截至1月底,全市共有16家“双通道”医院、30家“双通道”药店为参保人提供该服务。
● Promoting Mobile Payments to Solve the "Payment Difficulties" in Medical Treatment
● 推广移动支付,破解就医“缴费难”问题
Continuously advancing the work of medical insurance mobile payments to address the long queue times and payment difficulties faced by insured individuals at various medical institutions. Currently, 231 designated medical institutions in the city can provide medical insurance internet mobile payment services.
持续推进医保移动支付工作,解决参保人在各医疗机构排队时间长、缴费难的问题。目前,全市共有231家定点医疗机构可提供医保互联网移动支付服务。
When insured individuals visit a designated medical institution that offers medical insurance mobile payment services, they can handle outpatient registration through the hospital's WeChat public account or mini-program; after the doctor issues a prescription, they can then proceed to handle medical insurance settlement through the hospital's WeChat public account or mini-program, eliminating the hassle of waiting in line at the payment counter.
参保人到开展医保移动支付业务的定点医疗机构就医时,可通过医院微信公众号/小程序办理门诊挂号;在医生开具处方后,再进入医院微信公众号/小程序办理医保结算,免除了到收费处排队等候的烦恼。
● Promote "seamless payment" for medical credit to enhance the medical experience for insured individuals
● 推动就医信用“无感支付”,提升参保人就医体验
In collaboration with relevant departments, we have launched a medical credit seamless payment service that supports "see the doctor first, pay later," eliminating all queue payment processes at the window during the visit.
联合相关部门推出就医信用无感支付服务,支持“先看病,后付费”,免除就诊期间所有在窗口的排队缴费环节。
Guangzhou medical insurance policyholders can activate the medical credit seamless payment service through the "UnionPay QuickPass" App. They can confirm the activation of this service with designated medical institutions at the time of registration or before the visit. Costs that should be reimbursed by the medical insurance fund will be settled in real-time, and costs that should be borne by the individual will be deducted in real-time from the medical insurance personal account or the credit medical account, similar to the experience of using a credit card for consumption. The use scenario covers general outpatient visits, specific outpatient diseases, and hospitalizations. Policyholders can repay the bill before the repayment date. This service has been launched in some designated medical institutions.
广州医保参保人可通过“银联云闪付”App开通就医信用无感支付服务,在挂号时或就诊前与定点医疗机构确认启用该服务,就诊发生应由医保基金报销的费用将实时医保记账结算,应由个人负担的费用将在医保个人账户或信用就医账户中实时扣减,类似刷信用卡消费的体验,使用场景覆盖普通门诊、门诊特定病种及住院。参保人在账单还款日前还款即可。该项服务已在部分定点医疗机构上线。
● Further expand the scope of outpatient payments
● 进一步扩大门诊支付范围
The reimbursement catalog for general outpatient visits has been expanded to be consistent with inpatient care, and all drugs, diagnostic and treatment services, and medical consumables that meet national and provincial regulations can be included in the scope of general outpatient reimbursement. For example, most diagnostic service items that were not reimbursable in the original outpatient visits, such as color ultrasound, hand trauma debridement, extracorporeal shock wave lithotripsy, CT, MRI, etc., can be reimbursed according to regulations.
普通门诊报销目录扩大到与住院一致,符合国家、省规定的药品、诊疗服务及医用耗材均可纳入普通门诊报销范围。例如,彩超、手外伤清创术、体外冲击波碎石、CT、核磁共振等大部分原有门诊不能报销的诊疗服务项目,均可按规定实现普通门诊报销。
● Continue to increase the number of designated institutions
● 持续增加定点机构数
Currently, there are 2,661 designated medical institutions and 6,025 designated pharmacies in the city, and the number will continue to increase to fully meet the needs of policyholders for nearby medical treatment and medication.
目前,全市有定点医疗机构2,661家、定点药店6,025家,并将持续增加,以充分满足参保人就近就医购药的需求。
● Strengthen the supervision of medical institutions through undercover visits
● 加强对医疗机构暗访督导工作
To fully protect the outpatient benefits of insured patients and to prevent the rights and interests of insured personnel from being damaged due to the inadequate implementation of new medical insurance policies by designated medical institutions, the Guangzhou medical insurance department has organized a working group to conduct undercover supervision of designated medical institutions.
为全面保障参保患者门诊待遇,杜绝定点医疗机构落实医保新政不到位导致参保人员权益受损,广州医保部门已组织工作组对定点医疗机构开展暗访督导。
It is recommended that policyholders strengthen communication with doctors when seeking medical treatment and try to use drugs, diagnostic and treatment items, medical consumables, and centrally bulk-purchased selected drugs within the medical insurance catalog.
建议参保人就医时,与医生加强沟通,尽量使用医保目录内药品、诊疗项目、医用耗材及集中带量采购中选药品。03 Foreign employees must meet the conditions for work visa processing
03外籍员工需符合办理工签条件
Basic requirements for foreign employees to apply for a work visa:
外籍员工办理工签基本条件:
1. Bachelor's degree with at least two years of experience (certification required from relevant departments)
1.本科毕业满两年(需要到相关部门认证)
2. Able to provide a non-criminal record certification
2.可以提供无犯罪认证
3. Chinese household registration has been canceled (for Chinese expatriates)
3.中国户口已注销(外籍华人)
4. Possess relevant work experience
4.拥有相关的工作经验
Materials required by the hiring unit:
聘请单位所需的材料
1. Materials required by the hiring unit
1.聘请单位所需的材料
2. Business license of the enterprise
2.企业营业执照
3. Legal representative's identity proof
3.法人身份证明
4. Identity proof of the designated handler
4.专办员身份证明
5. Company's fixed telephone number, etc.
5.公司固定电话号码等
List of documents required from the foreign employee:
外籍员工个人需提供资料清单:
1. Personal passport of the foreign employee
1.外籍员工的个人护照
2. Academic degree certificate
2.学历证书
3. Work experience proof
3.工作经验证明
4. Non-criminal record proof
4.无犯罪证明
5. Medical examination report, etc.
5.体检报告等