Foreign Freshman Medical - PowerPoint Presentation

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Foreign Freshman Medical Insurance Lecture

24/9/2019

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Medical Insurance Handbook for Jinan University International Student1. Designated hospital for medical treatmentFor emergency, insured may go to any hospitals for medical treatment. For non emergency, insured should go to school clinic in all campus and Guangzhou medical insurance designated hospitals. 2. Medical insurance coverage: Guangdong Social Basic Medical Insurance coverage.3. Insurance Period: 1 / 9 / 2019 - 31 / 8 / 20204.

Policy of medical claimsDuring the valid period of insurance, insurance company is responsible for the following liabilities, and the annual claim limit of RMB 400 thousand Yuan.(1). Liability of Personal Accidental Injury Outpatient

(Emergency) Medical Insurance (annual insurance claim limit of RMB 10 thousand Yuan):

Insured

suffers from accident injury, and received outpatient treatment since the date of the accident within one hundred and eighty days, the insurance company pays 100% of the expenses, in accordance with the items and expenses within Guangdong Social Basic Medical Insurance

coverage.

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For the medical expenses caused by accidental scratched or bitten by cat, dog, mice and other animals, the cost of vaccine is included in medical payment coverage.(2) Liability of Disease Outpatient (Emergency) Medical Insurance (monthly insurance claim limit of RMB 450 Yuan):(2.1) School clinic: Drugs included in medical insurance coverage (Chinese herbal medicine shall be all self paid) will be paid 80% of the expenses. Examination, test, dressing, infusion, physiotherapy, acupuncture, rehabilitation and others will be paid 80% of the expenses.(2.2) Guangzhou medical insurance designated hospitals: 50% of the medical expenses will be paid for the medical insurance covered items. (2.3) A single examination or treatment reach 300 Yuan or above, 50% of expenses will be paid if test result is positive. Insurance will not paid for the expenses if test results is negative (Claimed once per insurance year only).(2.4) Only the cost of basic extraction in the department of stomatology can be claimed. (Cost of extraction due to orthodontic t shall be self paid).

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(3). Medical Liabilities of Hospitalization:Occurred in insurance period, insured suffers from disease or accidental injury and being hospitalized , the insurance company pays 100% of insurance amount for the items and expenses within Guangdong Social Basic Medical Insurance coverage after deducting self paid and copayment amount (copayment portion is subject to attachment 2). The covered expenses include ward fee (limitation is RMB 70/day), drug costs, treatment costs, nursing fee(limit of 100 Yuan per day), examination lab fee, radiation costs, special examination treatment costs, ambulance (only to the ambulance fare prior to admission), operation fee and etc.. All expenses listed above have deductible standard. (subject to attachment 1).Outpatient specific items will be paid referring to the hospitalization medical liabilities.(4) Insurance company does not cover the following cost regarding maternity: cost of pregnant and perinatal period examination, cost of labor, cost of abortion for married or abortion due to termination of pregnancy and etc..

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(5)Regulation for other claims:(5.1) Rehabilitation treatment (physical therapy and etc.) due to accidents within the insurance coverage of this contract are included in the insurance liabilities.(5.2) Removal of the fix materials after surgery for accidental fracture: such as steel plate and etc., claim is valid for two years starting from the date of accident.

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Type of VisitingSpecific TypesJuvenile and Currently Enrolled StudentsGeneral HospitalizationPrimary Medical Institution

480 Yuan

Secondary Medical Institution

Tertiary Medical Institution

1000 Yuan

Items for Outpatient Special Diseases

Family Ward

300 Yuan/Phase

In Hospital Emergency Observation1000 Yuan each time annually Other Items for Outpatient Special DiseasesNo deductible Limit

Attachment 1

：

Deductible Standard

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General hospitalization, outpatient Special Items, General Outpatient Class B Drugs

Diagnosis and Treatment Items

15%

Treatment

20%

Examination

30%

Disposable medical material may be charged alone

30%Installation of various artificial organs and internal placement materials50%

Attachment 2:

Copayment Ratio

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Disclaimers The insurance company shall not be liable for the insurance claim due to one of the following medical expenses or conditions causing:(1) Beneficiary kills or harms the insured intentionally;(2) The insured commits a crime, resists arrest, cuffs, drunken, drug abuse, self mutilation or suicides; the insured takes or injects drugs;(3) The insured

drives under the influence of alcohol or without a driving license, drives a vehicle which without valid permits;(4) The insured has an abortion or a labor;(5) The insured suffers from the following sexually transmitted diseases

: AIDS or HIV infection

(HIV positive) and syphilis, gonorrhea,

condyloma

acuminatum

, genital herpes,

chancroid, lymphogranuloma venereum;(6) War, military action, civil strife or armed rebellion;(7) Nuclear explosion, nuclear radiation or nuclear pollution;

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(8) The insured involves with high risk sports like scuba diving, skydiving, rock climbing, adventure, martial arts competition, wrestling, stunt running, horse racing, car racing, etc. (except the activities organized by the school or represent school to participate in the games with written consent by school );(9) Medical malpractice due to cosmetic surgery or other internal, surgical procedures;(10) Expenses incurred by orthopaedic, cosmetic surgery or rehabilitation, and etc.;(11) Accompanying accommodation, meals, transportation fees, heating costs are paid by the insured;(12) Items and drugs of self paid and co-paid in accordance with Guangdong Social Basic Medical Insurance;(13) The insured did not follow the doctor's advice to take, apply, inject drug;

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(14) Services: registration fee, medical fee, consulting fee, special clinic fee, medical record fee, all data fee, home visits fee, a round of visit fee, examination and treatment express fee, high qualities special service fee, material fee for invoice, fee that remarked in the "other" items, tisane fee for Chinese traditional medicine (including efficacy-enhancing ingredients fee), all kinds of self-paid drugs do not include in "coverage", Chinese patent medicine that are not under the reimbursement provisions, medicines are not proved by the Department of Drugs Administration, drugs with the approval number "Drink" and "Trial" and "Clinical", as well as medicines with special packaging, cost of use of blood for non surgical and non rescuing purpose (including blood products, such as albumin).

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(15) Items for non disease treatment: all kinds of beauty, athletic items and non functional cosmetic, orthopedic surgery (such as blepharoplasty, breast augmentation, squint correction, stutter correction, treatment for freckles, age spots, and moles, pigmentation, acne, neoplasm, osmidrosis, alopecia, canities, blepharoplasty, scar removal, cosmetic laser, flat wart, cosmetics dentistry, dental prosthetics, orthodontics, stain teeth treatment, ultrasonic dental cleaning charge, light cured dental fillings or resin dental filling fee (imported materials) etc.); all costs of all weight lose treatments, increasing weight, heightening treatments; all kinds of physical examination cost, such as premarital examination, tourism physical examination, occupational physical examination, exit-health examination and etc.; medical cost (including drug costs) during working aboard, visiting relatives, exploring; all kinds of preventive care treatment (such as: all kinds of vaccine, preventive inoculation, general screening and treatment for disease, follow-up costs etc.); all kinds of medical consultation and medical appraisal (such as: health counseling, sexual counseling, marriage counseling, disease prediction fees, medical malpractice identification, forensic psychiatric evaluation, all kinds of inspection for wounds and evaluation for level of disability and genetic identification); costs of health care massage; recuperation , costs of using daily life and entertainment items for the rehabilitation.

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(16) Medical materials and equipments for diagnosis and treatment: PET, electron beam CT excimer laser treatment instrument, the human information diagnosis equipment and etc.; glasses (including ophthalmic), denture, ocular prosthesisl, artificial limbs, hearing aids, wigs, auricle prosthesis, nasal prosthesis and other rehabilitation apparatus, and all kinds of personal health, massage , examination and treatment equipment, such as costs of magnetic supplies, steel back supporting, waistband and kneepad, crutches, stomach support. Disposable medical materials cannot be charged separately according to the Department of Provincial and Municipal Price.Charge of hospital customized items, or costs of newly started examination and treatment without the approval of the Department of Price and the Department of Health; all the expenses of purchasing of drugs (including imported drugs), all medical expenses of medical units in insured's preference, doctors in insured's preference (including private clinics); medical expenses, consultation fee and transportation fee for consultation and treatment.

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(17) Item for Treatment: Source of all kinds of organ or tissue transplant; myopia correction; Qigong therapy, music therapy, balanced medical therapy and health care nutrition therapy, magnetic therapy.(18) Others: Treatments of all kinds of sterility, sexual disorder; treatments with the purpose of teaching, scientific research and clinical trial; medical expenses caused by drug abusing, fighting, illegal activities and crime; medical expenses due to self mutilation, drunkenness, rehabilitation, sexual transmitted disease (except AIDS) etc.; medical expenses due to traffic accident (liabilities of the other party ), medical malpractice and accident of other's liabilities ,or explicitly covered in work related injury insurance.(19) Receive medical treatment in foreign countries or Hong Kong, Macao and Taiwan.(20) Other Nonpaid conditions state in National, Provincial and Municipal provisions.

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Required documents for claimOutpatient1. Hospital Medical Invoices

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2. Outpatient Expenses Lists

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3. The Copies of Hospital Medical Records

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4. All the Hospital Inspection Reports

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5. The Copy of Passport6. The Copy of ICBC Bank Card

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7. Personal Information of the Bank Card (you can get it in the bank)

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or

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Hospitalization1. Hospital Medical Invoices

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2. Hospitalized Expenses lists

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3. The Copies of Hospital Medical Records

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4. All the Hospitalization Reports(Including in and out records )

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5. Certificate of Diseases Diagnosis

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6. The Copy of Passport7. The Copy of ICBC Bank Card

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8. Personal Information of the Bank Card (you can get it in the bank)

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or

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CAUTION:1、The invoice name must be the same as the passport name.Pay attention to the order of the family name and the given name, the space, uppercase and lowercase letters.If they are not the same, you should go to the hospital to handwrite down the correct name (the passport name) and stamp it by hospital. 2、The date of invoices should be the same as medical records .If you don’t have corresponding medical records, you should request the doctor to rewrite in hospital.

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Please provide the above documents to Clinic:1. Main Campus Address: Clinic (near the Xuri Playground) Processing Time:8:30-11:30 14:30-17:00 on Wednesday2.South CampusAddress: Clinic Processing Time: 8:30-11:30 14:30-17:00 on Thursday

Excluding winter holidays, summer holidays, national holidays

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Thanks!