Notice about MEDICAL INSURANCE
Editor:International Student Office Date:December 14, 2012 Hits:

关于武汉地区来华留学生住院垫付及住院费报销的暂行补充规定

武汉地区各院校来华留学生办公室:

自各院校与我公司建立来华留学生保险合作以来,各项工作进展良好,但近两年发现个别院校的学生利用保险公司提供的便利性保险条款,进行过度和恶性的住院治疗进行骗保,这种现象如不及时遏制将侵犯保险公司及正常就医学生的利益,也会给学校的留学生管理工作带来负面影响。经与各有关方面协商,现对武汉地区学生住院报销及垫付作出以下补充规定:

一、关于住院规定:

1. 就诊程序:留学生因病就医必须先在医院的门诊进行就医,如门诊医生根据检查结果及病情有充分诊断依据要求留学生住院治疗的,学生须提供:门诊病历、入院通知书、接收入院医生的联系电话,然后由学校老师帮助学生打电话通知环球救援机构,由环球垫付机构的进行审核,审核同意后才可以进入住院垫付流程。凡是住院都必须通过垫付机构进行审核垫付。如检查结果及当时的病情经过环球医生判断未达到住院条件,但学生自己要求住院,或未经审核自行办理入院手续的,保险公司将一律不予理赔。

2. 如就诊医院的医疗条件及水平不能满足学生的病情需要,须由医院开出转诊证(转院通知书)、由老师帮助通知环球垫付机构的专业人员,同意后可转往上一级转诊医院进行治疗。

3. 如病情所需需要住院的,办理住院时,需先行交付住院费用15%的住院押金,并保存好押金条,如果在住院治疗过程中需要追加资金的,由环球医生根据治疗的需要,按照同等比例通知留学生追加个人应该负担的费用。出院时将押金条提供给垫付公司(可电话联系010-59104919),协助办理出院及理赔。

4. 如病情所需需要住院的,凡医疗费用中的自费费用,由学生自己承担,保险公司按照规定不予赔付自费费用,自费费用后期将在押金中予以扣除,如果押金不足扣除自费金额的,差额将由学生在出院前补交齐全。

二、关于既往病症、先天性疾病:

根据保险条款规定:来华留学生的既往病症(投保之前已患有或已知的疾病)或先天性疾病不在保险责任范围内,因此如发现患有既往病症或先天性疾病的学生就诊,我公司将拒绝或中止垫付及理赔相关费用。

以上相关规定,自2012121日执行,请相关院校留学生办公室转发告知学生。

                                           

平安养老保险股份有限公司

北京分公司

二〇一二年十一月三十日


(Translation for reference only)

November 30, 2012

Provisional Regulations about the Advance Payment and Reimbursement for Hospitalization

To all International Student Offices in Wuhan:

Since the establishment of cooperation between all universities in Wuhan and our insurance company, everything goes smoothly. However, in recent two years, we’ve found some cases that the students swindle insurance fee by making excessive and vicious use of conveniences that the insurance company provides. If not prohibited, this phenomenon would not only infringe the interest of the company and the qualified students, but also bring negative effect to the administration. After discussion with all concerned parties, the following supplementary regulations are made:

1. About hospitalization:

1) Procedure: All students should first check in the outpatient clinic of the hospital. If the doctors suggest the students be hospitalized according to the checkup result and condition of the students, students should provide the medical record, the card for hospitalization, the contact of the doctor to the International Student Office. The office will inform the insurance company and the above-mentioned supporting document will be verified. If everything is approved, the advance payment will be activated. Any student who wants hospitalization must be verified and approved by the insurance company. If the checkup result and the condition do not meet the requirements for hospitalization while the student insists on hospitalization, all the fees would not be reimbursed by the insurance company.

2) If the medical treatment cannot meet the need of the students’ illness, a referral notice issued by the former hospital shall be needed. The International Student Office will inform the insurance company, and if agreed, the students can be transferred to the upper level hospital.

3) Before being admitted, the students should pay 15% of the total fees as the deposit in advance. If extra fee is needed, the insurance company will inform the students to pay the corresponding proportion (15%). The deposit receipt has to be well kept and timely presented to the insurance company (010-59104919) before students discharge from the hospital.

4) All the self-supported items during the hospitalization should be paid by the students themselves, which will be deducted from the deposit by the insurance company. If the deposit is not enough for the self-supported items, the balance must be completed by the students before they discharge.

2. About medical history and congenital disease

According to the insurance regulations, all the medical history (foregone disease and existed disease before buying the insurance) and congenital diseases are not covered by the insurance; therefore, students who follow into this category cannot get the refund from the insurance company.

The above regulations are valid since December 1, 2012. It will be appreciated if the International Student Office helps us to inform the students.


Beijing Branch

Ping An Annuity Insurance Company of China, Ltd.

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