Medical insurance must be fixed in community hospitals in Guangzhou Grade III Grade A hospitals. Relevant laws and regulations are as follows:
Notice on the Scope and Standard of Medical Expenses for Ordinary Outpatients Paid by the Social Medical Insurance Fund for Employees in Guangzhou
1、 The insured personnel of the social medical insurance for employees (hereinafter referred to as the insured personnel) who enjoy the general outpatient treatment as a whole shall go through the selection procedures according to the following provisions and go to the designated medical institutions for outpatient treatment:
（1） The insured shall select a primary medical institution from the designated medical institutions in this Municipality as the designated medical institution for general outpatient treatment (hereinafter referred to as the primary selected medical institution).
After the insured personnel select the primary medical institutions, they can select another medical institution from the designated medical institutions in this city as the designated medical institution for general outpatient treatment (hereinafter referred to as other selected medical institutions).
（2） Once the primary level selected medical institutions and other selected medical institutions are determined, they will not be changed in principle within one insurance year. However, if the insured person has moved his/her household registration, changed his/her residence, changed his/her work unit or changed his/her qualification as a designated medical institution during the year, he/she can go through the change procedures at the medical insurance agency with the corresponding supporting materials.
（3） The insured personnel are not restricted by the site selection when they go to the designated specialized medical institution for medical treatment in the corresponding specialized outpatient clinic. The specific designated specialized medical institutions shall be separately announced by the municipal medical insurance agency.
（4） The pooling fund will not pay the basic medical expenses of ordinary outpatient service incurred by the insured when they go to non selected medical institutions or non designated specialized medical institutions for medical treatment.
Extended data:
Notice on the Scope and Standard of Medical Expenses for Ordinary Outpatients Paid by the Social Medical Insurance Fund for Employees in Guangzhou
2、 The basic medical expenses of ordinary outpatient service incurred by the insured according to the regulations shall be paid by the pooling fund according to the following provisions:
（1） The payment proportion of the medical care pooling fund of the selected medical institutions at the grassroots level is 80%. The payment proportion of the medical care pooling fund of other selected medical institutions and designated specialized medical institutions within 30 days after the referral of the selected medical institutions at the grassroots level is 55%. The payment proportion of the medical care pooling fund of other selected medical institutions and designated specialized medical institutions without the referral of the selected medical institutions at the grassroots level is 45%.
（2） The maximum monthly payment limit of the pooling fund is 300 yuan. The maximum monthly payment limit is effective in the current month, and does not roll over or accumulate.
（3） During the period of inpatient treatment, the insured shall not enjoy the general outpatient pooling treatment at the same time. The insured shall not enjoy the social medical insurance treatment for specific outpatient items and chronic diseases designated by the outpatient service, and will not enjoy the general outpatient pooling treatment again.
