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关于事先预授权项目(永诚高端医疗产品)

作者:admin  来源:高端医疗保险   发表时间:2017-10-05 14:38:33
在接受以下列表中任何一项治疗或医疗项目之前,所有客户都必须获得事先授权。客户必须核实相关的医疗费用能得到赔付,而且在治疗之前确认他们的      保险能理赔这些费用。治疗之前未获得事先授权,客户有责任承担额外40%的整个医疗费用,保险公司保留不承担保险责任的权利。
1、Hospitalization- Pre-Authorization is required for all locations. (Incl. Hospital stay for Maternity / Delivery);
在所有地方的住院治疗都需要事先授权(包括生育/分娩的住院);
2.  Outpatient Surgeries requiring general anesthesia;
任何需要全麻下进行的门诊手术;
3.  Skilled or Private Duty Nursing - (When 4 or more visits are required);
专业或私人护士家庭护理(当需要 4 次或 4 次以上时需要事先授权);
4.  Organ, Bone Marrow, Stem Cell Transplants, and other similar procedures;
器官、骨髓、干细胞或其他组织移植;
5.  Air Ambulance - Air Ambulance service will be coordinated by Insurer’s air ambulance provider;
空中紧急转运——空中紧急转运服务将由保险公司指定转运供应商协调;
6.  Any condition, including cancer treatment or any chronic condition, which does not meet the above criteria, but are expected to accumulate over  ¥60,000 of medical treatment per policy year;
任何治疗,包括癌症和慢性疾病的治疗,虽然不在上述范围之内,但是一个保险年度内累计预计花费超过人民币 60,000 元,需要事先授权;
7.  Hospices;
临终关怀;
8.  Pre-Authorization through GBG Assist is required if you have a medication that will be in excess of $ 3,000 / CNY18,000 per refill;
如果您的单次配药金额预计超过 3,000 美元或人民币 18,000 元,请联系 GBG 援助中心以获得事先授权;
9.  Other conditions and treatment required pre-authorization in the proposal or policy.
其他条款及计划书中约定需事先授权的项目及治疗。
In cases of emergency when  pre-authorization is not possible, the member should seek care as quickly as possible in the nearest appropriate facility. GBG Assist and the GBG China must be notified within 48 hours of the occurrence in order to avoid the 40% co-pay for non-notification.
如果紧急情况不允许获得事先授权,您必须在急诊 48 小时内通知国际医疗网络及中国服务中心,确保不必因没有事先通知而要自负 40%的费用。


附:永诚白金计划
永诚钻石计划
家庭高端医疗保险汇总



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