Depending on the type of medical insurance, medical insurance can be reimbursed and indemnified

Most people don't know how to choose medical insurance, here is a collection of the more popular medical insurance products in China, which one is worth buying which is cost-effective, you can understand at a glance:"2020 Domestic Hot Million Medical Insurance Points".

It is generally recommended to buy medical insurance before buying commercial medical insurance. Medical insurance is the most basic guarantee, which is a welfare policy for the people, cheap and there is no insurance limit, almost anyone can buy it. Commercial medical insurance is a supplement to medical insurance, and some items that cannot be reimbursed by medical insurance can be reimbursed, such as high-end, special, and so on.

There are many types of medical insurance, and the common ones are three types: million medical insurance, hospitalization medical insurance, and cancer prevention medical insurance.

Let's talk about the differences between these 3 types:

1. Million medical insurance

Most people can buy millions of medical insurance, it can be reimbursed for a very high amount, but the cost is very favorable, and there is no limit on the types of diseases reimbursed, pay a premium of a few hundred yuan a year, but you can get millions of reimbursements, it is worth it. Not only that, the million medical insurance guarantee content is also very comprehensive, such as bed fees, nursing fees, surgery fees, drug costs, material costs, etc., can be reimbursed.

Here's a comparative analysis of some typical million-dollar health insurance:

Combined with **, a simple comment.

(1) Good medical insurance:The renewal conditions of this one are currently the best one. During the 6-year period, there will be no refusal or premium increase due to suspension of product sales or changes in physical health.

(2) Exclusive e-life:Added post-operative home care, oncology specialty services, and increased family sharing deductible options.

(3) Micro-medical insurance:Compared with the other two, this one has more value-added services for international second diagnosis and treatment.

After the above analysis, it can be seen that each product has its own unique advantages, and when choosing a product, we should choose according to our own needs.

In addition to these products, there are also other products with high prices and more worthwhile purchases, you can click on the original article to view:"Cost-effective! Top 10 Million Medical Insurance Points Worth Buying! 》

2. Hospitalization medical insurance

Low deductibles and low sum insured are the main features of hospitalization medical insurance. This type of insurance is mainly used to reimburse outpatient services, and this kind of insurance is generally more suitable for younger babies or the elderly. Because the resistance of children and the elderly is relatively weak, it is easy to accidentally catch a cold or fever, relatively speaking, this insurance plays a greater role in them.

3. Cancer prevention medical insurance

Since the maximum age of hospitalization medical insurance and million medical insurance is about 65 years old, the older ones cannot be insured, and they can be insured for cancer prevention medical insurance.

Cancer medical insurance only pays for hospitalization** or special outpatient clinics caused by cancer, and this insurance has a longer insurance age than other medical insurance, and the health requirements are relatively relaxed. It is very suitable for people who are old or have some minor physical problems.

This kind of ** is greatly affected by physical fitness and age, here are a few cancer prevention medical insurance cost-effective good, you can take a look at it if you need it:"Top 10 Popular Cancer Prevention Medical Insurance Plants for You! 》Hope!

All those within the scope of reimbursement stipulated by the state can be reimbursed.

Reimbursable medical insurance (general medical insurance) means that the insurance company reimburses the medical expenses incurred by the patient in the hospital. Generally, there are outpatient medical insurance and inpatient medical insurance.

Indemnity medical insurance (special medical insurance) means that the patient is clearly diagnosed by the hospital with a certain disease listed in the contract, and the insurance company pays the patient** and care according to the amount agreed in the contract. Generally, there are two types of critical illness insurance (such as cancer insurance) and critical illness insurance (10, 20 and 30 types of critical illness insurance).

The above two types of medical insurance have similarities but differences, the similarity is that only illness can be covered by insurance, and the main difference is that ordinary medical insurance is a full type, that is, all kinds of diseases can be covered by insurance. Special medical insurance is a special category, that is, a certain disease or surgery that is clearly listed in the insurance contract can be covered by insurance.

Medical insurance offered by insurance companies is often a combination of a portion of the above two types of insurance.

Insurance is divided into reimbursement type and compensation type according to the method of compensation. Reimbursement type, reimbursed by invoice, generally the premium is relatively low, the sum insured is relatively high, and it can leverage greater leverage. The reimbursement type is based on the actual cost of medical expenses.

The compensation type is diagnosed with a disease that belongs to the contract, and a lump sum of cash is paid according to the amount of insurance purchased, and he does not limit whether we are treated or not, nor does it limit whether it is treated at home or abroad, and it does not limit how much money is spent, such as hypothetical thyroid cancer.

50,000 yuan of medical expenses can cure our major diseases.

The amount of one-time compensation is 1 million, so if thyroid cancer occurs, a one-time compensation of 1 million, and 50,000 yuan of medical expenses can be reimbursed with social security or consumer insurance, and the 1 million is in cash. When a major illness occurs, there are several expenses to consider:

1.Medical expenses. In the event of a serious illness, most cases require the use of imported drugs to control the spread of cancer cells, but general social security or reimbursement insurance does not report imported drugs.

e-life insurance can solve the reimbursement of imported drugs and imported equipment for hospitalization in the event of accident and illness, with a deductible of 10,000 yuan.

2.Loss of income. When there is a serious illness or accidental disability, etc., we cannot work, and our income will decline or even be absent, but the family living loan and various expenses still exist, so the cash paid for the serious illness can be used to supplement the cash loss caused by our loss of income.

It is generally recommended to pay a lump sum sum sum for critical illness.

To buy five times your annual income. It is used to ensure that during the five years after the occurrence of a serious illness, you no longer have to worry about the problem of income and recuperate with peace of mind.

3.Long-term costs for recuperation in the later stage. Now that science and technology are developed, many serious illnesses can be used, but the body's resistance and immunity will decline, and some serious illnesses also require long-term recuperation and eating nutritional and health products, which also require a high amount of cost support, so the insurance cash for one-time compensation for serious illnesses can be used to solve these expenses after discharge.

If insurance is divided into functions, it is divided into financial management and protection. Their functions and roles are also different. Wealth management insurance can solve the problem of education, pension, and at the same time has the function of inheritance, helping us to isolate the wealth security of family and business, the wealth security of marriage risks, and tax planning.

Wait for the slim stupid. If it is convenient, you can take out all your insurance policies, and you can make an appointment with me to help you sort out the insurance policies, help you sort out the protection content and protection of your family, and help you analyze how to fill the gap. Knowing the insurance status of family members is what helps us manage our family wealth.

important link.

No matter what you do, you need to have a certain basis for what you say. It is based on a number of objectively existing facts. or the relevant provisions stipulated by the law, they all exist objectively and are not subject to human will.

This world is the world of matter, and matter is the origin of the world. Let me introduce to you what is the basis for medical insurance claims?

No matter what you do, you need to have a certain basis for what you say. It is based on a number of objectively existing facts. or the relevant provisions stipulated by the law, they all exist objectively and are not subject to human will.

This world is the world of matter, and matter is the origin of the world. Let me introduce it to youWhat is the basis for a medical insurance claim?

1. What is the basis for medical insurance claims?

1. Within three days of admission, the patient should go through the medical insurance registration procedures at the medical insurance office of the designated hospital with the "Admission Notice" and "Medical Insurance Certificate". During the hospitalization, the "Medical Insurance Certificate" shall be retained by the medical insurance office of the hospital and returned to the person when he is discharged from the hospital.

If you do not go through the registration procedures for more than three days, you will be responsible for the inpatient medical expenses.

2. When discharged, you should go to the medical insurance office of the hospital to go through the medical insurance discharge settlement procedures.

3. If the insured residents pay the medical insurance premiums on time and in full, the medical expenses paid by the medical insurance coordinator when the patient is discharged from the hospital will be directly settled and reimbursed by the hospital.

2. Reimbursement method for referral and transfer

1. Residents who really need to be transferred to hospitalization outside the city, need to be transferred to the central people's hospital or traditional Chinese medicine hospital, and the department director signs and agrees to report to the municipal medical insurance agency for approval before they can be transferred to other public medical institutions for hospitalization.

2. The medical expenses for transfer to the hospital shall be accepted and reimbursed by the medical insurance agency, and the following materials shall be provided:

1) Transfer approval form;

2) A copy of the complete inpatient medical record (stamped);

3) Original invoice (stamped);

4) Summary list (seal);

5) Medical insurance card.

3. Reimbursement methods for business trips and family visits

1. If the insured person is hospitalized for emergency rescue in a designated hospital for medical insurance in a foreign place due to a business trip or family visit, the patient or his family shall inform the Tengzhou Medical Insurance Office within three working days after hospitalization for the record. Failure to register is at your own expense.

2. When applying for reimbursement, you must bring the following information to the medical insurance office.

1) Proof of the insured person's unit (village, neighborhood committee);

2) Proof of residence of the person on a business trip or visiting relatives;

3) The medical pants of this hospitalization;

4) Emergency diagnosis certificate of this hospitalization (must be stamped with the official seal of the hospital);

5) Copies of inpatient medical records include the first page of hospitalization, hospitalization records, discharge summary, long-term and temporary medical orders;

6) Detailed summary of hospitalization expenses (the above information must be stamped with the hospital seal);

7) A copy of the patient's medical insurance certificate and ID card.

The above is what I introduced to youWhat is the basis for a medical insurance claim?You can't get back a lost life. I hope that those doctors who lack virtue for money will advise you to be kind!

Answers]: a, b, c, d

The classification of medical insurance is hospitalization medical insurance, general medical insurance, surgical insurance, comprehensive medical insurance, outpatient medical insurance, and high medical rotation therapy cost insurance.

In line with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and emergency and emergency medical expenses, in accordance with the provisions of the state from the basic medical insurance ** payment. According to the basic requirements of China's basic medical insurance treatment, the insured goes to the medical insurance institution to reimburse the medical expenses incurred in seeing a doctor.

1. Reimbursement conditions for medical insurance

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be paid from the basic medical insurance in accordance with national regulations.

According to the basic requirements for the payment of basic medical insurance benefits in China, the insured shall go to the medical insurance institution to reimburse the medical expenses incurred by himself for medical treatment, and generally meet the following conditions:

1) The insured person must go to the designated medical institution of the basic medical insurance to seek medical treatment and purchase drugs, or hold the medical prescription issued by the doctor of the designated hospital to the designated retail pharmacy determined by the social insurance institution to purchase drugs.

2) The medical expenses incurred by the insured in the process of seeing a doctor must meet the scope and payment standards of the basic medical insurance insurance drug catalog, diagnosis and treatment items, medical service facility standards, and can be paid by the basic medical insurance ** according to the regulations.

3) Among the medical expenses of the insured persons who meet the scope of basic medical insurance payment, the part of the expenses above the minimum payment standard of social medical co-ordination and below the maximum payment limit shall be paid by the social medical co-ordination ** in a unified proportion.

2. The legal basis of medical insurance

Social Insurance Act

Article 23.

Employees shall participate in the basic medical insurance for employees, and the employer and the employee shall jointly pay the basic medical insurance premiums in accordance with the provisions of the state. Individually-owned businesses without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other flexibly employed persons may participate in the basic medical insurance for employees, and the individual shall pay the basic medical insurance premiums in accordance with the provisions of the state.

According to the law, it can be learned that if the employer and its employees fail to pay medical insurance premiums, they will be suspended from the first day of the next month after the arrears, and all of them must be paid in time.

Legal analysis: According to the relevant regulations, there are many areas of reimbursement for medical insurance for urban residents in China, including drug expenses and auxiliary examinations, such as X-ray, laboratory tests, CT, MRI, filming, electrocardiogram, acupuncture, physiotherapy and other examination expenses are limited to 200 yuan. Among them, the cost of surgery is based on the national standard, and if it exceeds 1,000 yuan, it will be reimbursed according to the 1,000 yuan accompanying traveler.

The elderly over the age of 60 are hospitalized in the town health center, and their hospitalization fees, ** fees and nursing expenses are compensated every day.

Legal basisArticle 3 of the Regulations on Social Insurance.

Scope of collection of basic endowment insurance premiums: state-owned enterprises, urban collective enterprises, foreign-invested enterprises, urban private enterprises and other urban enterprises and their employees, public institutions and their employees who implement enterprise management.

Scope of collection of basic medical insurance premiums: state-owned enterprises, urban collective enterprises, foreign-invested enterprises, urban private enterprises and other urban enterprises and their employees, state organs and their staff, public institutions and their employees, private non-enterprise units and their employees, social organizations and their full-time personnel.

Scope of collection and payment of unemployment insurance premiums: state-owned enterprises, urban collective enterprises, foreign-invested enterprises, urban private enterprises and other urban enterprises and their employees, and public institutions and their employees.

The people of provinces, autonomous regions, and municipalities directly under the Central Government may, on the basis of actual local conditions, stipulate that urban individual industrial and commercial households shall be included in the scope of basic endowment insurance and basic medical insurance, and may also stipulate that social organizations and their full-time personnel, private non-enterprise units and their employees, as well as urban individual industrial and commercial households and their employees with employees, shall be included in the scope of unemployment insurance.

The base and rate of social insurance premiums shall be implemented in accordance with the provisions of relevant laws, administrative regulations and social insurance premiums.