What does the payout ratio for insurance geeks mean?

The payment ratio means that the insurer and the insured share the latter's ** expenses, that is to say, if the payment ratio is 80%, the insurance company bears 80% of the compensation costs, and the insurer bears 20% of the costs. It's also important to note that this fee is calculated regardless of the deductible.

Extended Resources:

What medical expenses are covered by Medicare?

1. Drug catalog.

Drugs prescribed at the hospital are only reimbursed if they are in the drug list.

There are two main categories of drugs that can be reimbursed:

Class A drugs: clinically necessary, widely used, with good efficacy, formulated by the state, and can be 100% reimbursed.

Class B drugs: can be used clinically, with good efficacy, slightly higher; Only partial reimbursement will be granted.

In addition, there are also Class C drugs, which are not included in the reimbursement list and need to bear all the costs themselves.

The new Medicare Catalogue will take effect on 1 January 2020.

2. Diagnosis and treatment items.

It mainly includes ** fee, examination fee, surgery fee, etc., and the expenses are reimbursed according to a certain proportion.

However, it should be noted that many common diagnosis and treatment items; For example, expenses such as ** fees, house visit fees, prosthetic eyes, prosthetic limbs and other equipment, beauty enhancement, health examination and other expenses cannot be reimbursed.

It can be easily understood that if it is not necessary, the cost of diagnosis and treatment is simple.

3. Service facilities.

The main thing is the bed fee for ordinary wards, and the high-end wards and special wards will not be reported. In addition, life services such as nursing fees, meal expenses, and ambulance fees are also not reimbursable.

Due to the existence of the reimbursement catalog, each person's ** method and project are also different, so the final reimbursement ratio can vary greatly.

As a universal welfare, medical insurance ensures the most basic dignity of everyone who "can be treated when they are sick", but medical insurance can only ensure that everyone gets a bowl of porridge, which is just white porridge, barely full; If you want to eat seafood porridge, abalone and cucumber wings are impossible.

If the payment ratio between you and the insurance company is 70%, and the amount included in the reimbursement scope is 1,000 yuan, the insurance company will pay 700 yuan.

The payment ratio means that the insurance company approves the ** cost shared by the insured, that is to say, if the payment ratio is 80%, the insurance company bears 80% of the compensation costs, and the insurer bears 20% of the compensation itself. It's also important to note that this fee is calculated regardless of the deductible.

The payout ratio of insurance geeks needs to be negotiated with the insurance company at the time of application, and after the payout occurs, the insurance company will pay the remaining part after deducting the deductible according to the payout ratio.

Shouldn't you consult an "insurance geek" about this? Choose it and believe it, there is no need to be so "first and second"1

The health insurance of the BAI expense reimbursement type DU is provided with a proportional clause.

It is more common for the insured insurer and the insurance company to jointly bear the loss of medical expenses according to a certain proportion; That is, the insurance company does not reimburse 100% of the medical expenses of the insured, but pays a certain percentage. For details, please consult the insurance company and refer to the terms and conditions of the contract.

Supplementary medical care is based on the employer's voluntariness as compared to basic medical care. After the unit and employees have done a good job of basic medical care, the medical insurance items should be appropriately increased in combination with the relevant needs of the unit or individual.

Corporate supplementary medical care, commercial medical care, social mutual aid and community medical care are all complementary medical care, which is a powerful supplement to basic medical care. Like social security and commercial insurance, the same complementary relationship, I won't say so much here, if you want to know more, you can click here:"If you have social security, you don't need to buy commercial insurance?

The difference between social security and commercial insurance is **

1.We pay for supplementary medical care once a year, you can pay this year, not next yearYou can only be reimbursed if you have paid it, and if you don't pay it, you won't be reimbursed.

2.Ordinary medical purchases can be reimbursed through supplementary medical careA full three days of hospitalization is required for medical reimbursement to be made.

3.Supplementary medical care has a reimbursement scopeChildbirth, plastic surgery, etc. are not allowed to be reimbursed, generally the company pays half of it, and is responsible for half of it.

4.Friends who have paid for supplementary medical care before,Medical records, checklists, and invoices should be taken at the time of medical appointment. Medical records, lists must be stamped, and invoices can be reimbursed, and all three are indispensable.

5.After that, you can go to the human resources department and submit your medical records, lists, and invoices for reimbursementYou have to fill in the relevant ** and provide the bank card number, and the time to receive the reimbursement is about a month.

I see that some friends here finally grasp some knowledge points of reimbursement and supplementary medical care, so that you can have a comprehensive understanding, and I also sorted out the related issues of medical insurance reimbursement, which can be referred to:Under what circumstances can medical insurance not be reimbursed? 》

Supplementary medical care in insurance geeks is an additional type of insurance in addition to social medical insurance, which is specially designed for non-medical insurance drugs.

Hello, at present, about the supplementary medical treatment in the insurance geek, I checked the official website of the insurance geek, but there is no official **.

Supplementary medical care, that is, in addition to medical insurance, the company will purchase additional insurance for you, providing comprehensive insurance in all aspects such as accidental injury, serious illness, critical illness insurance, etc., and also providing additional insurance for your family and children. This is a company benefit.

For example, its Geek Insurance - Classic Edition has achieved zero deductible for supplementary medical care, with a payout ratio of 90%; Its Geek Insurance-Premium Edition product has zero deductible for supplementary medical treatment, and the compensation ratio has reached 100%.

This supplementary medical treatment means that after you are insured because you are sick and receive ** in a medical institution approved by their company, then their insurance company should pay you the actual hospitalization medical expenses that meet the payment scope of the local social basic medical insurance, and the insurance company will pay the medical insurance according to the agreed payment ratio after deducting the deductible as agreed in the contract. That is, if you see a doctor, the insurance company should pay you the insurance money.

Don't believe the claims contract of any insurance company, none of them are for the sake of users to make money, play word games, and be sure to read the contract clearly when you go to insurance.

What is complementary medicine in insurance geeks, complementary medicine is about the rules and regulations that you don't have under that insurance, and you're in a good mood.

What is the supplementary medical care in the inbound medical insurance? That is, in the insurance, I will supplement it for you, and other insurance is also quite cost-effective.

What is the medical treatment that is supplemented by the insurance in the insurance collection? He was insured by a large amount of insurance, and then by his illness insurance, which was a major illness insurance of 42 kinds.

The social security mentioned in the supplementary medical insurance of social security mainly refers to basic medical insurance. In order to make up for the lack of basic medical insurance, employers or individuals are encouraged to purchase supplementary medical insurance. China Merchants Cigna warmly reminds that supplementary medical insurance is voluntarily purchased by employers and individual employees.

From a practical point of view, supplementary medical insurance can increase the medical security items of medical participants and improve the level of insurance protection. There are three main types of supplementary medical insurance for social security, including enterprise supplementary medical insurance, commercial medical insurance, and community medical insurance. Enterprise supplementary medical insurance is the supplementary medical insurance organized or participated by the employer, commercial medical insurance is the supplementary medical insurance sold by insurance companies, and community medical insurance is urban medical insurance.

Supplementary medical insurance is relative to basic medical insurance, including enterprise supplementary medical insurance, commercial medical insurance, 、..Supplementary medical insurance is different from basic social medical insurance and has some of the properties of commercial insurance.

Supplementary medical care is that you see a medical insurance company to pay for your expenses, but you need to be in a medical institution approved by them**, this supplementary medical treatment also has a deductible, which refers to the amount specified in the insurance contract that the insurance company is not liable for compensation within a certain limit. The deductible can only be deducted once during the term of a policy. This is quite a good deal, and I took out an insurance policy for my parents.

Supplementary medical insurance is the part that is not reimbursed outside the normal scope of medical insurance, and supplementary medical insurance will reimburse you.

Supplementary medical care is a kind of medical auxiliary function in insurance.

Supplemental medical care is inpatient medical care, and when you are hospitalized with illness, you can be reimbursed on a pro-rata basis.

This is a medical supplementary insurance, so you need to find out for yourself.

Supplementary medical care is the medical treatment for a serious illness that is required in addition to normal insurance.

That is, in addition to the fees paid by the unit, if you still want to increase the medical insurance items and amounts, you can make up the fees yourself.

According to your own economic conditions, you can buy accident insurance and so on.

This means that employees can be compensated for outpatient and emergency and hospitalization expenses (including drug fees, ** fees, examination fees, material costs, bed fees, etc.) incurred in designated hospitals in accordance with the local social basic medical insurance and service agreement.

Geek Insurance is an insurance service platform for insurance geeks' corporate employees, and companies have insured supplementary medical insurance for employees, who can make claims through this WeChat *** login, upload medical documents, prescriptions, medical records and other information, and can view the progress of claims in time after submission, and can also view claim records. It is more convenient for employees to operate. Many insurance companies now offer similar services on their official WeChat or app.

For example, for individual or group accident insurance and medical insurance claims, many companies will set a limit by uploading claim information through WeChat, and below the limit, you only need to provide electronic ** of invoices, prescriptions, medical records and other supporting information according to the insurance company's claim list, and you don't need to submit paper information to the insurance company. Very convenient. In order to attract and retain talents and solve the pressure of employees in medical treatment, many units will consider providing employees with group medical benefits.

Introduction to group complementary medicine: It usually consists of two parts: outpatient and emergency and inpatient. The insurance is that if the insured employee is injured or hospitalized in the hospital due to accidental injury or illness, the actual medical expenses incurred by the employee will be reimbursed according to the compensation ratio agreed in the contract after being reimbursed by the local public-funded medical treatment or social security of the insured local government-funded medical treatment or social security.

Group supplementary medical care has its limitations, it can only reimburse the remaining part of the expenses within the scope of social security that are not reimbursed by social security, if the hospital's ** items, drugs, etc. belong to the three major catalogs of social security when the employee is treated, then the supplementary medical treatment usually cannot be reimbursed, unless the unit has agreed with the insurance company to expand the class B drugs and social security out-of-pocket items. Therefore, if the employer only insures the most basic supplementary medical care and does not expand the self-pay program, it is recommended that the individual employee still consider configuring a commercial medical insurance for himself, such as million medical insurance, medium and high-end medical insurance, etc., to solve the large medical risks.

Your invoice date is not covered by the insurance, the insurance geek's insurance within the coverage period of your plan, after the waiting period, the reasonable and necessary medical expenses incurred by the regret Chang, according to the plan to pay the medical insurance premium; If it is not covered by the insurance, the key front team will not be able to pay. In addition, if the date of your visit is within the coverage template of the lapsed plan, you can upload the materials to the lapsed plan to initiate a claim.

Ren Bin, founder & CEO of Insurance Geek, was invited to attend the 36Kr Wise Industry New Ecology Summit and delivered a speech on "New Practices of Enterprise Group Insurance Digitalization". Ren Bin mentioned that what insurance geeks are doing is to use insurance as the entrance and technology as a means to build an industrial ecology that connects industry partners around the health management and disease risk of people in the workplace. In the future, corporate group insurance will become more and more integrated into our daily life and become an existence like "water, electricity and coal".

It's better to be flexible, our company currently has nearly 100 people, such as the insurance for employees in a company before, it is very troublesome to operate when employees enter or leave, and it takes a long time to deal with it, and it is more convenient for insurance geeks to do this, if an employee leaves the company, you can remove the employee directly in their system, and you can also directly add employees if you have an employee, which obviously reduces a lot of workload for HR.

Insurance Geek, an insurance platform for corporate employees. We are committed to providing enterprises with intelligent employee welfare insurance and health management solutions through product technology innovation

Is there anything special about insurance for insurance geeks? There is nothing special, it's just insurance, there is no need for anything special, it's just a thing and a product that can guarantee you.

To put it bluntly, geek insurance is a professional channel for customizing related business with insurance companies, and some insurance businesses cannot be seen in relevant insurance companies.

This may be different from regular insurance, similar to this type of special insurance.