Which of the urban medical insurance is serious illness insurance?

The critical illness insurance in the urban resident medical insurance includes:

1.Malignancy — Excludes some early-stage malignancies.

2.Acute myocardial infarction.

3.Stroke sequelae — permanent dysfunction.

4.Major organ transplantation or hematopoietic stem cell transplantation — Allogeneic transplantation is required.

5.Coronary artery bypass grafting (also known as coronary artery bypass grafting) — Thoracotomy is required.

6.End-stage renal disease (or chronic renal failure, uremia) requires dialysis** or a kidney transplant.

7.Multiple limb loss — complete disconnection.

8.Acute or subacute severe hepatitis.

9.Benign brain tumors — Craniotomy or radiation** is required.

10.Decompensated chronic liver failure — This does not include alcohol or drug abuse.

11.Sequelae of encephalitis or meningitis — permanent dysfunction.

12.Deep coma — Does not include alcohol or drug abuse.

13.Deafness in both ears — permanently irreversible.

14.Binocular blindness — permanent and irreversible.

15.Paralysis — permanently complete.

16.Heart valve surgery — Thoracotomy is required.

17.Severe Alzheimer's disease — Complete loss of the ability to live independently.

18.Severe brain injury — Permanent functional impairment.

19.Severe Parkinson's disease — Complete loss of the ability to live independently.

20.Severe burns — up to at least 20% of body surface area21Severe primary pulmonary hypertension — Manifestations of heart failure.

22.Severe motor neuron disease — Complete loss of the ability to live on their own.

23.Loss of language ability — Complete loss and positive for at least 12 months.

24.Major aplastic anemia.

25.Aortic surgery — Thoracotomy or laparotomy is required.

26.Diversity hardening.

27.Insulin-dependent diabetes mellitus.

28.Severe acute necrotizing pancreatitis.

29.Vegetable.

30.Muscular dystrophy.

The definitions of critical illnesses 1-25 above refer to the 25 definitions of critical illnesses specified in the "Specification for the Use of Disease Definitions in Critical Illness Insurance" formulated by the Insurance Association of China.

It is not accurate enough, it is not what major diseases are included, basically all major diseases are included, medical insurance is universal, from cold and fever to cancer and heart disease, as long as it exceeds the minimum payment line, it can be reimbursed proportionally, and the reimbursement part is basically some hospitalization expenses, diagnosis and treatment expenses, blood transfusion fees and so on. The most important thing is that the use of drugs outside the social security is not reimbursed, and the efficacy of the drugs outside the social security is often better than that in the social security, so the social security is only the basis of the guarantee, and it still needs to be supplemented by certain commercial insurance.

Yes, there is. The medical insurance for urban and rural residents includes serious illness insurance, and as long as you purchase medical insurance, you will have serious illness protection.

Critical illness insurance is aimed at situations where the insured person suffers from a serious illness and is hospitalized** during a period of protection, and the medical expenses borne by the individual are still very high after the reimbursement by the resident medical insurance. Therefore, critical illness insurance must meet a certain cost standard before it can be reimbursed.

In addition, critical illness insurance can not only reimburse the local ** expenses, but also reimburse the medical expenses of hospitalization in other places.

Extended information: The protection object of critical illness insurance is the basic medical insurance for urban residents in the city, mainly four categories of personnel, including students and children, urban elderly, unemployed residents, disabled people, etc.

After the insured person enjoys the basic medical insurance treatment for urban residents in the current year, the part of the medical expenses paid by the individual (the amount of medical assistance that has been deducted by the civil affairs department will be deducted accordingly) exceeds the per capita disposable income of urban residents in the city in the previous year (hereinafter referred to as the starting line) shall be included in the scope of payment of serious illness insurance.

Serious illness medical insurance is reimbursed according to the data of the medical insurance information system, and insured residents must hold the card to seek medical treatment when seeking medical treatment, so as to ensure that the medical reimbursement data is complete and the reimbursement expenses are accurate. At the same time, insured residents should adhere to the community first diagnosis system and seek medical treatment reasonably.

During the replacement period of the lost social security card, the insured residents need to keep the medical treatment receipts, and the medical expenses will also be uploaded through the information system when the reimbursement is made manually.

If insured residents need to inquire about the reimbursement details of medical treatment, they can go to the social security office where their household registration is located to inquire about the reimbursement of personal medical expenses.

How to reimburse the serious illness medical insurance for urban residents.

Serious illness insurance is to reimburse urban and rural residents for the high medical expenses incurred due to serious illness, with the purpose of solving the problem of "poverty due to illness and return to poverty due to illness", so that the vast majority of people will no longer fall into economic difficulties due to illness.

Reimbursement ratio of medical insurance for serious illness:

The reimbursement ratio of critical illness insurance is that the reasonable medical expenses that the patients with serious illnesses still need to bear after the reimbursement of the basic medical insurance, and then give more than 50% of the actual reimbursement, and the payment ratio of medical expenses is formulated in stages, in principle, the higher the medical expenses, the higher the payment ratio. In other words, about 70% of the urban residents' medical insurance and NCMS will be reimbursed within the scope of the policy, and the remaining out-of-pocket expenses will be reimbursed by the serious illness insurance at least 50%.

The protection object of critical illness insurance is the insured of urban residents' medical insurance and NCMS, and the funds required are allocated from urban residents' medical insurance and NCMS**, and there is no additional burden of individual payment.

It is not covered by the medical insurance for serious illness:

Clause. 1. Seeking medical treatment in a non-designated hospital without approval (except for emergency rescue);

Clause. 2. Suffering from occupational diseases, work-related injuries or work-related injuries; Injuries caused by traffic accidents (commercial accident insurance is recommended);

Clause. 3. Causing harm due to their own violations;

Clause. 4. Food poisoning caused by a liability accident;

Clause. 5. Caused by suicide (except for psychotic episodes);

Clause. 6. Injuries caused by medical accidents;

Clause. 7. Those who shall pay for their own medical expenses in accordance with state regulations.

Summary. There is a serious illness medical insurance in the medical insurance for urban residents, and naturally they can also apply for reimbursement, provided that the standard of reimbursement for serious illness is met.

Hello includes, the urban medical insurance includes serious illness insurance.

There is a serious illness medical insurance in the medical insurance for urban residents, and naturally they can also apply for reimbursement, provided that the standard of reimbursement for serious illness is met.

It is only after enjoying the reimbursement treatment of basic medical insurance that the remaining amount of unreported rental sales reaches the reimbursement amount of serious illness medical insurance, and then you can enjoy the reimbursement treatment of serious illness medical insurance for urban and rural residents.

Legal Analysis: 1) Targets of Critical Illness Insurance.

Resident critical illness insurance covers all urban and rural residents, and its protection targets are those who have participated in the basic medical insurance for residents. Newborns shall go through the procedures for participating in the basic medical insurance for residents in accordance with local regulations, and enjoy the benefits of basic medical insurance and serious illness insurance from the date of birth.

2) Coverage of critical illness insurance.

Resident critical illness insurance is linked to basic medical insurance. From 2015 onwards, the compensation policy according to the type of disease will be cancelled, and the method of compensation according to the amount of medical expenses will be adopted, and the inpatient medical expenses incurred by residents in a medical year and the outpatient chronic disease expenses included in the scope of overall payment will be compensated by the residents' critical illness insurance after being compensated by the residents' basic medical insurance. The medical year for domestic critical illness insurance is from January 1 to December 31.

3) Financing standards and financing channels for critical illness insurance.

The state clearly stipulates that a certain proportion of the funds for serious illness insurance will be allocated from the medical insurance for urban residents and the New Rural Cooperative Medical System.

Legal basis

The Implementation Plan for the Integrated Critical Illness Insurance System in Shandong Province clarifies the basic policies of residents' critical illness insurance, and makes specific provisions on the protection objects and coverage scope, compliance fees, financing channels and financing standards, and payment standards.

First, the cost of drugs in line with the provisions of the "Shandong Basic Medical Insurance Drug Catalogue", including the self-paid part of Class B drugs; The Provincial Department of Human Resources and Social Security organized a unified negotiation of the cost of anti-tumor molecular targeted drugs and some specific drugs. Second, in addition to the non-payment items in the "Catalogue of Diagnosis and Treatment Projects of Basic Medical Insurance in Shandong Province" and the "Scope of Medical Service Facilities of Basic Medical Insurance in Shandong Province", the remaining expenses (including the part paid by individuals) are all included in the scope of payment of compliant medical expenses.

China's critical illness insurance includes: deafness in both ears, blindness in both eyes, paralysis, heart valve surgery, malignant tumors, acute myocardial infarction, sequelae of stroke, major organ transplantation or hematopoietic stem cell transplantation, coronary artery bypass grafting, end-stage renal disease, multiple limb loss, acute or subacute severe hepatitis, benign brain tumor, deep coma, severe Alzheimer's disease, etc.

Article 25 of the Law on Social Insurance.

The State shall establish and improve a basic medical insurance system for urban residents.

The basic medical insurance for urban residents implements a combination of individual payment and subsidy for Liang Cong.

Those who enjoy the minimum living guarantee, the disabled who have lost the ability to work, the elderly and minors over the age of 60 from low-income families, etc., will be subsidized by **.