Is it profitable to recommend friends to buy health insurance in Zhao Yan?

What's the difference between health insurance?

We should pay attention to two issues:

Definitions of specific past illnesses and reimbursement rules

What is the scope of reimbursement?

Hebei Huimin Insurance: Which is better, Hebei or Health Insurance? Can we buy them together?

The difference lies in the picture, just look at the picture carefully, especially the red part ~

Simply looking at insurance liability, Zhao Yan's health insurance is more comprehensive, especially for specific people with past diseases.

2. Should I buy health insurance or health insurance?

After reading the above picture, the two types of Hebei Huimin insurance do have their own advantages and disadvantages, but at the same time there will be two questions:

Which is better?

Buy together. Can it be reimbursed at the same time?

1. Which is better?

If the health information, age and occupation are consistent, and there is no exemption from past diseases, the conventional million medical insurance is preferred, especially for children and adolescents.

If you can't participate in the regular million-dollar medical insurance, you can participate in the health insurance of and. If you have to choose between them, Zhao Yan health insurance will be given priority.

At this time, you will definitely have questions: Can you buy them together and reimburse them at the same time?

2. Can I buy them together and reimburse them at the same time?

First of all, it is clear that for commercial medical insurance, if compensation has been obtained from other channels (including but not limited to basic medical insurance, free medical care, work units and any insurance institutions), it is necessary to deduct this part of the expenses first, and then reimburse the rest according to the agreed deductible and reimbursement ratio.

In short, the cumulative reimbursable amount of medical insurance+Hebei+medical insurance is at most the actual medical expenses.

Suppose that Mr Y, a medical insurance participant in Shijiazhuang, was hospitalized in May 2022 because of his first diagnosis of liver cancer (non-specific past diseases), and the total hospitalization expenses were 300,000, of which 65,438+08,000 was reimbursed by medical insurance pooling fund and serious illness insurance, and 654,38+02,000 was borne by individuals. Details are as follows:

Out-of-pocket expenses of inpatients in the medical insurance catalogue: 50,000 yuan.

Out-of-pocket expenses of inpatients outside the medical insurance catalogue: 70,000 yuan.

If you are insured with Ji and health insurance at the same time, can you reimburse them together?

Of course you can.

(1) Out-of-pocket expenses for hospitalization in the medical insurance catalogue

It should be paid by Ji first. Reimburseable amount = (50,000-deductible 1.5 million) × reimbursement ratio 80% = 28,000.

At the same time, because Ji's reimbursement amount can deduct the deductible of health insurance, and Ji's reimbursement amount is 28,000, which is greater than the deductible of health insurance 1.5 million, at this time, the deductible is no longer calculated for reimbursement of hospitalization expenses of health insurance.

Then, the reimbursable amount of Zhao Yan medical insurance = (50,000-28,000) × reimbursement ratio 80% = 1.76 million.

Then, the cumulative reimbursable amount of out-of-pocket hospitalization expenses in the medical insurance catalogue is 28,000+65,438+0.76 million = 45,600.

(2) Out-of-pocket hospitalization expenses outside the medical insurance catalogue.

Reimbursable amount = (70,000-deductible 65,438+500,000) × 50% = 27,500.

Similarly, the reimbursement amount of Ji can deduct the deductible of health insurance, and the reimbursement amount of Ji is 27,500 yuan more than the deductible of health insurance, which is 1.5 million yuan. At this time, Zhao Yan Health Insurance will no longer calculate out-of-pocket expenses when reimbursing out-of-pocket hospitalization expenses.

Then, the reimbursable amount of Zhao Yan medical insurance = (70,000-27,500) × reimbursement ratio 70% = 29,750.

Then, the cumulative reimbursable amount of out-of-pocket hospitalization expenses is 27500+29750 = 57250.

To sum up, the total reimbursable amount is (45,600+57,250 =102850) if the health insurance is insured at the same time.

Hebei Huimin Insurance: Which is better, Hebei or Health Insurance? Can we buy them together?

Special reminder:

The case is based on hypothetical data and is for reference only, subject to the actual reimbursement amount;

Cases are for reference only, and the final reimbursement amount is different for different diseases and different expenses;

First, use the discipline to reimburse, and at the same time, let the corresponding insurance company issue a claim split sheet, and then submit the relevant information to the health insurance underwriting company for claim settlement.

How can I put it? If you are a medical insurance participant in Hebei province, especially those who are diagnosed with specific diseases, you really don't have to worry about buying health insurance or health insurance. Add them up to 198 yuan/year, and you can buy them all!

So far, which do you think is better than health insurance?

Finally, a cliche, and then reiterate the insurance advice:

The health status can pass, the budget allows, the occupation and age match, and there is no previous illness exemption. It is recommended to choose the regular million medical insurance first, especially for children and adolescents.

Not to mention many problems such as small reimbursement amount, narrow reimbursement scope and high deductible, the key lies in the stability of renewal. At present, the conventional million medical insurance can be renewed for 20 years, and Huimin insurance is not renewed. Many cities have lost it last year.

If there are two exclusive Huimin insurances in the local area, it is recommended to buy both, learn from each other's strengths and offset each other's deductibles.

Admittedly, this is a good policy to protect the people, and it has indeed helped many families to alleviate some of the pressure, but it is really not a long-term solution.

Please leave me a message for more questions ~

The author declares that there is no interest relationship in this article, and welcomes the rational exchange and harmonious discussion of value friends ~

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