Health insurance case
Last year, at the suggestion of a friend, Ms. Qin from Beijing bought an insurance policy with a coverage of 20,000 yuan. In May of this year, Ms. Qin spent 25,000 yuan on medical expenses when she was hospitalized. According to the insurance payment ratio, she can get 17780 yuan from the insurance company. However, because she has already reimbursed the medical expenses of 18800 from social security. Therefore, the insurance company only compensated her for the difference between actual expenses and reimbursement expenses, 6200 yuan. This makes Ms. Qin very unacceptable. After communication, she learned that health insurance is divided into two types: expense type and subsidy type. Which insurance company is stronger? I just sorted out the relevant content, hoping to help you: the latest list! Top Ten Insurance Companies in China
First, the type of expenses. The insurance company will pay compensation according to the proportion stipulated in the contract and the total amount on all medical expenses documents of the insured. If the social security has been reimbursed, the insurance company can only make up the difference according to the principle of insurance compensation.
Second, the subsidy type. Also known as subsidized medical insurance, if the insured's income is interrupted or reduced due to accidental injury or illness, the insurance company will provide compensation for it. Generally speaking, it is an insurance that the insurance company pays to the insured according to the subsidy standard stipulated in the contract, no matter how much treatment expenses the insured actually spends or whether it is reimbursed through social security.
In this case, because Ms. Qin bought commercial medical insurance with fees, she could only get the difference after social security reimbursement. If the insured is subsidized commercial medical insurance, Ms. Qin will receive 20,000 yuan compensation regardless of whether the medical expenses are reimbursed through social security. For the strategy of medical insurance reimbursement, I just sorted out the relevant contents, hoping to help you: how to use social security medical insurance? 1. Teach you how to apply for reimbursement!
Therefore, I suggest that when you apply for health insurance, you must consult the business personnel about what kind of products you are insured.
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