What is the guarantee of "Beijing Pratt & Whitney Health Insurance" in which Beijing citizens actively participate? Who can buy it? How do new citizens participate in insurance?
The reporter sorted out some hot issues that everyone cares about.
1.Who can participate in Beijing Pratt & Whitney Health Insurance in 2023?
1. Insured people closely connected with Beijing's basic medical insurance: insured people in the state of Beijing's basic medical insurance (basic medical insurance for urban workers and basic medical insurance for urban and rural residents); Second, this year's expansion of the insured population: the specific population managed by the Beijing Municipal Health Insurance Bureau and other relevant government departments, and the new citizens of Beijing who have Beijing household registration or Beijing residence permit and have participated in basic medical insurance in different places.
Which new citizens in Beijing can participate in the insurance? How to participate in insurance?
New citizens in Beijing who have Beijing household registration or Beijing residence permit and have participated in basic medical insurance in different places can participate in the insurance. New citizens who meet the insurance conditions can pay attention to the official account of the official designated insurance platform "Beijing Pratt & Whitney Health Insurance" WeChat WeChat. Click on the menu bar at the bottom of the homepage to join the insurance immediately, fill in the information of the insured and the insured according to the prompts, read the "Notice of Insurance" and "Important Tips" carefully, select a new citizen when confirming your identity, and click OK.
Whether it is a courier brother who works hard in Beijing, a network car master, or grandparents who come to Beijing from other places to bring grandchildren, as long as they hold a Beijing residence permit and have medical insurance in different places, they can also apply for the "Beijing Pratt & Whitney Health Insurance" in 2023.
3. How do individuals participate in Beijing Pratt & Whitney Health Insurance?
Beijing residents can pay attention to the official WeChat account of the officially designated insurance platform "Beijing Pratt & Whitney Health Insurance". On the homepage of WeChat official account, click the insurance entrance in the menu bar at the bottom, and fill in the relevant information according to the prompts, so you can quickly apply for insurance online. You can also search for "Beijing Pratt & Whitney Health Insurance" online in Alipay, or you can apply for insurance through professionals from six insurance companies. The enrollment period ends at 65438+ February 3, 20221,and the guarantee period is from 20231October 65438+to February 3, 20231.
4. Can I use the balance of medical insurance account to pay the premium of "Beijing Pratt & Whitney Health Insurance"?
Sure! Beijing employees' medical insurance participants can use the balance of medical insurance accounts to insure themselves; From 12 and 1, after the medical insurance account is filed (which can be handled on the medical insurance service platform or the medical insurance agencies in various districts), the balance of the medical insurance account can be used to pay the spouse, parents and children who can enjoy the basic medical insurance benefits in Beijing, and one person can pay the whole family.
Last year, I insured "Beijing Pratt & Whitney Health Insurance" as a healthy population, and I was diagnosed with a specific past disease during the protection period. Can I still enjoy the protection of healthy people when I renew my insurance this year?
Sure! In the first year, you insured a healthy body. Even if you have a specific past disease during the insurance period, you can still get compensation according to the treatment standard of healthy people after renewal in 2023; This year, the standards for specific past diseases have also been adjusted. Diabetic patients without complications are no longer identified as specific past diseases and can be paid according to the proportion of healthy people. You can learn more about the compensation standards for healthy people/specific past diseases through the official account of "Beijing Pratt & Whitney Health Insurance" WeChat.
6. The guarantee of "Beijing Pratt & Whitney Health Insurance" bought last year has not expired. Do you want to join insurance this year?
For those who participated in Beijing Pratt & Whitney Health Insurance last year, the coverage will expire on June 5438+February 3, 2022 1, and for those who participated in Beijing Pratt & Whitney Health Insurance in 2023, they will enjoy June 65438+1October1to February 3/kloc-2023.
7. What are the contents of "Beijing Pratt & Whitney Health Insurance"?
1. Out-of-pocket liability in medical insurance (out-of-pocket medical expenses for outpatients and inpatients in the basic medical insurance catalogue): 1 the insured amount is 1 10,000/year. 2. The deductible line is consistent with the deductible amount of Beijing basic medical serious illness insurance in the underwriting year. Individuals above the deductible line of basic medical insurance and serious illness insurance pay their own medical expenses, and the payment ratio is 80% for healthy people and 40% for people with specific past diseases.
2. Self-paid liability for hospitalization outside medical insurance: 1, insured amount 1 10,000/year. 2 Deductible10.5 million yuan (deductible for previous diseases of specific population is 20,000 yuan). The proportion of payment is 70% for healthy people and 35% for those with specific past diseases. The annual reimbursement limit for a single drug is 300,000 yuan; The annual reimbursement limit for a single implant or consumable is 654.38+10,000 yuan.
The third is the responsibility of special drugs (specific drugs purchased by domestic special drugs in outpatient clinics or pharmacies of medical institutions designated by medical insurance; Foreign special drugs are treated and prescribed in designated medical institutions in Lecheng, Boao, Hainan): 1 The domestic special drug coverage is 500,000 yuan/year, the foreign special drug coverage is 500,000 yuan/year, and the total coverage is 6,543.8+0,000 yuan/year. The deductible is 0 yuan. The proportion of payment is 60% for healthy people and 30% for those with specific past diseases.
Relevant government departments, such as Beijing Medical Insurance Bureau, manage specific groups, have participated in basic medical insurance in different places, and have a residence permit in Beijing or a household registration in Beijing. The medical insurance liability of "Beijing Pratt & Whitney Health Insurance" only guarantees hospitalization, and other guarantees are the same.
8. What diseases did the specific past diseases include?
In 2023, the scope of specific past diseases agreed in Beijing Pratt & Whitney Health Insurance was adjusted. Diabetic patients are no longer recognized as specific past diseases without complications, and can be paid according to the proportion of healthy people.
In 2023, "Beijing Pratt & Whitney Health Insurance" stipulated specific past diseases including: (1) malignant tumor (including leukemia, lymphoma and carcinoma in situ) (2) liver and kidney diseases: 1 renal insufficiency: chronic renal insufficiency and chronic renal failure. ② Hepatic insufficiency: chronic hepatic insufficiency, liver cirrhosis and chronic liver failure. (3) Cardiovascular and cerebrovascular diseases: 1 Heart diseases: coronary heart disease, myocardial infarction, cardiac rupture, stroke, chronic cardiac insufficiency and chronic heart failure. Cerebrovascular diseases: cerebral embolism, cerebral infarction, cerebral hemorrhage and stroke. 3 Hypertension: Hypertension III. 4 Diabetes: Diabetes with complications. (4) Lung disease: 1 chronic obstructive pulmonary disease 2 chronic respiratory failure. (5) Other diseases: 1 systemic lupus erythematosus; ② Aplastic anemia; Ulcerative colitis
The enrollment of "Beijing Pratt & Whitney Health Insurance" is not limited to health status, and some past diseases can be guaranteed and compensated. In addition to the above-mentioned specific past diseases, people suffering from other diseases such as breast nodules, uterine fibroids and thyroid nodules can pay compensation according to the proportion of healthy people, benefiting more sick people. Pay attention to the official account of "Beijing Pratt & Whitney Health Insurance" WeChat for more details.
Citizens can pay attention to the official insurance platform "Beijing Pratt & Whitney Health Insurance" WeChat official account to insure online, or they can search for "Beijing Pratt & Whitney Health Insurance" on Alipay online, or they can insure through professional staff of six insurance companies, or they can purchase insurance through offline outlets of China Industrial and Commercial Bank, China Agricultural Bank, China Bank, China Construction Bank, Bank of Communications, China Postal Savings Bank, Bank of Beijing and Beijing Rural Commercial Bank. The enrollment period is from June 5438+February, 2022 to June 3 1 day, and the guarantee period is from June 5438+1month, 2023 to February 3 1 day.