What is "Bao Hui Insurance"?
"Hui Medical Insurance" is an inclusive medical insurance supplementary product aimed at the insured persons (including employees and residents (including the former new rural cooperative medical system) of Huizhou, which is highly connected with the current basic medical insurance system in Huizhou. Compared with other commercial insurances, Bao Hui has the following advantages:
1, the government-led can be trusted: rooted in Hong Miao, the government-led has continuity, and there is no need to worry about the sudden suspension of product sales;
2. Full coverage of out-of-pocket expenses: all expenses during hospitalization are covered, and both out-of-pocket expenses and out-of-pocket expenses can be reimbursed; Not restricted by the medical insurance catalogue.
3. Ensure a low overall deductible: in addition to hospitalization expenses, it also undertakes the responsibility of specific outpatient clinics, rare diseases and "preventing diseases" in Chinese medicine. For example, if the out-of-pocket expenses outside the medical insurance policy exceed 6.5438+0.2 million, they can be reimbursed.
4. Medical insurance account saver: employees' medical insurance accounts can not only insure themselves, but also be purchased by up to 7 relatives; Equivalent to "zero cash" insurance.
5, no health restrictions, no age restrictions: you can also participate in insurance or sickness compensation; there is no age limit. The first guarantee: partial guarantee of the individual out-of-pocket ratio (within the medical insurance policy): after the hospitalization expenses and specific outpatient medical expenses are reimbursed by the current medical insurance system in Huizhou, 95% of the out-of-pocket expenses exceeding 6,543.8+million yuan will be reimbursed, with an annual maximum limit of 6,543.8+million yuan (see the reimbursement rules on the insurance page for details).
Second guarantee: individual self-funded part and self-funded part (outside the medical insurance policy): the self-funded part and self-funded part of hospitalization expenses are reimbursed by stages, with a maximum annual limit of 6,543.8+0,000 yuan (see the reimbursement rules on the insurance page for details).
The other four additional safeguards are:
1. Medical security for patients with rare diseases
2. The characteristic guarantee of "preventing disease" in traditional Chinese medicine.
3. Nursing services for patients with specific diseases
4.6 Care and protection for children under the age of 6: The insured under the age of 6 will be reimbursed 55% for outpatient medical expenses incurred in the designated general outpatient medical institution selected by his guardian, which exceeds the annual payment limit of the outpatient medical insurance fund, with a single limit of 70 yuan and an annual cumulative limit of 500 yuan (parents, don't act quickly? )。
How to reimburse "Bao Hui Insurance"?
In other words, we certainly hope that everyone will be safe, not sick and not having an accident. At present, there are two reimbursement methods for "medical insurance", namely "one-stop" service and sporadic reimbursement.
1. "One-stop" service: All insured persons who meet the reimbursement conditions need to pay in advance when they are hospitalized in medical insurance designated medical institutions in Huizhou or outside the city. The insured person does not need to submit paper materials, and the joint undertaking company will provide "one-stop" service according to the relevant data of the medical insurance settlement system, and directly pay the medical expenses reimbursed by "Bao Hui" to the financial account or bank account of his guardian's medical insurance card. There is no need for the insured to apply separately, which saves worry and effort. (At present, the system is being upgraded urgently, and the transformation is expected to be completed in April. )
legal ground
People's Republic of China (PRC) social insurance law
Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.
Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.