However, I hope you can understand the insurance liability and payment rules before making a decision, instead of buying it just because it is cheap.
Let's see if Shenyang Shengjingbao is worth buying through the six issues that everyone is most concerned about.
1 What is the positioning?
Who can buy it?
3 What is security?
How much can I reimburse?
5 where to reimburse?
6 who is suitable for buying?
First, what is the positioning? Shengjingbao is the exclusive Huimin insurance for the insured of Shenyang basic medical insurance. Its essence is still commercial insurance, which is guided by Shenyang Medical Insurance Bureau and jointly underwritten by nine insurance companies.
No matter which city's Huimin insurance, including Shenyang Shengjingbao, its positioning is to solve the large medical expenses of families. Please note that it's a "large sum", not that you spent 35000 or even 350000 on reimbursement.
After all, every year 1 15 yuan, it's a bit unrealistic for you to expect it to reimburse everything.
Let me show you the price difference of different deductibles of this medical insurance:
If you want to spend 1 yuan for reimbursement, you can buy medical insurance of 00,000 yuan without compensation, but the price is also more expensive.
Therefore, only when we have a clear positioning of the local people, can we look at it objectively, not polarized: either we buy it for the sake of cheapness, or we think it is useless at all.
Second, who can buy Shengjingbao? Knowing the positioning of Shenyang Shengjingbao depends on who can buy it.
Shenyang Huimin Insurance "Shengjingbao" follows the principle of four unlimited insurances, namely, no age, no occupation, no household registration, no health status, no sex, no age and no age, and the unified price is 1 15 yuan per person per year.
The only requirement: it must be the insured person of basic medical insurance in Shenyang and the insured state, including medical insurance in Liaoning Province, medical insurance for urban workers in Shenyang and medical insurance for urban and rural residents in Shenyang (including the new rural cooperative medical system).
3. What does Shengjing promise? I made a relatively intuitive description of Sheng Jingbao's insurance liability. You can take a closer look or save it in your mobile phone and study it again.
What expenses can be reimbursed and how much can be reimbursed are clearly stated in the picture. Be sure to look at the picture carefully, or carefully check the relevant introduction of the insurance interface before insurance.
Don't buy it just for the sake of cheap. As a result, if you don't reimburse, you will think that insurance is a lie.
There are four points for attention about Shenyang Huimin Insurance "Shengjingbao":
1. There is no waiting period, but the contract takes effect at 0: 00 on July 16, 2022, and medical expenses incurred before the effective date cannot be reimbursed.
2. Before the contract comes into effect (before 0: 00 on July 16, 2022), you can still participate in the insurance, but the related medical expenses in the later period will not be reimbursed.
3. Look at the scope of reimbursement, not all medical expenses can be reimbursed.
4. Three responsibilities * * * enjoy a deductible of 30,000 yuan. After medical insurance reimbursement, the part exceeding 30,000 yuan can be reimbursed by 60% of the total amount.
4. How much can Shengjingbao reimburse? In order to better understand how Shenyang Huimin Insurance "Shengjingbao" is reimbursed, let's give a simple example.
Special reminder: please read this part carefully, or you will never know how much Shengjingbao can reimburse!
Ms. Y, a medical insurance participant of Shenyang residents, joined Shenyang Shengjingbao in June 2022. After the policy came into effect, Ms. Y was hospitalized in a 3A hospital in Shenyang for breast cancer (non-specific past diseases), with a total cost of 400,000 yuan, medical insurance and critical illness insurance reimbursement of 6.5438+0.8 million yuan, and the remaining 220,000 yuan was reimbursed.
Step 1: How is the remaining 220,000 constituted?
The details of the assumptions are as follows:
Out-of-pocket expenses of inpatients in the medical insurance catalogue: 40,000 out-of-pocket expenses of inpatients in the medical insurance catalogue: 60,000 designated pharmacies to buy specific drugs for breast cancer:1.20,000 Step 2: How much will the remaining 220,000 be reimbursed?
According to the reimbursement rules, three responsibilities * * * enjoy 30,000 deductibles, then:
Reimburseable amount = (40,000 out-of-pocket expenses of inpatients in the medical insurance catalogue+60,000 out-of-pocket expenses of inpatients outside the medical insurance catalogue+65,438,002 yuan for purchasing high-value drugs in designated pharmacies-30,000 yuan for deductible) × reimbursement ratio 60% = 1 1.4 million.
Of course, this does reflect the shortcomings of Huimin insurance such as Shenyang Shengjingbao: narrow reimbursement scope, high deductible and low reimbursement ratio.
PS: Please refer to the relevant contents of the insurance interface for the detailed protection scheme, and the reimbursement amount shall be subject to the actual situation. The above cases are for demonstration only, not as a basis for claim settlement.
5. Where to reimburse? Shenyang Huimin Insurance "Shengjingbao" supports online and offline claims, which is also very convenient.
1. Apply online
The claimant applies for self-service through the designated platform, truthfully fills in relevant information as required according to the prompts in the operation interface, and takes photos to upload the claim data, which should be clear pictures.
Designated platform: official account of "Shengjingbao" WeChat
Acceptance time: 365*24 hours service.
2. Offline applications
Claims applicants need to prepare claims materials in advance as required, and bring claims materials to designated outlets to submit applications within the acceptance time.
Designated outlet: Liaoning Branch of Taiping Endowment Insurance Co., Ltd.
Address: Floor 5, Fiona Fang Building 1No. Yue Bin Street, Shenhe District, Shenyang, Liaoning.
Acceptance time: every Monday to Friday from 9:00 am to 1 1:30, and in the afternoon from 13:30 to 17:30, except for national holidays.
Special reminder:
1 Keep original medical data. It is recommended to copy and keep a copy of the claim information.
2 Because the medical expenses of the provincial medical insurance participants need to be settled in the provincial medical insurance center in advance, the online application method is not applicable, and only the offline application method is applicable.
6. Who is suitable for producing refined treasure? What is certain is that people who are healthy and can buy millions of regular medical insurance should not join in the fun and take advantage, especially young people and children.
Huimin insurance in any city, including Shenyang Huimin Insurance "Shengjingbao", is actually more suitable for the following three types of people:
1. Elderly people
It is very expensive for these people to buy regular million medical insurance. The key is that they may not get health advice, so buy a Shengjing insurance first.
2. People who have been seriously ill
These people have basically bid farewell to conventional commercial insurance, but Shenyang Shengjingbao has no health notice, but some past diseases will not be reimbursed.
In other words, even if serious diseases such as cancer have been diagnosed, they can still be purchased, but the follow-up medical expenses caused by cancer cannot be reimbursed, and other diseases are not affected.
3. Excluded underwriting population
For example, if you buy insurance for common diseases such as hypertension, pulmonary nodules, thyroid nodules, breast nodules and hysteromyoma, it will generally be excluded, that is, related medical expenses cannot be reimbursed.
In this case, you can make up a Shengjing insurance, and the above diseases are still within the scope of reimbursement, just in case.
To sum up, it depends on whom you buy Shenyang Huimin insurance "Shengjingbao".
Once again, the positioning of Huimin insurance such as Sheng Jingbao is to deal with large medical expenses. Please note that it is big, big, big and important to say it three times.
Anyway, I hope you will carefully look at how it is reimbursed before buying it, rather than buying it for the sake of cheapness.