"Huimedicare" official background: in order to implement the "Central Committee of the State Council on deepening the reform of the medical security system" (Zhongfa [2020] No. 5) and "Huizhou Municipal Party Committee of Huizhou Municipal People's Government issued" on the promotion of traditional Chinese medicine inheritance of innovative development of the implementation of the program "of the notice (Huizhou Municipal Party Committee Fa [2020] No. 1) of the spirit of the document, after the Huizhou Municipal Government agreed to the Huizhou Municipal Bureau of Medical Protection, Huizhou Municipal Bureau of Health, Huizhou Municipal Bureau of Financial Work and Huizhou Banking and Insurance Supervision Bureau of the joint guidance of the four government agencies to launch the "Huimedicine insurance" program, on the origin, it is the proper root of the seedling red.
What is the product?
"Huiminao" is a universal health insurance supplement product for all Huizhou basic medical insurance participants (including employees, residents (including the former New Agricultural Cooperative)), and is highly integrated with the current basic medical insurance system in Huizhou. Compared with other commercial insurances, "Huiminao" has the following advantages:
1, government-led and reliable: the roots of the government-led continuity, do not have to worry about the product suddenly discontinued;
2, out-of-pocket expenses are fully covered: hospitalization costs are fully covered during the period of out-of-pocket expenses, out-of-pocket expenses, out-of-pocket expenses can be reimbursed; Not subject to the limitations of the medical insurance catalog.
3, comprehensive coverage starting low: in addition to bear the hospitalization costs, but also bear the specific outpatient, rare diseases, traditional Chinese medicine "treatment of disease" and other responsibilities, such as health insurance policy outside the out-of-pocket expenses of more than 12,000 can be reimbursed.
4, health insurance account to protect the whole family: employees health insurance account in addition to their own insurance, but also for up to seven relatives to buy together; equivalent to "zero cash" insurance.
5, no health limit, no age limit: you can enroll and pay out even if you are already sick; there is no age limit. The first guarantee: Individual Out-of-Pocket Partial Guarantee (within the medical insurance policy): After reimbursement of hospitalization medical expenses and specific outpatient medical expenses by the current medical insurance system in Huizhou City, the part of out-of-pocket expenses exceeding 10,000 yuan will be reimbursed at 95%, with a maximum limit of 1 million yuan in a year (for details, please refer to Reimbursement Rules on the enrollment page).
The second guarantee: Individual deductible and out-of-pocket expenses (outside of the medical insurance policy): the deductible and out-of-pocket expenses paid by the individual are reimbursed in a stepwise manner by segments, with a maximum limit of 1 million yuan a year (for details, please refer to the Reimbursement Rules on the enrollment page).
The other four additional benefits are:
1. Rare disease patients' medical protection
2. Traditional Chinese Medicine (TCM) "treatment of future illnesses" featured protection
3. Nursing care services for patients with specific illnesses
4. Care and protection for children under the age of 6 years:
4. For those who incur outpatient medical expenses at the designated general outpatient medical institutions selected by their guardians, outpatient medical expenses incurred after exceeding the annual payment limit of the outpatient medical insurance fund will be reimbursed at 55%, with a single-time limit of RMB 70 yuan and an annual cumulative limit of RMB 500 yuan (Treasure Parents, don't you act fast yet?). The outpatient medical expenses are reimbursed at 55% of the annual payment limit.
How can I get reimbursed under the "Wai Medical Insurance"?
What we want is for everyone to be safe and not to get sick or have accidents. "There are two ways to get reimbursed, one-stop service and sporadic reimbursement.
1. "One-stop" service: Where eligible for reimbursement of participants, hospitalization and specific outpatient medical institutions in Huizhou City or outside the city health insurance designated medical institutions is required to pay the individual first, participants do not need to submit paper information, the joint contractor based on the relevant data of the health insurance settlement system to provide The joint contractor will provide "one-stop" service based on the relevant data of the health insurance settlement system, and pay the reimbursed medical expenses of "Huimedian Insurance" directly to the financial account or bank account of the health insurance card of the participant or guardian. There is no need for participants to apply separately, which saves effort. (The system is currently being upgraded and is expected to be completed in April.)
2. Sporadic reimbursement: Sporadic reimbursement is the traditional reimbursement method of preparing materials and applying for reimbursement from the insurance company. This kind of reimbursement applies to special cases that do not qualify for the "one-stop" service, as well as cases where the "one-stop" service is not yet on-line but reimbursement is needed. For more information, please refer to "Huizhou Huimedian Insurance" public number - Personal Center - Reimbursement Rules.