Difference between social security and commercial major medical insurance
Major disease insurance is to protect the risk of catastrophic expense payment brought by certain major diseases to the patient, once the insured person is diagnosed to suffer from one of the major diseases defined in the contract, a lump-sum payment of insurance amount will be made immediately to alleviate the financial pressure on the patient and his/her family from the huge medical expenses incurred by the major diseases.
Prior to the 1990s, China implemented a publicly-funded health care system, the state is a big deal, after the 1990s, the country implemented social health insurance, medical care has become a part of the state to bear a part of the individual's reimbursement model, social security reimbursement of the catalog of medicines within the treatment costs of the two sides **** with the same, and outside the social security directory (including imported medicines, equipment) is completely by the individual to bear, and for a lot of For many families can not afford the insurance for major illnesses due to social security reimbursement ratio is relatively low, so families can only be supplemented by commercial insurance.
Social security insurance is a reimbursement type (according to the amount of money spent to report), that is, if a family member suffers from a serious illness, he or she must first come up with the money to see the social security system according to our medication and treatment, and remove the part of the personal commitment and imported drugs, equipment, and other parts of the final remainder of the money will reach us in the hands of the social security system, according to the amount of money to remove the part of the out-of-pocket expenses, the major medical reimbursement is generally about 100,000 yuan.
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Commercial insurance for major illnesses generally belongs to the early payment type, in short, according to the amount of compensation, for example, a person purchased a 200,000 amount of commercial insurance for major illnesses, if you suffer from a major illness, regardless of whether the ill person is spent 10,000 or 1 million, the insurance company will be based on the amount of money purchased at the time of a one-time payout, buy 200,000 on the 200,000 payout (not based on the number of money spent on the report), the payout will only need a doctor's certificate of diagnosis and cases. Need a doctor's certificate of diagnosis and cases and other information can be, at present, China's insurance company claims faster, the average is 30 days, while other countries and regions average 42 days, compared with other markets, China's overall claims experience does not show any bad state, or even slightly better.
When it comes to medical insurance, we need to talk about outpatient and hospitalization. Social security outpatient and hospitalization insurance does not distinguish between accidents and illnesses, and reimbursement is the same, while commercial insurance for outpatient and hospitalization is divided into accidental cases and disease cases.
The first outpatient, the current domestic provinces and cities on the outpatient reimbursement standards are not quite the same, Beijing is currently the starting line of 1800 to 20,000 reported 70%, visible part of the outpatient we still have to pay out of pocket. Commercial insurance outpatient insurance, at present, mainly for accidental outpatient (knocking, touching, animal to injury.). Is a good supplement to social security outpatient, for disease outpatient commercial insurance is currently very little, even if there is some cost is very expensive, cost-effective, we can not consider!
Then say hospitalization, due to social security hospitalization reimbursement ratio has been very high, Beijing starting 1300 minimum reported to 87%, so if a small amount of hospitalization, they bear less, so do not have to buy a very high amount of commercial hospitalization insurance, to do a complementary can be, if you can report some of the imported drugs hospitalization supplemental insurance is better. In addition, buy hospitalization insurance allowance insurance must be purchased, similar to the lost wages, live in the hospital one day pay one day's salary.
For supplemental medical insurance, many units are now given to employees on the, is for social security can not reimburse part of the compensation, there is this protection of the people, commercial insurance, accidental medical and hospitalization compensation insurance feel can be omitted, because in the same amount can not be repeated reimbursement.
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