Is there really such a product? In fact, ah, there is this function of the product is medical insurance, but there is no product is able to reimburse all the expenses, medical insurance is already a very good insurance product, the cost is low, the coverage is high, of course, reimbursement is also subject to certain limitations.
Today, we will talk to you about medical insurance products.
A. What is medical insurance? What's the difference between it and social security?
Medical insurance, simply put, is medical expense reimbursement insurance, within a limited scope, the actual reimbursement of your medical expenses.
Because medical insurance is reimbursement-based, how much the insurance company pays out depends on how much you actually spent, and the amount paid out will not exceed the cost of treatment.
Because social security has a starting line, below a certain amount, can only be completely out of pocket, there is also a certain limit on the proportion of benefits, the proportion of benefits outside the part, you need to bear the reimbursement of the amount of limitations, can only help us solve the problem of basic medical expenses. It simply can't do anything to make us go to the doctor without worries.
So, in order to avoid the risk of illness, social security + commercial medical insurance is the best choice.
Commercial medical insurance is a supplement to social health insurance, most commercial medical insurance is characterized by low premiums and high protection, and it is a type of insurance that people insure more widely.
What does medical insurance cover?
General medical insurance mainly covers the general medical expenses of the insured for treatment of diseases, mainly including outpatient expenses, medical expenses, examination costs. This type of insurance has lower premiums and is more suitable for families with an average income.
Because of the difficulty of controlling the expenditure on medicine and checkups, this type of policy also generally has a deductible and proportional benefit provision, whereby the insurer pays a certain percentage (e.g., 80%) of the portion above the deductible, and the cost of the insurance is renewed once a year. The insurer is no longer liable for costs incurred for each illness that exceed the sum insured in the aggregate.
The deductible is an amount that the insurer will not pay if the treatment does not cost more than this amount. If the total amount of multiple payments exceeds the insured amount, the insurance policy is no longer in effect, and the insurer will not pay for any further insurance coverage.
The content of the hospitalization medical insurance is that the cost items of the hospitalization insurance are mainly the cost of the hospital room per day, the cost of the doctor's treatment during the hospitalization, the cost of using the hospital's equipment, the cost of the surgery, and the cost of the medicine, etc. The length of the hospitalization will directly affect the cost of the hospital room. The length of hospitalization will directly affect the cost.
Therefore, the amount of coverage for this type of insurance should be based on the average hospitalization cost of the patient. In order to control unnecessarily long hospitalization, this type of policy usually stipulates that the insurer will only be responsible for a certain percentage of all the costs, which means that the full cost will not usually be reimbursed.
In short, as an insurance policy that we often come into contact with, commercial medical insurance should still focus on its coverage when taking out a policy to see what it covers and what it doesn't, after all, each type of commercial medical insurance is different.
Three, what are the categories of medical insurance?
Based on the different levels of benefits, medical insurance on the market today is divided into four main categories: general medical insurance, million dollar medical insurance, interruption medical insurance, and high-end medical insurance.
1, general medical insurance
Low coverage (1-50,000), low deductible (from 0 to several hundred), mainly to solve the problem of some common minor hospitalization medical expenses, ordinary minor hospitalization, accidental hospitalization, self-payment of medicines, outpatient expenses can be reimbursed through the general medical insurance.
These products are more suitable for preschool children with poor resistance or those who don't want the trouble of reimbursement from other places, and adults with poor resistance.
2, million medical insurance
The insurance amount is high, ranging from several million, the deductible is also high, about 10,000. In terms of reimbursement, hospitalization costs can be reimbursed if they exceed the deductible, and there is generally no limit to the type of disease, the extent of the disease, or the mode of treatment.
Suitable for people: children, adults, the elderly can be insured, the annual premium is only 200-300 yuan.
3. Mid-range medical insurance
The coverage is high, ranging from a few million dollars, and the premiums are expensive, ranging from a few thousand to a few tens of thousands of dollars, with a low deductible. The scope of reimbursement can be expanded to some designated private hospitals, and will also provide direct payment services. The main focus is on solving the front-end experience of seeing a doctor, as well as the problem of access to medical resources.
Suitable for: middle-class families who value public hospitals for their specialty care and are financially sound.
4. High-end medical insurance
There is no upper limit to the amount of coverage, and premiums are also expensive, with a deductible of 0 or 25,000 yuan, providing quality medical services. At present, there is no good high-end medical insurance in mainland China, and you need to go to Hong Kong to buy it.
Suitable for: elite people and high net worth people who emphasize on medical experience.
Four, medical insurance how to configure?
After understanding the characteristics of various types of medical insurance, the next question is how to configure it.
For different groups of people, "different insurance + medical insurance" can be configured in this way:
1, the basic package A = million medical insurance + accident insurance: suitable for low budget, healthy young groups.
2, the basic package B = million medical insurance + general medical insurance: double complementary and non-conflict medical insurance, suitable for people with special protection needs.
3. Standard Package C=Package A/B+Critical Illness Insurance+Term Life Insurance: Standard adult protection configuration.
4. High-end Package D = Standard Package C + High-end Medical Insurance: Suitable for high-income groups with sufficient budgets who want comprehensive protection and quality services.
5, special package E = cancer medical insurance + million medical insurance: suitable for people who have exceeded the age of insurance or have special protection needs.
Fifth, the purchase of medical insurance considerations
There are a variety of medical insurance products on the market, you need to pay attention to these points when selecting a medical insurance:
1, the content of the coverage
General medical insurance, will contain the following basic protection: general hospitalization, special outpatient, outpatient surgery and hospitalization The first thing you need to know is that you are not going to be able to get the best out of it.
While we all have these basic protections, the coverage or limitations may be very different:
Hospitalization days: some products do not have a limit on the number of days of hospitalization, while others require that the annual reimbursement of hospitalization expenses not exceed 180 days;
Special outpatient services: individual products will set an annual limit on special outpatient services, such as not exceeding 20% of the basic sum assured;
So, you can choose the best medical insurance for your needs, and the most important thing is to make sure that you have the best coverage.
So, when choosing a medical insurance policy, don't just look at the promotional page that says "hospitalization expenses can be reimbursed", "special outpatient can be reimbursed" and so on, but also click on the product terms and conditions to see if there are any relevant restrictions.
2, deductible
This depends on the individual situation, if they can own part of the risk, you can consider 10,000 deductible or even higher. If the anti-risk ability is low, hope to maximize the coverage of risk, you need to choose a low deductible products.
There is also a situation where children want to buy health insurance products for their elderly family members, and the main demand is that when there is a large amount of medical expenses, there is part of the financial compensation.
3, renewal conditions
The best choice is to have a guaranteed renewal clause of the medical insurance products, note that is "guaranteed renewal", rather than the promotional page said that "can be renewed to the age of 99/100 years".
Now there are a few products that can be renewed for 5-6 years, during which time, whether or not you are sick, whether or not you have made a claim, whether or not the product is discontinued, it will not affect the renewal of the insurance policy, and the premium will not increase.
4, value-added services
In addition to the basic protection, medical insurance may also be attached to a very large number of value-added services.
The more practical value-added services: expense advances, reimbursement of purchased medicines, green channel for medical treatment, etc., you can pay attention to and compare this part of the content.
Lastly, the risk is unpredictable, a serious illness can empty our decades of savings. Instead of selling your house and car when the time comes, you should choose the right insurance in advance. In case something unfortunate does happen, it will also give you more confidence in the face of huge medical bills.
To choose the right medical insurance for yourself, you must find a professional insurance broker to provide services to yourself and configure the most suitable medical insurance for yourself, you can search for Baibaojun in Baidu, Baibaojun platform has screened the country's best insurance brokers.