Unlimited occupation
Unlimited household registration
"Zibo Qihuibao" is the first inclusive supplementary medical insurance in Shandong Province, and it is an innovative measure for our city to explore the implementation of multi-level medical security system. Guided by Zibo Medical Insurance Bureau, supervised by Zibo Yinbao Supervision Branch, supported by Tencent Micro-insurance, and jointly tailored by 12 Insurance Company for the people of Zibo. On the insurance threshold, "Zibo Qihuibao" has broken the insurance limit of general commercial health insurance and will be reduced.
"Zibo Qihuibao" focuses on the protection of large medical expenses, which greatly reduces the burden of patients' medical expenses. The premium is only 99 yuan a year, and you can enjoy a maximum of 2 million yuan, including 6,543,800,000 yuan for inpatient medical expenses and 6,543,800,000 yuan for outpatient specific high medical expenses. Among them, hospitalization medical insurance refers to the expenses incurred in hospitalization in the medical insurance catalogue, which are paid by individuals after the basic medical insurance. In the medical insurance catalogue, the hospitalization expenses and outpatient specific high drug insurance premiums each have an annual deductible line of 20,000 yuan, and the part exceeding 20,000 yuan is paid by 80%; Outpatient specific high drug costs are for 16 kinds of drugs, such as pure self-funded drugs outside the medical insurance catalogue, including liver cancer, lung cancer, breast cancer and other high-risk cancers.
Data expansion:
How to reimburse Zibo Qi Bao Hui?
1, claim method
After an insurance accident, you can directly apply for self-service claims in the official account of Zibo Qihuibao WeChat, or you can bring relevant claims materials to Pacific Life Insurance Service Online to apply for claims. If you encounter problems in the process of claim settlement, you can call Zibo Qihuibao's exclusive service hotline (0533-3053000) for consultation, and a customer service staff will answer your questions.
2. Description of the claim case
Mr Xi, 40, is an insured of the basic medical insurance for urban workers in Zibo. At the end of September, 2020, he joined Zibo Qihuibao. On October 2002165438 10, Mr. Xi was unfortunately diagnosed with liver cancer and was treated in a designated hospital in the city. During the treatment, a total of 729,900 yuan was spent, including 209,600 yuan for basic medical insurance and serious illness insurance reimbursement, and the remaining 520,300 yuan. The reimbursable expenses of Qi Bao Hui are:
(1) Hospitalization medical expenses: (32,200 yuan+286,500 yuan-20,000 yuan deductible) * 80% = 238,900 yuan.
(2) Specific drug cost: (2010.6-20,000 deductible) * 80% =10.452 million yuan.
During the treatment period, Mr. Wang incurred medical expenses of 729,900 yuan, including medical insurance and critical illness insurance reimbursement of 209,600 yuan and reimbursement of 3.8410.000 million yuan, and Mr. Wang only had to bear10.362 million yuan in the end.