With the vigorous implementation of the country and the popularization of medical insurance, urban residents are fully covered. As a kind of social insurance, medical insurance is very important to people. However, when we buy medical insurance, we should pay attention to the compensation scope agreed in the medical insurance contract, so as to better choose the medical insurance that suits us.
First, within the deductible, medical insurance does not pay.
For some low medical expenses, insurance companies generally adopt deductible clauses. Take Allianz as an example. Except for some medical insurance products, which have no deductible, the rest basically have the deductible of 100~ 150 yuan. In other words, medical expenses below this amount cannot be claimed. This provision, which allows the insured to bear a small amount of risks, makes the premium cheaper.
Two, medical insurance deductible items
1, service project class. Registration fee, medical record fee. Consultation fee, home visit fee (including family sickbed patrol fee), expedited fee for examination and treatment, surcharge for name calling operation, high quality and good price fee, escort fee, self-invited special care fee and other special service fees.
2. Non-disease treatment projects. Various cosmetic and bodybuilding projects and some non-functional cosmetic and plastic surgery expenses. All kinds of weight loss, weight gain and height increase projects. All kinds of health checks. Various prevention and health care diagnosis and treatment projects. Various medical consultation and medical appraisal projects.
3. Medical materials. Glasses, dentures, artificial eyes, artificial limbs, hearing AIDS and other rehabilitation appliances. All kinds of self-use health care, massage, examination and treatment equipment. Implantable automatic cardioversion defibrillator (ICD). Disposable medical materials that cannot be charged separately as stipulated by the provincial and municipal price departments.
3, diagnosis and treatment equipment. Large-scale medical equipment such as positron emission tomography (PET), electron beam CT and ophthalmic excimer laser therapeutic apparatus are used for examination and treatment.
4. Treatment project. Organ source or tissue source of various organ or tissue transplants. Organ transplantation or tissue transplantation other than kidney, heart valve, cornea, skin, blood vessels, bone and bone marrow transplantation. Orthopedics of myopia. Qigong therapy, music therapy (except mental patients), health nutrition therapy, magnetic therapy and other auxiliary treatment projects.
5. others. A variety of infertility (fertility) and sexual dysfunction diagnosis and treatment projects. Various scientific research and clinical verification diagnosis and treatment projects. All expenses incurred due to fighting, alcoholism, traffic accidents, medical accidents, injury liability accidents, intentional self-injury, etc. Medical expenses incurred during going abroad and going to Hong Kong, Macao and Taiwan for visiting relatives, meetings, inspections, further studies and lectures. In addition to emergency and first aid, designated medical institutions carry out diagnosis and treatment projects beyond the scope of registered diagnosis and treatment subjects. Foreign cooperative diagnosis and treatment projects of designated medical institutions. Not included in the medical service charges stipulated by the provincial and municipal price departments.
Although medical insurance allows the insured to reimburse part of the expenses during medical treatment, not everything can be reimbursed; Medical insurance has some deductible items. When purchasing some commercial medical insurance, we must pay attention to the exemption clauses of the insurance company in the medical insurance contract and consult the insurance company in time to avoid economic losses.