Fewer restrictions mean a wider scope of compensation, and correspondingly more expensive premiums. Do not easily trust the insurance benefit demonstration form and insurance plan proposal prepared by the insurance company. It is best to read the insurance terms carefully. Because there is a certain gap between the insurance benefits and exclusions conveyed by some very tempting insurance benefit presentation forms and the insurance clauses that customers finally get.
Most high-end medical health insurance plans have detailed sub-limits for various medical expenses. Generally speaking, the more sub-limits, the clearer the risks locked by the insurance company, and the more inconvenient it will be for the insured to use the insurance. The costs of medicines, examinations and treatments in mainland China are roughly divided into two categories. One category is reimbursed or partially reimbursed by the social security co-ordination fund; the other category is the part that needs to be paid for out of pocket.
Usually, high-end medical and health insurance no longer differentiates between social security catalogs and non-social security catalogs for medical expenses, but breaks through the social security restrictions, so that the insured no longer needs to consider the constraints of social security when seeking medical treatment, and can focus on treatment. High-end medical health insurance will also distinguish between outpatient and inpatient costs. Generally speaking, if the insurance has too many restrictions on outpatient medical expenses, the premium level should be much lower than if there are no restrictions. Excessive medical treatment is a chronic disease of the modern medical industry. Some people say that the US financial crisis did not start with real estate subprime mortgages. The real root cause is the government's overwhelming burden on medical expenses. Due to the lack of an independent third party, no one is questioning and checking the excessive medical treatment of hospitals. Excessive medical treatment not only costs patients more money, but may also cause irreversible physical and psychological effects on patients. With the help of a professional team of doctors, insurance companies have the basis to question and balance hospital medical practices from the perspective of reasonably controlling claims.