1, from the scope of reimbursement:
(1) The basic medical insurance pooling fund and individual account shall delimit their respective payment ranges and be accounted for separately. Medical expenses that meet the payment scope of the basic medical insurance fund shall be reimbursed in accordance with the list of basic medical insurance drugs, the list of diagnosis and treatment items, the scope of service facilities and the payment standard stipulated by this Municipality;
(2) The difference between the critical illness insurance and the personal burden within the reimbursement scope of the insured's basic medical insurance shall be reimbursed by 75% of the critical illness supplementary medical insurance; The scope of reimbursement of serious illness medical insurance is very important, that is, the insured exceeds the maximum payment limit of the basic medical insurance pooling fund, which is in line with the personal burden within the scope of reimbursement of basic medical insurance, and the reimbursement of supplementary medical insurance for serious illness is 75%; In a natural year, the cumulative maximum reimbursement amount is 400,000 yuan.
2. Different security capabilities: The basic medical insurance is an important part of the social security system, and it is a kind of social insurance formulated by the government with the participation of employers and employees. The overall medical care system for serious illness belongs to the supplementary form of basic medical insurance.
3. From the perspective of commercial insurance, commercial medical insurance is usually a kind of insurance that is guaranteed once a year and also guaranteed for life. Critical illness insurance is divided into consumption type, return type and life-long type. Consumer-oriented insurance is paid for several years, with low cost and high guarantee, and the maximum guarantee can be realized with less money; In the case of return type, the insured amount or premium will be returned when the insurance expires. During the insurance period, there is a guarantee function, and it also plays the role of compulsory savings. When you are sick, you can play a protective role, and you can spend the insurance period safely and supplement your pension.
The difference between critical illness insurance and whole life insurance.
1. Their protection objects are different.
Critical illness insurance refers to a commercial insurance behavior that is handled by an insurance company, taking specific major diseases as the insurance object. When the insured suffers from the diseases agreed in the insurance contract, the insurance company gives appropriate compensation for the medical expenses incurred.
Life insurance is a kind of insurance with life and death as the insurance object. It is insurance in which the insured survives or dies during the insurance liability period and the insurer pays the insurance money according to the contract. Whole life insurance, on the other hand, provides lifelong protection for death or total disability, generally reaching the final life table age of 100.
2. Different compensation methods.
Critical illness insurance is generally paid first, that is, after being diagnosed with a major disease agreed in the contract, you can apply for compensation; On the other hand, whole life insurance can only apply for insurance compensation after the insured is completely disabled or dead.
3. They have different protection functions.
Generally speaking, the coverage of critical illness insurance and whole life insurance is relatively high, but the protection of critical illness insurance provided by critical illness insurance is mainly to prevent families from becoming poor due to illness; Whole life insurance, on the other hand, is mainly used to guard against the risks brought by the death of family breadwinners, or to inherit family wealth.
Extended data
Divided by the insurance period
time/fixed term insurance
Give priority to the protection of serious illness and give protection within a certain period of time. Generally, the balanced premium is adopted. The maximum duration of this critical illness insurance is 30 years. If you buy it at the age of 20, you can only keep it until you are 50. If you buy it at the age of 30, you can only keep it until you are 60, not for a day. It should be noted that although this kind of insurance is the main insurance, it also belongs to the consumption type, and it is impossible to return the premium without paying the claim.
whole life insurance
Lifelong critical illness insurance provides lifelong protection for the insured. There are two forms of lifelong protection. One is to provide major illness protection for the insured until the insured dies. The other is that when the insured lives to the limit age agreed in the contract (such as 100), the insurer pays the insurance premium equal to the critical illness insurance, and the insurance contract is terminated. General life-long critical illness insurance products will include death insurance liability, so the rate is relatively high because of the high risk.
Resources Baidu Encyclopedia Critical Illness Insurance