First, improve the level of security on the basis of "basic security"
Social basic medical insurance is not accounted for, but reimbursed according to a certain proportion, and the reimbursement ratio is only maintained at the level of basic security. Therefore, the "basic guarantee" of social basic medical insurance leaves more guarantee space for commercial health insurance. For example, commercial health insurance can reimburse the proportion of individual self-payment, the medical expenses that exceed the social security ceiling line (including the individual self-payment below the outpatient and inpatient qifubiaozhun), as well as the proportion of the overall fund that needs individual self-payment, and the proportion of large outpatient and inpatient medical expenses that needs individual self-payment according to the insurance liability.
Second, "wide coverage" applies to the floating population.
The insurance of commercial insurance follows the principle of equivalent exchange of "more investment and more insurance, less investment and less insurance, no investment and no insurance", and follows the risk transfer contract between individuals and commercial insurance companies. The agreed responsibilities and obligations do not change with the personal time and space transfer, employment relationship and household registration. In changing the contract details, commercial health insurance is more portable than the entry and exit procedures related to social basic medical insurance.
Third, commercial attributes help to achieve "sustainability"
Commercial health insurance has the commercial attribute of realizing profit, and pursues the coordination and optimization of commercial benefits and social benefits in its development. Therefore, cost management helps the relevant government departments to solve the problem of large financial expenditure in the current social basic medical security system. Mainly manifested in: commercial health insurance has professional actuarial data analysis and risk management and control capabilities. Compared with ordinary life insurance, health insurance combined with specialized health management services can collect the basic data of health insurance more comprehensively, and formulate different rate standards according to different levels of risk factors.
Fourth, the service quality and level have comparative advantages.
Under the background of the new medical reform policy, people's medical expenses can be partially compensated, and the demand for health protection and management is stronger. At present, the main health management methods of commercial health insurance include: pre-diagnosis health guidance (including health consultation), health examination service (including health risk assessment), family doctor in treatment, disease management (including chronic disease management), convenient treatment service (including green channel for diagnosis and treatment), post-treatment rehabilitation nursing service and third-party management service. Through the above health management means, for customers, the incidence of diseases can be reduced and the quality of life can be improved.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.