Huimin insurance, which is now popular all over the country, originated in Shenzhen.
The predecessor of Huimin Insurance is Shenzhen Critical Illness Medical Insurance (hereinafter referred to as Shenzhen Critical Illness Insurance), which was launched by Shenzhen Medical Insurance Bureau and Ping An Pension Insurance Company on 20 15 as one of the major livelihood issues.
"All social medical insurance participants in Shenzhen, regardless of household registration, age and disease, can participate in supplementary medical insurance for serious diseases on a voluntary basis. The hospitalization expenses of the insured can be reimbursed twice. The accumulated out-of-pocket expenses of individuals in the medical insurance catalogue exceed 1 1,000 yuan, and commercial insurance companies reimburse 70%, which is not capped.
At the same time, 70% of the drugs used in Shenzhen Supplementary Medical Insurance for Serious and Serious Diseases can be reimbursed, and there is no deductible. The reimbursement limit in a medical insurance year is 6.5438+0.5 million yuan.
20 15 premium 20 yuan/person/year;
20 17 rose to 29 yuan/person/year;
20 19 rose to 30 yuan/person/year;
202 1, rising to 39 yuan/person/year.
After several years of successful trial, the second reimbursement mode of expensive drugs in medical insurance has become the initial standard mode of urban "Huimin insurance"
Following the trend of Huimin Insurance 1.0, Shenzhen launched exclusive group medical insurance in 2020, which increased the protection of "out-of-pocket expenses other than medical insurance".
"Shenzhen's exclusive medical insurance is closely linked to Shenzhen's basic medical insurance and Shenzhen's critical illness supplementary medical insurance. * * * together constitute the three pillars of Shenzhen's social medical security system, providing the most comprehensive protection for the majority of insured persons.
First, the medical insurance catalogue is fully guaranteed inside and outside, and the medical insurance covers personal expenses outside the scope of Shenzhen medical insurance payment and medical expenses borne by individuals within the scope of Shenzhen medical insurance payment;
Second, on the basis of Shenzhen Supplementary Medical Insurance for Serious Diseases 13 kinds of special drugs, 20 kinds of special drugs were added to meet the treatment needs of many major diseases;
Third, the new anti-cancer technology proton heavy ion medical expenses can be reimbursed up to 1 10,000 yuan, and the nursing allowance for radiotherapy and chemotherapy for malignant tumors is 1 10,000 yuan, which escorts cancer treatment.
Insurance premium: 365 yuan a year, renewed for three years; Six years 1998 yuan (average 333 yuan/year)
On March 3, 2023, Shenzhen introduced a new insurance system, namely Pengcheng Insurance.
"Pengcheng Insurance" covers hospitalization expenses outside the scope of medical insurance, with a maximum guarantee of 2 million yuan; At the same time, 84 kinds of specific self-funded and high-priced drugs are guaranteed, with a maximum guarantee of 6.5438+0.5 million yuan.
Premium: 99 yuan/person/year.
Here are some friends who look silly. There are three kinds of insurance for the benefit of the people in a city. Which one should I buy?
Today, Bao Ge will sort out the differences between these three products in detail, and finally give purchase suggestions.
Or go to the most intuitive comparison table first:
Analysis:
These three have something in common.
1. "No household registration, no age, no occupation", as long as they are insured by Shenzhen Medical Insurance, they can participate in the insurance;
2. The premium is "one price", regardless of age.
Three differences
1. Different requirements for previous diseases:
Shenzhen critical illness insurance has no restrictions on past diseases, and can be insured and paid.
Shenzhen's exclusive medical insurance does not cover 8 types of patients with previous diseases.
Pengcheng insurance is open to all medical insurance participants, but the medical expenses incurred by the previous five diseases will not be paid.
2. The scope of protection is different
For the self-paid part in the medical insurance catalogue for reimbursement of hospitalization medical expenses of Shenzhen critical illness insurance, the deductible line is 1 1,000 yuan, and the reimbursement ratio is 70%, with no cap; Three kinds of expensive drugs are 6.5438+0.5 million yuan;
Shenzhen's exclusive medical insurance can be covered both inside and outside the medical insurance catalogue, but the reimbursement agreement: in addition to medical insurance first, se must reimburse supplementary medical care.
(2) The expenses of 84 kinds of cancer-specific drugs can be reimbursed up to RMB 6.5438+0.5 million, and no compensation will be given. After medical insurance reimbursement, the reimbursement ratio is 100%, and the reimbursement without medical insurance is 90%. Best of all, it can reimburse 1.2 million CAR-T drugs.
3. Differences between insurance companies
Shenzhen's critical illness insurance and Shenzhen's exclusive medical insurance are jointly formulated by the medical insurance bureau and the "life insurance company" of the insurance industry.
Shenzhen's critical illness insurance is exclusively underwritten by Ping An Pension, and Shenzhen's exclusive medical insurance is underwritten by 14 company, both of which are life insurance companies or health insurance companies.
Pengchengbao is underwritten by three property insurance companies, PICC P & amp； Ampc insurance, Taiping Procter & Gamble; China Insurance and China PICC. C insurance.
Since property insurance companies can only operate one-year medical insurance, they can't promise "three-year guarantee renewal" and launch a "six-year" product similar to "Shenzhen exclusive medical insurance". Therefore, in theory, every year's renewal should be reviewed, and it may be impossible to renew the insurance if you are sick.
4. Waiting time difference
The waiting period of Shenzhen critical illness insurance is 0, and it is guaranteed for one year from 1 every year;
Pengchengbao 0 waiting period, guaranteed for one year from May 1 every year;
The waiting period for exclusive medical insurance in Shenzhen is 30 days. You can insure at any time throughout the year, and the insurance will take effect the next day.
abstract
Judging from the insurance rules, Shenzhen critical illness insurance
Pengcheng insurance belongs to "Huimin insurance" in the strict sense, because both of them can realize "unconditional underwriting" of "no age, no disease, no occupation and no household registration".
Shenzhen's exclusive medical insurance has a coverage threshold, and it is not covered for people who already have eight serious or chronic diseases.
From the perspective of coverage, the combination of Shenzhen Pengcheng Insurance's critical illness insurance is close to the ceiling of domestic "Huimin Insurance" products, which can be guaranteed both inside and outside medical insurance, especially the reimbursement conditions of "outside medical insurance" and "expensive medicine", which belong to the top stream of "Huimin Insurance" in the country.
And the price of this combination is more close to the people. 39.99 = 138 yuan/person/year, even if a family of seven buys it, the annual premium will not exceed 1000 yuan, which is suitable for most families.
Shenzhen's exclusive medical insurance is closer to the pure commercial million medical insurance, with more comprehensive protection and higher premium. However, due to the restriction of health notification, it needs to be used together with Shenzhen's critical illness insurance, otherwise it can only be reimbursed by 30%.
Purchase suggestion
After comprehensive comparison, Bao Ge thinks that the combination of Shenzhen Pengcheng critical illness insurance is more in line with the "Pratt & Whitney Principle" of Huimin Insurance, which can solve the risk of large medical expenses with the lowest insurance cost, and there is no insurance restriction, which is suitable for middle-aged and elderly people or patients who cannot insure commercial insurance.
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