Coiling method
"Rizhao Warm Heart Insurance" takes 12 months as the guarantee period, and the insurance period is 202 1110 month1to 202 1 year 1 2.
The insured can purchase through the online payment platform and the third-party service platform published by the insurance institution, or at the offline service outlets designated by the insurance institution.
Employees who purchase medical insurance personal account funds for their immediate family members can go through the formalities of entrusted withholding and remitting through online payment platforms and third-party service platforms published by insurance institutions.
Guarantee content
The expenses for chronic diseases and special diseases in inpatient and outpatient clinics within the overall scope of basic medical insurance refers to the part that is borne by individuals after being reimbursed by Rizhao's basic medical insurance, serious illness insurance, large medical assistance, medical assistance, preferential poverty alleviation insurance and other related policies (excluding the part that individuals in different places bear first), and the insured amount per person is 6.5438+0 million yuan/year.
Deductible and payment ratio: the annual deductible is 20,000 yuan, and the payment ratio is 80%.
The hospitalization expenses beyond the overall planning scope of basic medical insurance refer to Class B out-of-pocket expenses and full out-of-pocket expenses required for reasonable treatment in designated medical institutions of basic medical insurance (excluding expenses other than 25 specific high-priced drugs and 9 rare diseases and indications listed in the catalogue), and the insured amount per person is 6.5438+0 million yuan/year.
Deductible and payment ratio: the annual deductible is 20,000 yuan, and the payment ratio is 60%.
Specific high-priced drugs refer to the high-priced drugs for the treatment of malignant tumors and leukemia listed in the Catalogue of Specific High-priced Drugs of Rizhao Warm Heart Insurance (see Annex 1 for details), and the insured amount per person is 6.5438+0 million yuan/year.
The designated drug expenses for some rare diseases refer to the drug expenses for the treatment of rare diseases listed in the Catalogue of Designated Drugs for Some Rare Diseases in Rizhao Warm Heart Insurance (see Annex 2 for details), and the insured amount per person is 300,000 yuan/year.
Deductible line and compensation ratio: deductible line is calculated by combining the specific high drug costs with the designated drug costs for some rare diseases, and the annual deductible line is 6.5438+0.5 million yuan. The compensation ratio is 60%.