"Beijing Pratt & Whitney Health Insurance" has a uniform price of per person 195 yuan regardless of age, occupation and health status. The insured amount of this product is * * * 3 million yuan, except for the high personal out-of-pocket medical expenses in the basic medical insurance catalogue (the insured amount is 6.5438+0 million yuan), the insured amount of out-of-pocket hospitalization expenses outside the basic medical insurance catalogue is 6.5438+0 million yuan, and the insured amount of high specific drug expenses is 6.5438+0 million yuan (including 500,000 yuan for domestic special drugs and 500,000 yuan for foreign special drugs)
The domestic and international 100 kinds of special drugs covered by this product are mainly aimed at the high incidence of tumor diseases such as lung cancer, gastric cancer, liver cancer, breast cancer and leukemia among the insured population in this city, including the treatment of 1-4 drugs, which ensures the accessibility of patients. Patients can use new and good drugs in the world at the same time without going abroad.
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Hot answer-
Q: How does Beijing Pratt & Whitney Health Insurance achieve Pratt & Whitney?
A: "Beijing Pratt & Whitney Health Insurance" can be insured as long as it is insured by Beijing Medical Insurance, regardless of age, occupation, household registration and past medical history. Specific past diseases can be insured and paid, and five specific past diseases, such as malignant tumors and liver and kidney diseases, form differentiated payments with healthy people, which is impossible for ordinary commercial insurance. In addition, other diseases, such as hepatitis B, breast nodules, uterine fibroids, etc., can be paid according to the compensation standards of healthy people, benefiting more sick groups and embodying "general".
Take a 60-year-old man for example. If you insure millions of medical insurance for ordinary businesses, the annual premium may cost thousands of dollars. However, the unified premium standard of "Beijing Pratt & Whitney Health Insurance" is less than 6 cents per year 195 yuan for both the elderly and children, and the maximum premium can be 3 million yuan, which reflects the "benefits".
Q: What is the difference between the reimbursement rate of healthy people and those with specific past diseases?
A: The biggest feature of "Beijing Pratt & Whitney Health Insurance" is that healthy people and five groups of people with specific past diseases can be insured and paid, but there are certain differences between them in reimbursement ratio and payment standard.
For example, 80% of healthy people are reimbursed for the part above the critical illness deductible line within the scope of medical insurance, and the proportion of reimbursement for specific past diseases is 40%. For the self-funded part outside the scope of medical insurance, the deductible line for healthy people is 20,000 yuan, and the reimbursement ratio is 70%. The deductible for people with specific past diseases is 40,000 yuan, and the reimbursement rate is 35%. At home and abroad 100 kinds of special drugs are reimbursed, with the deductible of 20,000 yuan for healthy people and 60% for healthy people, and the deductible of 40,000 yuan for specific people with previous diseases and 30% for reimbursement.
Following the word "Pratt & Whitney", "Beijing Pratt & Whitney Health Insurance" can also underwrite and compensate the nodules found in the physical examination. Ordinary commercial insurance is often not within the scope of insurance liability and will be judged as non-payment scope. The "Beijing Pratt & Whitney Health Insurance" can be insured, but there are differences in deductible and reimbursement ratio between five specific groups with past diseases and healthy people.
Q: The company has supplementary medical insurance. Does it conflict with "Beijing Pratt & Whitney Health Insurance"?
A: There is no conflict. Both can be configured at the same time. First of all, the expenses reimbursed through the unit's supplementary medical insurance can be deducted from the deductible of "Beijing Pratt & Whitney Health Insurance" simultaneously. Limited by the budget, the unit's supplementary medical insurance generally only bears the "out-of-pocket" expenses for outpatient service and hospitalization, and cannot cover the "out-of-pocket" and "out-of-pocket" expenses, and "special drug protection" and "value-added services" rarely appear in the unit's supplementary medical insurance.
In addition, the unit supplementary medical insurance general outpatient coverage 1 to 20 thousand yuan, hospitalization coverage of about 50 thousand yuan. In contrast, the guarantee amount of "Beijing Pratt & Whitney Health Insurance" of 3 million yuan can make the majority of policyholders feel at ease. Therefore, the allocation of supplementary medical insurance and "Beijing Pratt & Whitney Health Insurance" at the same time can better solve the problem of medical expenses burden.