In addition, if there are other past diseases, the insurance company can reimburse them normally, and if there are non-past diseases, those who meet the reimbursement conditions can be reimbursed.
Bao Hui, Anhui Province is a provincial-level inclusive supplementary medical insurance introduced by Anhui Province, which is underwritten by China People's Property Insurance Co., Ltd. Anhui Branch. All participants in the basic medical insurance for urban workers and urban and rural residents in Anhui Province, regardless of age, occupation and health status, can even participate in the insurance due to illness. In addition, if there are other past diseases, the insurance company can reimburse them normally, and if there are non-past diseases, those who meet the reimbursement conditions can be reimbursed. Social basic medical insurance refers to the basic medical insurance stipulated in the newly revised Social Insurance Law, including basic medical insurance for employees, basic medical insurance for urban residents, new rural cooperative medical care and other basic medical insurance sponsored by the government.
However, Bao Hui will not reimburse people who suffered from five diseases before insurance, namely:
1. Malignant tumor (including leukemia and lymphoma);
2. Liver and kidney diseases: liver cirrhosis, hepatic insufficiency and renal insufficiency;
3. Cardiovascular and cerebrovascular diseases, glucose and lipid metabolic diseases: ischemic heart disease (including coronary heart disease and myocardial infarction), chronic cardiac insufficiency (cardiac function above Grade III), cerebrovascular diseases (cerebral infarction and cerebral hemorrhage), hypertension (Grade III) and diabetes with complications;
4. Lung diseases: chronic obstructive pulmonary disease, chronic respiratory failure;
5. Other diseases: systemic lupus erythematosus, aplastic anemia, paralysis, ulcerative colitis.
Take Bao Hui, Anhui as an example: Xiao J, a 30-year-old Anhui citizen, insured Bao Hui, Anhui this year. He was diagnosed with a serious illness in March 20021year, and spent 500,000 yuan during his hospitalization. Among them, 200,000 yuan is reimbursed for medical insurance, and 300,000 yuan (10.8 million out of pocket,10.2 million out of pocket) needs to be borne by itself. Bao Hui, Anhui can be reimbursed as follows: out-of-pocket medical expenses: (654.38+0.8-20,000 deductible) * 75% = 6.5438+0.2 million, out-of-pocket medical expenses (6.5438+0.2-20,000 deductible) * 75% = 75,000, which means that a * * can be reimbursed.