Shun Net - Ji'nan Times reporter Yao Dongshu
recently, Ms. sun of Ji'nan people was found to have benign tumor, hospitalization fee, medicine The cost, the operation fee, and so on cost nearly 80 thousand yuan. According to the new medical insurance policy, miss sun finally reimbursed $34 thousand. Serious medical insurance can lighten many burdens, but the medical expenses that are borne by oneself are still a bit too much to eat. Ms. Sun said frankly.
recently, a group of data released by the Ministry of health has shocked many people. The probability of serious illness is 72.18%. Several life insurance companies in Ji'nan found that 30 to 45 year old consumer groups began to turn their eyes to commercial serious diseases as a powerful supplement to social health insurance. At present, the commercial health insurance market, including the serious illness insurance, has begun to usher in a red sea. The strict standard of underwriting has turned many people out. Medical insurance system social health insurance
social medical insurance refers to workers when they are ill, the social insurance agencies give appropriate subsidy or reimbursement to the medical expenses they need. Social medical insurance is an important part of social insurance, which is usually carried out by the government. The government will enforce and organize management by means of economic means, administrative means and legal means.
commercial medical insurance
including general medical insurance, accidental injury medical insurance, inpatient medical insurance, operation medical insurance, special disease insurance,
commercial medical insurance process fill out the policy form
provide identity card, bank card, beneficiary ID number and so on < br / > order personnel Recognised
when the insured insured the insured's cumulative risk exceeds the exemption limit of the age of the insured, the insured shall confirm the insured, and issue a formal notice of physical examination and a physical examination form.
when the insured does not exceed the exemption of physical examination and no previous insurance record, the cumulative risk of the insured exceeds the limit of the age exemption of the insured by the computer, and the medical notice is issued by the insured.
if the insured does not exceed the exemption amount, the health notification has the medical examination indications. After the confirmation of the insurance, the medical examination must be taken as a physical examination.
two physical examination confirmed
the first physical examination, there are still difficulties in the judgment. The insured has the right to require the insured to make two physical examinations, two medical examinations, and the medical hospital and the project to be designated by the nuclear insurance.
35 year old sun Ms. sun, 35 years old, worked in a state-owned enterprise and was found to have a benign tumor two weeks ago. After the hospitalization procedures, the cost of operation and all kinds of treatment drugs cost 77 thousand and 600 yuan. Ms. Sun told reporters that according to the relevant medical insurance policy, 80% of the reimbursement ratio can be enjoyed, but the class B needs to bear 15% of its own, and the higher cost of the class C needs to be completely free. Count down, Ms. sun has reimbursed 34 thousand.
faced with serious diseases, Ms. Lin of Ji'nan has another experience. 2 years ago, a pair of twin daughters were born. Not long ago, both of them were diagnosed with leukemia, requiring a medical fee of about 900000 yuan. Facing the sudden disaster, Ms. Lin saw the hope, when the child was born, I bought them a serious disease risk respectively, the amount of insurance was 300 thousand yuan, and the annual premium of each person was 5000 yuan. After the child was diagnosed with leukemia, I got a total of 600 thousand yuan, and I took out about 300000 yuan from my family. My children were saved. Recently, the twins were reborn through bone marrow transplantation.
the introduction of big disease insurance is basically for a major disease, which can help patients to solve the urgent problem, but the cost of hospitalization and medical care in large diseases is also relatively high in proportion and amount. Zhang Aiyun, who has been engaged in life insurance for more than 20 years, has been introduced by Ping An Life Insurance. In recent years, the probability of people suffering from major diseases is becoming higher and higher. As a powerful supplement to the medical insurance of big diseases, the commercial serious disease insurance is the guarantee object in the insurance clause. The insured can get the compensation in one time and do not conflict with the social medical insurance reimbursement. . At present, most of the insured persons aged between 30 and 45 have insured themselves or their children.
PK short term insurance coverage for light disease disease, insurance for life only wise
reporter visited Pingan, Taiping and other life insurance companies found, in the latest release of the serious disease products, in addition to the protection of malignant tumors, leukemia and other major diseases, but also the more than 10 kinds of light disease included in the scope of protection, culvert At the same time, high incidence and frequent glassy diseases such as cancer in situ, a variety of interventional operations, minor cerebral apoplexy, and impaired visual acuity at specific age have been found. In the light of some major diseases with high risk of suffering, subdivision risks have appeared, and the short term insurance products such as "one year insurance" and "five year insurance" are also beginning to come out.
what kind of serious disease insurance is suitable for yourself? The head of the marketing service department of Taiping Life Ji'nan City, the head of marketing service, "the short term insurance premium is relatively cheap, but the product attribute of the serious disease determines that the guarantee period should be long-term and life-long, and should not be" fragmented "in the term, otherwise it will lose the meaning of the insurance itself. Righteousness. "
recommends that the insured should choose to ensure a comprehensive and practical product, that is, a product that covers the number of common major diseases and the key protection of cancer diseases. The insured can determine the insured amount according to the annual income level. The scope of coverage is not as broad as possible.
physical examination, observation period and other links, "strict" "can not buy" is a problem
in the insurance industry, it seems that the commercial health insurance market, including the serious disease insurance, is coming to a red sea. But for policyholders, the purchase of serious illness insurance in the underwriting link may be faced with "brush". "
" some policyholders are not insured when they are in good health. They find the condition of health insurance, which is equivalent to "counter choice" and is not fair to the insured. " Cao Jiping, the senior insurance agent of China life, told reporters that the insurance policy holders should be strictly controlled in the physical examination, observation period and other links. High blood pressure, high blood sugar, serious overweight and old age will be rejected. He disclosed that this is also an insurance company to ensure the quality of claims service, we must consider the way of making profits.
this is a "alarm" for people who want to buy a serious disease and can't buy it: when you are healthy or young, you need a risk plan ahead of time. Yu Ting introduced, in order to protect a certain heavy disease of 300 thousand yuan as an example, when the baby was insured at birth, the annual premium needed four thousand or five thousand yuan, and a continuous insurance for 20 years enjoyed a lifetime guarantee. For the young people of 30, the equal amount of insurance needed to be insured more than 10 thousand annually and the premium increased by more than half. "When adults grow one year old, the premium for serious illness insurance can increase by hundreds."
extended reading "insurance hospital" model to
"from the depth of insurance, there are 7 insurance policies per capita in Japan and 0.3 insurance policies per person in our country; the insurance density in Japan is 70%, and that of our country is only 20%." Ting Ping, director of Marketing Services Department of Taiping City, told reporters that it is not difficult to find out from these two dimensions that China's insurance industry still has huge market space.
People's health company recently said that the first health management company is being set up in the insurance industry. Starting with the "health archives management", it will master the medical report of the insured, the electronic medical record, the data of the gene and so on, or invest in the hospital in a variety of ways, such as holding, participating in or using the plan of creditor's rights. China life has also indicated that it will create an "insurance hospital" mode and gradually extend to the upstream of the traditional insurance business chain. According to the insurance industry, referring to the experience of developed countries, this will be the general trend of the future development of the insurance industry.
in fact, the "ten new countries" of the insurance industry clearly indicates that it supports the insurance institutions to participate in the integration of the industrial chain of health services, and to explore the use of equity investment and strategic cooperation, to establish medical institutions and to participate in the reform of public hospitals. In the process of insurance companies entering into the field of health management, whether they should be connected with hospitals has always been a hot topic in the industry.
"chronic diseases occupy the highest proportion of medical expenses, and the patients can find and treat the chronic diseases early and reduce their economic burden through the health management platform." Cao Jiping believes that excessive medical treatment is a major problem in the field of medical health in China. The health management platform can help patients save cost of medical expenses, reduce costs for insurance companies and avoid excessive medical treatment to some extent.