The number of insureds has exceeded 4.95 million! How to pay for the hot-selling "Huhuibao"?
Look at the news Knews reporter Ma Jie
2021-05-09 21:30
It has been less than two weeks since the Shanghai city customized commercial supplementary medical insurance, Huhuibao, was launched. The participation rate is as high as 25.8%. While the premium level is very low, Shanghai Huibao is very popular because of its high coverage and maximum policy setting. But for some of these terms, many policyholders still have some doubts.
In Shanghai Huibao's protection liability, the deductible for out-of-pocket medical expenses for specific hospitalizations is 20,000 yuan per year. It needs to be clear that the 20,000 yuan deductible is a cumulative system, rather than paying more than 20,000 yuan for each hospitalization.
Wu Guoliang, Deputy Secretary-General of Shanghai Insurance Association, said: "There is a deductible amount every year for specific hospitalization and self-paying medical expenses. This deductible amount is accumulated and accumulated within a year (the guarantee period is one year)."
Another cause Quite a few misread terms are, at your own expense and at your own expense. Wu Guoliang said: "Huhuibao products have a very big feature, that is, they complement our basic medical insurance with our non-basic medical insurance catalogue. It is such a difference that is covered by medical insurance, and self-pay is not covered by medical insurance.”
For example, the insured’s first hospitalization medical expense is 280,000, of which 162,000 is within the scope of medical insurance, and 85% of the hospital reimbursement is based on the proportion of on-the-job employees, then 15% of this part belongs to the conceit of medical insurance, so it is not covered by Shanghai Huibao.
In the medical expenses, after deducting the medical insurance coverage, the insured can claim 118,000 yuan at his own expense. It is worth noting that the self-paid part and the accumulation of deductibles are to be deducted from the hospitalization part's meal expenses, bed expenses, etc.
The proportion of compensation for people with pre-existing and non-pre-existing conditions is different. From a comprehensive perspective of different projects, the highest compensation is 70% and the minimum is 30%. For the claims for the self-paid part of hospitalization or the part of high drug costs, the insured must be diagnosed and treated in hospitals designated by the second-level and above medical insurance.
The insured who has commercial insurance at the same time does not conflict with Huhuibao, and Huhuibao will compensate for the cost. The deadline for Shanghai Hui Insurance to apply for insurance is June 30, and the unified start date is July 1.
It is understood that Huhuibao’s claims settlement system is still under construction, and it is planned to be launched on July 15. Policyholders can make claims online with the application and WeChat official account.
(Look at News Knews reporter Ma Jie Editor: Bai Bai)
