"One person gets sick, the whole family suffers."
Especially for serious illnesses, such as cancer, the sky-high medical expenses are often unbearable for an ordinary family.
Like the CAR-T (cell immunotherapy) anti-cancer drug "Yikaida" that was popular on the entire network some time ago, it costs 1.2 million yuan in one injection.
However, many anti-cancer drugs cannot be reimbursed and cannot be purchased by the hospital. You need to buy them at a pharmacy outside the hospital. Therefore, many friends are now buying medical insurance and are very concerned about the protection of outbound drugs.
So, today we will talk about out-of-purchase medicines. The main content is as follows:
- What is out-of-purchase medicines? Is it effective?
- Which insurance can be applied for outbound medicines? How to apply for a claim?
- out-of-purchase drugs, what issues should be paid attention to?
Many friends may not be sure what is outsourced medicine? Do I have to bring out-of-purchase medicines to buy medical insurance?
In layman's terms, it is necessary for treatment, but it cannot be bought in the hospital where you are visiting the hospital. You need a doctor to prescribe it. The medicine purchased at an outside pharmacy is the purchased medicine . Generally, it is some more expensive anti-cancer drugs. How expensive are
anti-cancer drugs? In order to make everyone feel more intuitive, we have compiled the following table:
(the price will fluctuate, based on actual purchase)
You can see that the price of anti-cancer special drugs is very expensive. For example, "An Shengsha" who treats lung cancer, the drug fee for a month is nearly 50,000, which is simply unbearable for ordinary working families.
Although some special drugs have been included in medical insurance now, the price is discounted. For example, the original price of An Shengsha is about 50,000 yuan, and only 15,000 yuan after being included in medical insurance, it may not be able to buy it. A survey on the "Dancing with Cancer" online forum on
"Dancing with Cancer" showed that 54.9% of 504 cancer patients said they could not buy medical insurance anti-cancer drugs.
Therefore, whether can reimburse the purchased medicines is very important for patients. If you have insurance to apply for outbound medicine, you don’t have to worry about not being able to afford medicine, not being able to see a doctor, being overwhelmed by medical expenses.
What insurances can be applied for outbound medicines? Let's continue to see below.
The common insurances that can reimburse the purchased drugs are million medical insurance and special drug insurance .
Although they can both reimburse the purchase of drugs, the specific guarantees of the two will be different. Whose out-of-purchase drugs have better protection? How do we choose?
. Million-dollar medical insurance, what is the protection for outsourced drugs?
We evaluated the five million-dollar medical insurances that are sold on the market and found that the protection of outbound drugs for each company is quite different. The specific analysis is as follows:
We judge whether a million-dollar medical insurance is good for outbound drugs. mainly depends on whether there are many types of drugs and whether the renewal conditions are stable. If the terms can be written, there are value-added services such as direct payment and home delivery of medicine, will be even more icing on the cake.
also needs to pay attention to the continuation of responsibility. After all, anti-cancer is a long-lasting thing. The responsibility for purchasing drugs for
million medical insurance is extended, and it needs to be combined with the renewal conditions. If the product can guarantee renewal of , it means that the purchased drugs can be applied for during the guaranteed renewal period.
Like good medical insurance for 20 years and 1 year of exclusive e-life 2021. Although the responsibility extension is the same, good medical insurance can be covered for 20 years. The terms of purchase of drugs are written into the guarantee, which is more stable.
So, in this way, the out-of-purchase drugs of Good Medical Insurance (20th Edition) and Chaoyue Insurance 2020 (Special Edition) are relatively excellent, the renewal conditions are better, and there are more types of drugs.
In addition, although the insurance page of Hao Medical Insurance (6th year version) will be updated in real time, the purchase of drugs does not include the terms. It is just a value-added service. There may be instability. Friends who care about it recommend considering the other two.
Although purchasing medicines is important, , when you buy million-dollar medical insurance, you must comprehensively consider other protections.
. Is the special drug insurance good?
special drug insurance is relatively single compared to millions of medical insurance, and only reimburses special drug expenses . We have selected several good special drug insurances at present to see how the specific protection is?
directly tell the conclusion:
Compared with the other two products, medicine is worry-free (upgraded version) has better protection . Although the price is a bit expensive, it covers more types of drugs. If cancer is diagnosed, the anti-cancer drug costs within 3 years can be reimbursed, and the responsibility lasts for a longer time.
Although the price of Medicine God Insurance (Basic Edition) is the cheapest, the liability extension time is slightly shorter, and the drug costs within 2 years after the diagnosis of cancer can only be reimbursed.
You should pay attention to most special drug insurances on the market, and once cancer is diagnosed, they cannot be renewed.
Then the length of the extension of special drug insurance liability is more important. The longer the extension of , the longer the protection time is.
In general, the protection of million medical insurance is more comprehensive. In addition to purchasing drugs from outside, other hospitalization medical expenses of millions of medical insurance that meet the regulations can also be reimbursed.
If the million-dollar medical insurance you bought contains the protection of out-of-purchase drugs and the out-of-purchase drugs can guarantee renewal, there is no need to buy special drug insurance.
But if your million-dollar medical insurance does not cover the outbound medicine, or if you can apply for outbound medicine but the renewal is unstable, it is best to add a special medicine insurance.
Many people think that the claim for purchase of drugs is very simple. After buying the drugs, they just need to take the invoice to the insurance company to reimburse them. In fact, it is not as easy as everyone thinks, and some specific processes are required.
Next, let’s teach you how to apply for claims? And what pitfalls should be paid attention to when making claims?
. How to apply for a claim?
Apply for out-of-purchase pharmacy claims, and the operations of each insurance company generally do not vary much. We take Exclusive e-life 2021 as an example, which is mainly divided into the following 3 steps:
① Submit the application
After calling the insurance company’s customer service phone number to report the case, submit an application for purchase of drugs according to the claimant’s requirements. The required materials are:
- Claim application
- Insured ID card
- Medical record information, Original medical diagnosis, pathological examination report, imaging report, examination and laboratory report, invoice, etc.
- Drug prescription issued by doctor
- Out-of-purchase drug certificate issued by hospital
② Drug prescription review
After submitting the application, the insurance company will conduct a drug prescription review. If the prescription meets the requirements (details on point 2 below), the insurance company will only make a claim.
③ Drug purchase and reimbursement
There are two situations:
- First application: After the drug prescription is reviewed, the insured can bring the drug prescription, ID card, and social security card to the designated pharmacy to collect the medicine.
- Non-first application: can choose to pick up the medicine at a designated pharmacy or deliver the medicine to your door-to-door service. The drug costs within the coverage of
are settled directly by the insurance company and the pharmacy, and there is no need to be reimbursed in the future.
Remind everyone that you must apply for claims according to the above process, otherwise it may affect reimbursement.
. What should you pay attention to when making claims?
Highly require a wide range of claims for out-of-purchase drugs. Generally speaking, must meet the following conditions :
- A prescription is given by a hospital specialist and is a necessary medicine for treatment
- Doing for medicines cannot exceed one month
- 6
- Drugs must be approved by and launched on the market by the Drug Administration, and are designated drugs in the drug list.
- . Before purchasing
- . Before purchasing drugs, you must submit an application and review in accordance with the above prescribed procedures.
. Reimbursement conditions for each product for purchase of drugs may be different. It is recommended that you read the terms carefully before buying drugs.
Purchasing medicines seems simple, but in fact there are many issues to pay attention to. We have selected two common questions, hoping to help everyone understand more.
. How many times can I reimburse for outbound medicines?
If you have a serious illness, the treatment cycle is relatively long, and the amount of drugs purchased can only be prescribed for up to 30 days each time, so many friends will be concerned: If you have applied for drugs purchased, can you still be reimbursed next time? How many times can I report it?
In fact, you don’t have to worry. There is generally no limit on the reimbursement of out-of-purchase drugs for . As long as the drug fee does not exceed the limit, it can be reimbursed.
For example, the purchased drugs of Good Medical Insurance (20 years of insurance) share a total of 4 million yuan insured, as long as the expenses of these three items do not exceed 4 million yuan, the purchased drugs during the coverage period can be reimbursed until the limit of 4 million yuan is exceeded.
. Can externally purchased drugs only reimburse cancer-specific drugs?
At present, most of the purchased drugs for millions of medical insurance are limited to special anti-cancer drugs. Generally, there is a drug list, such as Chaoyue Insurance 2020:
( Chaoyue Insurance 2020 terms)
If you buy other drugs from outside the hospital, they cannot be reimbursed if they are not on the drug list.
In addition, if the million-dollar medical insurance does not have out-of-purchase drugs, the drugs purchased outside the hospital during hospitalization will generally be rejected by the insurance company.
said: "In the face of cancer, everyone is equal."
Everyone is equal when they get cancer, because the pain they experience is the same, but rich people can "spend money to buy their lives" when they get cancer, but what do ordinary people rely on?
If you spend dozens or hundreds of dollars to make yourself and your family live more confidently, why not do it? We sincerely hope that everyone will give their families a real guarantee as soon as possible.
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