The 2022 annual protection is about to start the exclusive protection benefits of Hangzhou people, and the only inclusive commercial supplementary medical insurance in Hangzhou supported by government guidance and support, "Zhejiang Li Medical Insurance • West Lake Yilian Insurance", has ushered in good news, and the starting line of the 2022 annual protection liability one (major illness insurance supplementary medical protection) has been lowered from 25,000 yuan to 13,000 yuan.
This is the "Zhejiang Medical Insurance , West Lake Yilian Insurance" on the basis of the previous "one rise, two drops and three expansions" to optimize the protection responsibility again. The optimization is expected to benefit more than 50,000 people, of which about 25,000 people will be paid new, and the amount of compensation will be increased by 120 million to 150 million yuan.
The staff of West Lake Yilian Insurance guided the citizens to apply for insurance at the Citizens' Home
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More than 50,000 people are expected to benefit
Increase compensation by 120 million to 150 million yuan
Click to watch the video to learn more about the optimization.
This upgrade includes two aspects: the threshold of responsibility one and the reimbursement ratio. Let's take a look at the upgrade details:
Before the upgrade, the liability payment line was consistent with the minimum payment line of major illness insurance, of which the urban and rural residents' medical insurance and the employee's medical insurance were both 25,000 yuan, that is, the compliance expenses incurred by the insured after the medical insurance reimbursement incurred during hospitalization or outpatient treatment of the specified diseases, and the part exceeding 25,000 yuan was paid according to the proportion of 80%.
After the upgrade, the responsibility is reduced to 13,000 yuan, and the progressive reimbursement is implemented, of which the reimbursement ratio of medical expenses in the range of 13,000-25,000 yuan is not less than 30%, and the reimbursement of 25,000 yuan and above is 80%.
Zhu Aimin, the external contact of the West Lake Yilian Insurance Co-insurance Body and the deputy manager of the health insurance department of the Chinese Life Hangzhou Branch, introduced that some insured citizens feedback that their medical expenses for serious illnesses may only be 10,000 or 20,000 yuan, which cannot reach the starting line, hoping to optimize and personally feel the benefits of "Zhejiang Medical Insurance • West Lake Yilian Insurance". In order to actively respond to the voices of the public, under the guidance of the Hangzhou Municipal Medical Security Bureau, the co-insurance body decided to reduce the responsibility and pay the line together.
After this optimization, the insured citizens who spend 13,000-25,000 yuan on medical expenses for serious illnesses cannot be reimbursed according to the original plan, and they can also be reimbursed next year, at least 30%. It is estimated that 25,000 insured citizens are expected to meet the reimbursement in this paragraph, that is, an increase of 25,000 people.
The insured who originally reached the original payment line of 25,000 yuan can also be reimbursed at least 3,600 yuan, which can also further reduce the medical burden of serious illness.
It is estimated that after optimization, the total number of reimbursements in the two tiers will benefit more than 50,000 people.
Zhu Aimin said that in order to encourage the insured to apply for insurance continuously and make the protection uninterrupted, for customers who have continuous insurance, the reimbursement ratio between 13,000 and 25,000 yuan will be appropriately increased, and the specific proportion will be announced at the end of December.
It should be noted that the optimization is aimed at urban and rural residents' medical insurance (including children's medical insurance and college students' medical insurance) and on-the-job employee medical insurance, and other medical insurance personnel are still reimbursed according to the original agreement.
In addition, the part of the responsibility of more than 25,000 yuan and the retirees and licensed personnel of the employee medical insurance continue to implement "one-stop" settlement, that is, reimbursement like medical insurance. Due to the reasons for system transformation, the optimized part of 13,000-25,000 yuan does not implement "one-stop" settlement for the time being, but adopts the form of retroactive reimbursement, but does not require the insured to apply, nor does it need to provide invoices and other documents, and the system will automatically compensate.
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Respond to the voices of the public
Contribute to common prosperity
So far, the 2022 "Zhejiang Medical Insurance • West Lake Yilian Insurance" has carried out two rounds of major optimization and upgrading.
The previous "one rise, two decreases, three expansions" covered 4 contents, namely: increasing the sum insured to 3.15 million yuan, reducing the premium of children's/college students' medical insurance to 100 yuan / year, reducing the responsibility of the two minimum payment lines to 0.7 million yuan, and expanding the protection items of two, three and four.
West Lake Yilianbao 2022 two optimization and upgrading of the main project
Zhu Aimin said that the continuous optimization and upgrading of "Zhejiang Medical Insurance • West Lake Yilian Insurance" reflects the purpose of universal medical insurance: to do everything possible to compensate and effectively reduce the burden of serious illness of the people. According to the relevant regulations, 90% of the premiums of "Zhejiang Medical Insurance • West Lake Yilian Insurance" are used for compensation, even if there is a slight surplus in the current year, it must be rolled into the next year, and truly realize "taking from the people and using it for the people".
As the only commercial supplementary medical insurance in Hangzhou supported by government guidance, "Zhejiang Medical Insurance • West Lake Yilian Insurance" scientifically and accurately analyzes the needs of the people to reduce the burden of medical treatment, takes the initiative to respond to the voice of the citizens, dynamically optimizes the product program, can effectively enhance the people's sense of happiness and sense of gain, narrow the gap between urban and rural areas, occupations between different groups of medical expenses has a positive effect, and is of great significance to promoting the construction of the province's common prosperity demonstration zone.
In 2021, a total of 4.7 million citizens participated in the "Zhejiang Medical Insurance • West Lake Yilian Insurance", and as of the end of November, the cumulative compensation exceeded 56,000 people and more than 400,000 person-times, with a compensation amount of 460 million yuan, which effectively supplemented the coverage of medical insurance and reduced the medical burden of patients with serious and exceptionally serious diseases.
After the two optimizations, Westlake Yilian Insurance 2022 has less deductibles, more claims, lower premiums, higher sum insured, more complete liabilities and better renewals.
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Enrollment is approaching
The renewal benefit is better
In 2022, the insurance payment of "Zhejiang Medical Insurance • West Lake Yilian Insurance" will be closed at 17:00 on December 31, 2021, with only the last ten days left, in order to avoid the risk of insurance interruption and leakage of insurance, it is recommended that the general public apply for insurance as soon as possible.
Citizens can renew their insurance for themselves and their families through 6 channels, such as "West Lake Yilian Insurance" and "Hangzhou Medical Security" WeChat public account, Zhejiang Office, Alipay, insurance company QR code, and offline service outlets of insurance companies, and all support payment with medical insurance accounts.
The staff of West Lake Yilian Insurance assisted Qianjiang International Times Square in lifting the isolation
It should be reminded that from 2022, there will be a 3-month exclusion period for insurance interruption. For example, when insured in 2021, uninsured in 2022, and re-insured in 2023, the related medical expenses incurred in January-March 2023 are not included in the threshold accrual and claims.
However, for continuous insured persons, not only is there no exemption period, but the reimbursement ratio of responsibility one will be higher and the protection of rights and interests will be better.
Spend only 4 cents a day to stay healthy. As a government livelihood project, "Zhejiang Medical Insurance • West Lake Yilian Insurance" provides a reliable, affordable and fair health protection plan for all Hangzhou citizens. Sick to get guaranteed, no illness to do charity, forget to participate in the insured citizens remember to seize the time, miss not only have to wait for a year, the claim treatment will be discounted.
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Orange Persimmon Interactive City Express reporter Wang Xiaoxiao