With medical insurance, do you still need "Health Buddha Medical Insurance"?
Basic medical insurance follows the principle of "wide coverage and basic protection", but having medical insurance does not mean that "everything is fine". The places that cannot be taken care of by the basic medical insurance need to be supplemented by "Health Buddha Medical Insurance"!
As shown in the figure, we can divide the expenses incurred in hospitalization into three types according to the reimbursement scope of medical insurance and "Health Buddha Medical Insurance":
(1) Expenses reimbursed by medical insurance
There are three major directories of medical insurance, namely the drug catalog, the diagnosis and treatment items and the medical service facility catalog.
In these three catalogues, the expenses incurred in medical treatment and hospitalization that exceed the threshold will be reimbursed on a pro-rata basis.
In the second case, the medical insurance does not report, but the scope of reimbursement can be made by the "Health and Buddha Medical Insurance".
Self-paid expenses outside the scope of the medical insurance catalog: After the medical insurance reimbursement, the remaining expenses in the catalog are included in the "Health Buddha Medical Insurance" responsibility 1, and can be reimbursed at 80% after deducting the annual deductible of 20,000 yuan.
Personal out-of-pocket expenses outside the scope of the medical insurance catalog: medical insurance does not reimburse, and is included in the second responsibility of "Health Buddha Medical Insurance", which can be reimbursed at 60% after deducting the annual deductible of 20,000 yuan.
Self-financed drugs for specific diseases: The insured person carries out the treatment of specific diseases, and the designated self-financed drugs are used during the insurance period, including chemotherapy drugs, targeted drugs, immune preparations, enzyme replacement therapy drugs, overseas special drugs, etc., and the drug expenses incurred are not reimbursed by the medical insurance, and are included in the "Health and Buddha Medical Insurance" responsibility three, after deducting the annual deductible of 10,000 yuan, non-pre-existing conditions can be reimbursed at 60% or 30% of pre-existing conditions.
Ultra-high medical expenses: The remaining ultra-high medical expenses after the reimbursement amount of basic medical insurance, serious illness insurance, other medical security benefits and liability benefits will be included in the "Health and Buddha Medical Insurance" responsibility four, and the part with a cumulative amount of more than 80,000 yuan and less than 250,000 yuan (inclusive) will be reimbursed 90%, and the part of more than 250,000 yuan and less than 1 million yuan (inclusive) will be reimbursed 100%.
Compensation for high medical expenses in general outpatient clinics: After reimbursement by medical insurance, the high medical expenses of outpatient clinics borne by individuals are included in the fifth responsibility of "Health and Buddha Medical Insurance", and the cumulative part of the annual minimum payment standard of more than 20,000 yuan, the reimbursement ratio is 60%, and the maximum annual reimbursement limit is 100,000 yuan.
Category (3) is the part that is not covered by the "Health and Buddha Medical Insurance".
The cost of not reaching the corresponding liability line needs to be borne by the individual, of which the responsibility is 20,000 yuan, the second responsibility is 20,000 yuan, the third payment line is 10,000 yuan, and the fifth responsibility is 20,000 yuan, which exceeds the annual compensation limit of each liability.
As a government-guided inclusive commercial health insurance in Foshan, "Health & Buddha Medical Insurance" is not limited to age, occupation, or pre-existing conditions, with a price of only 185 yuan a year, less than 5 cents per day, and a maximum guarantee of 3.3 million, so that Foshan citizens can realize "medical treatment and medical insurance".
"Health and Buddha Medical Insurance" realizes the mutual complementarity with the government-run medical security systems such as basic medical insurance, serious illness insurance, and medical assistance, and gives full play to the function of commercial health insurance to reduce the burden of cascades, playing a dual role in guarantee! "Health and Buddha Medical Insurance" has the characteristics of "low threshold, low premium, and high insurance amount", which can reduce the medical burden borne by the insured citizens due to major diseases, and effectively resolve the risk of returning to poverty due to illness.
For the average family
"Health & Buddha Medical Insurance"
It can effectively reduce the number of participants in Foshan basic medical insurance
Financial burden due to a serious illness
Further improve the people
The happiness and sense of belonging of living in Foshan
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Editor: Zhenhua
Source: Buddha City Protection