(Participation can be pulled down directly to the end of the article)
Remember a hot insurance policy that appeared around you this time last year? Regardless of men, women and children, as long as 59 yuan a year, you can get up to 1 million yuan of inpatient medical insurance and 1 million yuan of high-value special drug protection. She is the exclusive guarantee and welfare of Hangzhou citizens——
Hangzhou Citizen Insurance
Now, she returns as scheduled with the upgrade guarantee of "increasing the amount without increasing the price".
Yesterday afternoon, the 2021 "Hangzhou Citizen Insurance" product was released, and the "Hangzhou Citizen Insurance 2021" was officially launched, with less than 3 cents per day and a maximum compensation of 2.2 million yuan. From now until August 15, as long as you have the basic medical insurance for employees of provincial-level units in Zhejiang Province or the basic medical insurance of Hangzhou City, you can get exclusive protection for the new year.
I. Highlights of Hangzhou Citizen Insurance 2021 Edition - "Two Upgrades, One Innovation"
1. No increase in the amount of guaranteed amount
"Hangzhou Citizen Insurance" is the first city-level inclusive commercial supplementary medical insurance in Hangzhou, closely linked to the basic medical insurance, first released on June 30, 2020, at an inclusive price (59 yuan / year), providing protection of up to double million (1 million yuan in hospital medical expenses + 1 million yuan in specific high drug costs). The simple understanding is that after the medical insurance is reported, the hospitalization expenses within the scope of medical insurance are reimbursed twice, and 20 kinds of self-paid specific high-value drugs that are not covered by medical insurance are reimbursed.
"Hangzhou Citizen Insurance 2021" has been upgraded and innovated on the basis of the original, and two versions have been launched for citizens to choose, namely the basic version and the subsidy version.
The premium of the basic version is consistent with 2020, that is, 59 yuan / year, including two parts of inpatient medical expenses and specific high drug costs.
Among them, the inpatient medical expense protection is that the insured's hospitalization expenses generated by the hospitalization of the general department of the designated medical insurance hospital in Hangzhou City, after being reimbursed by medical insurance, deduct the deductible of 20,000 yuan, and the remaining part can be reimbursed 80%, and the maximum reimbursement is 1 million yuan.
Specific high drug cost protection for 30 kinds of specific drugs outside the medical insurance list at pure self-payment, applicable to lung cancer, liver cancer, ovarian cancer, breast cancer, prostate cancer and other malignant tumors, as well as rare diseases such as Gaucher disease, Pompeii disease, Fabre disease, etc., there is no deductible, the reimbursement ratio is also 80%, and the maximum reimbursement is 1 million yuan.
Compared with 2020, the "two upgrades" of "Hangzhou Citizen Insurance 2021": one is to upgrade the reimbursement ratio of hospitalization medical expenses from 75% last year to 80%; the other is to upgrade the special drugs from 20 to 30, and the designated pharmacies for special drugs will increase from 6 to 25, which will further improve the protection of citizens to deal with serious diseases and reduce the economic burden.
2. Innovative introduction of critical illness allowance
The "one innovation" of "Hangzhou Citizen Insurance 2021" is to add a new severe illness allowance guarantee on the basis of the two guarantees of the basic version, and the premium of the subsidy version is 89 yuan / year.
The severe illness allowance is that the insured person receives a total of 30,000 yuan in hospitalization medical expenses and specific high drug costs during the insurance period, and the subsidy version of the product pays a one-time allowance of 200,000 yuan to the insured, so that the insured can not only reimburse the cost of treatment, but also recuperate with peace of mind.
The popular understanding is that citizens who have insured the subsidy version, as long as the actual reimbursement amount of the basic version of the corresponding liability reaches 30,000 yuan, they can get an additional one-time compensation of 200,000 yuan.
Second, there are already other insurance, do you still need to buy?
Many citizens may ask, I have medical insurance, but also bought other commercial insurance, do I still need to buy Hangzhou citizen insurance? Let's take a look at the features of Hangzhou Citizen Insurance:
1. Critical Illness Allowance
The severe illness allowance is a major innovation of "Hangzhou Citizen Insurance 2021". Chen Lei, senior insurance planner and president of Hangzhou Hanqiao Society, said that this innovation is the first time in the country's similar products, and its significance is that it can not only reimburse the cost of medical treatment, but also help the insured to recuperate with peace of mind, for short-term loss of income due to illness and low-income families, there is a role in sending charcoal in the snow and helping the poor.
She also said that the premium of the subsidized version is only 30 yuan more than the basic version, which is equivalent to 30 yuan to buy a major illness insurance with an insured amount of 200,000 yuan, which is impossible in the traditional major illness insurance market, and the latter premium is at least hundreds of yuan.
It is worth mentioning that although the name is "severe illness allowance", it is not required to meet the "serious illness" standard defined by the China Insurance Association, but to use the reimbursement amount of hospitalization and special drugs as the basis for compensation, which means that even if the insured person is hospitalized due to accidents, as long as the actual reimbursement amount of inpatient medical expenses reaches 30,000 yuan, a one-time compensation of 200,000 yuan can also be obtained.
For example, if Ms. W buys the 89 yuan allowance version for the first time this year, and in February 2022, she receives a one-time critical illness allowance of 200,000 yuan from the insurance company for hospitalization and 18,000 yuan in special drug claims within the product protection liability, for a total of 33,000 yuan, then she can also receive a one-time critical illness allowance of 200,000 yuan after receiving the aforementioned compensation of 33,000 yuan.
2. You can participate in insurance with illness
According to reports, "Hangzhou Citizen Insurance 2021" has no health notice, and can be insured with illness. It should be noted that if you have five major pre-existing diseases such as malignant tumors and liver and kidney diseases, you cannot claim the relevant inpatient medical expenses, special drug costs and severe illness allowances arising from pre-existing diseases and complications during the insurance period.
For example, if Mr. A is already suffering from lung cancer when he applied for "Hangzhou Citizen Insurance 2021", then during the insurance period, if Mr. A is hospitalized for lung-related diseases, then these treatment costs cannot be claimed; but if Mr. A is hospitalized for stroke during the insurance period and has nothing to do with lung cancer, then these treatment costs can be claimed.
This is a great boon for the elderly and the sick. As we all know, the elderly over 65 years old and people with nodules and three high chronic diseases will basically be rejected by ordinary health insurance, even if the conditions of insurance are relatively relaxed millions of medical insurance, there are restrictions, either can not be insured normally, or related diseases are not covered.
In addition, "Hangzhou Citizen Insurance 2021" also encourages the public to apply for insurance continuously, according to the "Claims Instructions", if the first insurance is taken in 2020, the five major pre-existing diseases that occur for the first time in the 2020 policy year can continue to be reimbursed in 2021, but are not included in the responsibility of the 2021 severe illness allowance.
This means that as long as there is no pre-existing illness at the time of first participation, the same coverage liability for subsequent consecutive insurance is not limited by pre-existing illness, which is obviously in favor of the insured.
3. Special drug 0 deductible
Citizens who have watched the movie "I am not a medicine god" must remember that several patients with malignant tumors, because there is not enough medical cost protection, finally "the house is gone, the family eats down." With this guarantee, even out-of-pocket medicines can reimburse most of the costs, which is very practical.
"Hangzhou Citizen Insurance 2021" not only increases the variety of special drugs, but also expands the scope of pharmacies, and perhaps you can buy expensive special drugs at the Jiuzhou Pharmacy at your doorstep. At a price of less than 100 yuan, you can enjoy 30 special drugs 0 deductible, 80% of the compensation ratio.
At the kick-off meeting, Mr. Jiang told the story of his compensation in 2020, "the insurance of 59 yuan has reduced the cost of more than 70,000 high-value special drugs (Krida) for himself." It is worth mentioning that Mr. Jiang has received compensation of 68,000 yuan and 15,000 yuan from Hangzhou Citizen Insurance and another similar million medical insurance product.
More than 80% of the special drugs in the list of special drugs for the two products are not the same, and the corresponding deductibles, compensation ratios and protection amounts are also different, which can be said to have their own advantages and complement each other.
4. Deductibles are deductible
"Hangzhou Citizen Insurance 2021" also has a major highlight, the compensation paid by other commercial insurance can be included in the deductible of "Hangzhou Citizen Insurance 2021". What do you mean? Let's look at an example.
Ms. C insured "Hangzhou Citizen Insurance 2021", accidentally fell during the insurance period, was diagnosed by the doctor as a fracture of the proximal right humerus, and underwent "right reverse total shoulder replacement" during hospitalization, spending a total of 105595.08 yuan during hospitalization, medical insurance overall reimbursement of 36143.39 yuan, personal burden 69451.69 yuan, and the remaining out-of-pocket payment of 16780.47 yuan in medical insurance.
After verification, Ms. C also purchased other commercial medical insurance, and the medical expenses paid by the third-party commercial insurance can be deducted from the annual deductible of all Hangzhou citizens' insurance. Therefore, the Hangzhou Citizen Insurance reimbursement no longer calculates the deductible of 20,000 yuan.
Ms. c can reimburse 16780.47 yuan to "Hangzhou Citizen Insurance×80% = 13424.38 yuan.
Even if you have purchased other million medical commercial insurance, and Hangzhou Citizen Insurance does not conflict, citizens can be reimbursed again after the million medical insurance claim, reducing personal out-of-pocket payment caused by deductible.
3. Exclusive welfare of Hangzhou citizens
At yesterday's press conference, the Hangzhou Citizen Insurance Operator also released the relevant data for the first year. According to reports, in 2020, a total of 750,000 Hangzhou citizens insured "Hangzhou Citizen Insurance", of which the oldest is 106 years old, the youngest has just reached the full moon, and the elderly over 60 years old account for a quarter.
As of June 2021, the "Hangzhou Citizen Insurance" has accumulated 6,162 cases, with a cumulative service of 27,226 person-times, a single maximum claim of 75,529.22 yuan, an average claim limitation period of 7.84 days, and the fastest case closure is only 2.64 hours. Judging from the claim data, "Hangzhou Citizen Insurance" reflects the characteristics of universal benefit.
Chen Lei believes that according to the protection characteristics of "Hangzhou Citizen Insurance 2021", it is especially recommended for the elderly, those with poor health or citizens with small defects, such as thyroid nodules, lung nodules, gastric ulcers, etc.; healthy people are recommended to apply with millions of medical insurance as a complement, to prepare for the future; insurance preferentially chooses the subsidy version.
Tips:
"Hangzhou Citizen Insurance 2021" is voluntary insurance, from now until 24:00 on August 15, within the scope of Greater Hangzhou (including the urban area and Qiantang, Xiaoshan, Yuhang, Linping, Fuyang, Lin'an, Chun'an, Tonglu, Jiande and other districts and counties), Zhejiang Provincial Unit Employee Medical Insurance participants, regardless of age, occupation and health status, can scan the code to pay attention to the "Hangzhou Citizen Insurance" WeChat public account, for themselves and their families. The coverage period is from 0:00 on August 1, 2021 to 24:00 on July 31, 2022.
For more details and insurance, WeChat search to pay attention to Hangzhou citizen insurance
Orange Persimmon Interactive Reporter Wan Yu Editor Tong Wei