I already have medical insurance, do I still need to buy health insurance?
The State Council executive meeting held on the 9th called for speeding up the development of commercial health insurance, supporting the development of more insurance products for serious illnesses, doing a good job of connecting and supplementing with basic medical insurance, and improving urban and rural areas. Residents’ critical illness insurance coverage.
So, what is health insurance? Do I still need health insurance if I have health insurance? What should you pay attention to when choosing health insurance products?
What is health insurance?
The so-called health insurance refers to the insurance that the insurance company pays the insurance money to the insured due to health reasons or medical behavior, mainly including medical insurance, disease insurance, disability income loss insurance, nursing insurance, and medical accident insurance.
In recent years, with the continuous improvement of consumers’ health awareness, the demand for health insurance products has also continued to increase. According to the “China Health Insurance Development Report”, since 2018, health insurance has shown a rapid development trend. In 2019, the entire industry achieved an original health insurance premium income of 706.6 billion yuan, a year-on-year growth rate of 29.7%.
This year, due to the impact of the new crown epidemic, consumers’ demand for health insurance has increased significantly. According to data from the China Banking and Insurance Regulatory Commission, in the first three quarters of this year, health insurance premiums were 716.2 billion yuan, a year-on-year increase of 16.6%, and the growth rate far exceeded the average growth rate of industry premiums.
If you have health insurance, do you still need to buy health insurance?
Many people think that if you have medical insurance, everything will be fine, so why bother paying for insurance?
China’s basic medical insurance mainly follows the principle of “guaranteeing the basics, covering the bottom line, and being sustainable”. From the literal meaning, it can be seen that it mainly plays the role of guaranteeing the bottom line and meeting the basic medical needs of everyone.
In other words, basic medical insurance cannot reimburse all medical expenses. During the settlement, personal expenses may be incurred due to the threshold line, out-of-pocket expenses outside the scope of medical insurance, out-of-pocket expenses first, and the remainder after pro-rata reimbursement within the scope of medical insurance.
Here is a set of data. In the past ten years, the average annual growth rate of China’s total health expenditure has been more than 15%, and it has reached 5.8 trillion in 2018. Among them, the actual reimbursement ratio of the basic medical insurance for the masses only accounts for about 1/3; and in the past three years, the proportion of personal medical expenses in China’s medical expenses has stabilized at more than 28%.
This all shows that it is difficult to meet the multi-level medical and health needs of the 1.4 billion people if only relying on basic medical insurance. Commercial health insurance is particularly important as a supplement to basic medical insurance.
What should I pay attention to when buying?
At present, there are many types of health insurance products on the market, and the coverage of different products is also different. So, can I buy more copies to get more protection? What should be paid attention to when choosing?
First of all, buy medical insurance and do not re-insure!
Medical insurance is insurance that protects the medical expenses stipulated in the insurance contract. It mainly includes doctor’s outpatient expenses, medical expenses, hospitalization expenses, nursing expenses, operation expenses, various inspection expenses, etc. Generally speaking, according to the nature of insurance benefits, it can be divided into cost compensation medical insurance, and fixed benefit medical insurance.
If you are insured with cost-compensating medical insurance, the payment amount cannot exceed the number of medical expenses incurred by the insured. That is to say, no matter how much medical insurance you have invested, the final medical expenses can only be reimbursed once.
The fixed-payment medical insurance usually guarantees hospital allowances, surgical allowances, subsidies, etc., and pays the insurance money according to the amount agreed in the contract. The assured only needs to prove that the medical behavior stipulated in the contract has occurred. Regardless of the number of medical expenses, the insurance company will pay the insurance money according to the amount stipulated in the contract.
So, don’t make unnecessary investments!
Secondly, pay attention to the number of claims when buying critical illness insurance!
There are both single-payment and multiple-payment insurance products on the market today. Generally speaking, the price of “multiple payments” is 30%-50% higher than that of “single payment”.
At present, two main types of critical illness insurance can be paid for multiple times. One is to make multiple claims for minor illnesses in the insurance contract and one claim for serious illnesses; the other product is to group multiple diseases, and any group of If you are diagnosed, you will be compensated. However, the same group of major diseases can only be paid once. If the same disease occurs next time, the insurance company will not pay.
In addition, it should be noted that some of the current critical illness insurance products with multiple payments will have interval and lifetime restrictions. Interval period means that at least 1 year after the occurrence of a certain group of serious illness liabilities, other groups of liabilities can be compensated; Survival period means that if the insured dies within the survival period (usually within 30 days) after being diagnosed with a serious illness, there is no second or third compensation.
