Insurance common sense

/ Michael翔

Original link: https://michael728.github.io/2022/12/04/life-insurance/

Insurance

The role of insurance: prevent problems before they happen, effectively transfer the economic risks brought about by diseases and accidents, and reduce the pressure on the family economy.

  • Social insurance: Social insurance, social insurance is commonly referred to as “five insurances”, the contents include:
    1. Pension Insurance: Retirement Salary
    2. Medical insurance: medical reimbursement, serious illness overall planning. When we buy medicine, see a doctor, and get reimbursed, the social security mentioned generally refers to “medical insurance”, that is, “medical insurance”
    3. Unemployment Insurance: You can get unemployment benefits for a certain period of time when you are unemployed
    4. Work injury insurance: You can get unemployment benefits for a certain period of time when you are unemployed
    5. Maternity insurance: women can be reimbursed for expenses and receive subsidies during childbirth, and men can enjoy expense reimbursement and allowances for maternity sterilization, reproductive health, etc.
  • Medical insurance: the most basic protection, “wide coverage, basic insurance”, with restrictions on the amount and scope of reimbursement. Drugs within the scope of the social insurance catalog can only be reimbursed, and high-priced drugs such as imported drugs and targeted drugs cannot be reimbursed.
  • Million-dollar medical insurance: Supplementary to social insurance, if you have a serious illness that burns money, special medicines, high-end equipment and treatment methods that are not covered by medical insurance, you can be reimbursed by the million-dollar medical insurance.

Insurance classification:

  1. Critical illness insurance: After a serious illness is diagnosed, a one-time payment will be made. For example, if the insured amount is 50W, you can pay 50W.
  2. Medical insurance: only the medical expenses incurred in going to the hospital can be reimbursed;
  3. Accident risks: such as sudden death, etc.

the term

  • Deductible amount: The amount that does not make compensation, such as “10,000 deductible amount”, means less than 10,000 yuan, which is borne by individuals. Personal payments exceeding 10,000 yuan in total can be reimbursed by insurance.
  • Insurance amount

buying strategy?

  • Premiums: no more than 10% of household income

Finally, I would like to remind everyone that you must do a good job of health notification, otherwise it will affect the follow-up claims.

medical insurance

Medical insurance: medical reimbursement, serious illness overall planning. When we buy medicine, see a doctor, and get reimbursed, the social insurance mentioned generally refers to “medical insurance”, that is, “medical insurance”, which is a kind of insurance in the “five insurances and one housing fund” of social insurance.

  1. Medical insurance usage record query: Search “medical insurance” in Alipay’s search box, and click “Usage Record” after entering. Refer to Hangzhou Medical Insurance Consumption Record Query Tutorial .

Zheli Office (Alipay search for “Zheli Office” or download the Zheli Office APP), after entering, search for “Zheli Medical Insurance”, click “Medical Insurance Account”, you can query:

  • Account Balance
  • Insurance status
  • Payment record
  • Expenses record

In addition, the “Zheli Medical Insurance” here in Zhejiang Office can also provide reimbursement, family mutual aid binding, designated hospital inquiries, drug catalog inquiries, and proof of payment

critical illness insurance

how to choose

  • Insurance amount: the higher the insurance amount, the better
  • Guarantee period: Sufficient budget, one-step guarantee for life. If you have an average budget, first increase the sum insured until you are 70 years old.
  • Health notices are important: If you ignore health notices, you may be denied a claim.

million medical insurance

Self-paid drugs, special effects drugs, targeted drugs, imported drugs, etc. that are not included in the medical insurance will be fully reimbursed.

Limitation of Liability

Reimbursable scope of liability:

  • Severe illness (serious illness): malignant tumor, etc.
  • Diseases (minor illnesses): appendicitis, gastric ulcer, etc.
  • Accidents: traffic accidents, burns, rabies vaccines,
  • clinic
  • Internet drug purchase

The conditions stipulated in the exemption clause cannot be reimbursed, and other diseases can apply for reimbursement.

Not covered by the guarantee:

  • give birth
  • Orthodontics
  • vision correction
  • plastic surgery

Reimbursement conditions:
Outpatient surgery without hospitalization, special outpatient clinic, outpatient and emergency department within 60 days before and after hospitalization.

key factors

  • Guaranteed renewal period: Guaranteed renewal for 20 years means that if claims have been settled during the 20-year period of protection, the insurance can also be renewed, and the suspension of sales will not affect the 20-year renewal rights.
  • Whether out-of-hospital targeted drugs can be reimbursed:
  • Family Single Sharing Deductible:
  • family single discount
  • Insurance age
  • advance payment

how to choose

  • Guarantee time: Select guaranteed renewal for 6 years/20 years
  • Reimbursement threshold: choose a low deductible or a family that can share the deductible
  • Value-added services: reimbursement of purchased drugs, proton heavy ions, advance payment for hospitalization, green pass for medical treatment, etc.

Pacific Medical Carefree

Taikang

scope

2 more:

  • Accident clinic
  • Infection Clinic

use channel

  • APP: Taikang Online
  • Official account: Taikang Online Insurance

member benefits

Thai Love Children’s Million Medical Insurance:

  • Uncle Kai Storytelling VIP
  • Remote consultation, home delivery of medicine

accident insurance

Cover accidents big or small, get reimbursed according to injuries, and get a sum of money for death/disability.

effect

  • Cover accidents, big or small, such as dog bites, burns, falls, etc.
  • A one-time payment for death and disability due to accidents
  • Reimbursement of medical expenses caused by accident

how to choose

  • Guarantee period: Don’t buy long-term accident insurance, just choose a one-year period
  • Bonus items: Vaccination accident protection, traffic accident additional compensation

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