Children's outpatient warm medical insurance is a small outpatient insurance of Huatai Insurance Company, which mainly covers children's small outpatient insurance. Not long ago, the children's outpatient warm medical insurance was upgraded, and some protection contents were updated. So what is the current situation of warm medical insurance in children's clinics? Let's talk about these today. The content is as follows:
1. What are the main selling points of children's outpatient medical insurance?
2. What are the insurance rules for children's outpatient warm medical insurance?
3. What are the compulsory and optional guarantees for children's outpatient warm medical insurance?
1. What are the main selling points of children's outpatient medical insurance?
At present, there are many types of insurance for children's clinics, but the contents of protection are basically the same. Let's look directly at the medical insurance for children's clinics:
It is not difficult to see from the table that children's outpatient warm medical insurance has many advantages. Let's see:
1, covering a wide range. This insurance has the protection of outpatient medical treatment and inpatient medical treatment, including accidental injury medical treatment and compensation for accidental death or disability. So after buying this insurance, you don't have to buy other accident insurance.
2, the deductible is relatively low, and the same disease is only treated once within 7 days.
3. The premium is relatively low. One-year premium is in 660 yuan. Children get sick every year because of their low self-resistance, so the premium is acceptable to everyone.
4. You can buy with or without social security, and the deductible without social security is slightly higher.
2. What are the insurance rules for children's outpatient warm medical insurance?
The insurance rules of children's outpatient warm medical insurance are as follows:
1, insurance age: 30 days to 17 years old.
2. Guarantee period and payment period: both guarantee period and payment period are 1 year.
3. Waiting period: There is a difference between outpatient waiting period and hospitalization waiting period, in which the outpatient waiting period is 30 days and the hospitalization waiting period is 90 days.
3. What are the compulsory and optional guarantees for children's outpatient medical insurance?
It is not difficult to see from the above table that the basic guarantee of warm medical insurance for children's outpatient service is as follows:
1, accidental death or disability. If the insured dies in an accident during the insurance period, the insurance company will pay 654.38+10,000 yuan in one lump sum, and the insurance contract will be terminated accordingly; If the disability is caused by accident, the insurance company will pay in proportion, and the contract will be terminated when it reaches 6,543,800 yuan.
2. Outpatient treatment due to illness. The amount of this guarantee is 5,000 yuan, and the deductible for each reimbursement is 100 yuan, but it should be noted that the daily compensation fee does not exceed 500 yuan.
3. Being hospitalized due to illness. The amount of this guarantee is RMB 65,438+0,000, with no compensation for 200 yuan. The rest is reimbursed according to 90% with social security and 60% without social security.
4. Accidental injury. The guarantee amount is 20,000 yuan, which will be reimbursed at the time of reimbursement 100%.
Fourth, insurance cases.
Ms. Yang is 38 years old and her son Huanhuan 10 years old. Considering the specific situation of her son, Ms. Yang decided to take out the children's outpatient medical insurance 1 year, and the premium paid was 660 yuan.
In August (the specific insurance waiting period has passed), Huanhuan needed to go to the hospital for fever and was diagnosed as respiratory infection. After five days of treatment, Huanhuan recovered. A total of 1327 yuan was spent during the period, all of which belonged to the scope of medical insurance, of which 306 yuan was reimbursed by medical insurance. After receiving the report, the insurance company determines that it is the insurance liability and pays compensation: after deducting the medical insurance reimbursement, the self-funded amount is 1.327 yuan -306 yuan = 1.0265438 0 yuan. After deducting 65,438 yuan+0,000 yuan stipulated in the contract, the insurance company paid 80% according to the regulations, and finally paid 736.8 yuan. During this medical treatment, Ms. Yang finally failed to visit 200 yuan at her own expense, which Ms. Yang said was easy to accept.
Verb (abbreviation of verb) frequently asked questions
Q: Is there an age limit for this insurance product?
A: The insurance era. The insurance age must be 30 days to 17 years old before you can buy it.
Q: Is there a waiting period for hospitalization and outpatient service under this insurance?
A: The waiting period for consultation is 30 days and the waiting period for hospitalization is 90 days. Under normal circumstances, if you choose continuous payment, there is no waiting period and you can seamlessly connect.
Q: How to reimburse this reimbursement?
A: There are social security reimbursement and no social security reimbursement at the time of reimbursement. Those with social security are reimbursed at 90%, and those without social security are reimbursed at 60%.
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