The "Enjoy Your Health" critical illness insurance plan covers cancer in situ and 30 kinds of critical illness protection. However, as a new medical insurance policy, most people still have some understanding of this new policy. Since there is such a good policy, do you still need the insured to pay a certain fee? To what extent can this new policy alleviate people's difficulty in seeing a doctor, and how much can it be reimbursed?
New policy of "free" for critical illness insurance
According to the Guiding Opinions on Developing Serious Illness Insurance for Urban and Rural Residents, a certain proportion or quota will be set aside from the urban residents' medical insurance fund and the new rural cooperative medical insurance fund as the serious illness insurance fund. If there is a balance between urban residents' medical insurance and the new rural cooperative medical fund in some areas, we can use local materials to raise more serious illness insurance with the balance. If there is no balance or insufficient balance, it is necessary to solve the problem of funding sources as a whole when improving the medical insurance for urban residents and the financing of the new rural cooperative medical system.
In this regard, Liu Guoen, a member of the State Council National Medical Reform Expert Advisory Committee and a professor of economics at Guanghua School of Management, Peking University, explained that there are still many balances in medical insurance funds in many areas, and the accumulated balance is relatively large. If simple storage is difficult to exert its greatest social effect, the new policy of serious illness insurance can fully mobilize this part of funds, so that the government can spend less and the people can pay less, and at the same time, it can greatly improve the level of protection against major diseases.
The new policy of serious illness insurance is beyond imagination.
According to "Guiding Opinions on Developing Serious Illness Insurance for Urban and Rural Residents", the insured persons of urban residents' medical insurance and the new rural cooperative medical system are the protection objects of serious illness insurance. The main goal of the new policy of serious illness insurance is to avoid catastrophic medical expenses for urban and rural residents. The payment ratio determined by the current policy is not less than 50%; The proportion of payment is determined according to the level of medical expenses. In principle, the higher the medical expenses, the higher the payment ratio.
In this regard, Liu Guoen believes that the original basic medical insurance pays more attention to the breadth and the degree of protection is limited, but the new policy of serious illness insurance is actually an extension of the vertical depth, which is equivalent to reinsurance on the basis of basic medical insurance. When the medical expenses borne by the insured individual exceed the medical insurance standard, the serious illness insurance will once again play the corresponding reimbursement role, effectively reducing the phenomenon of returning to poverty due to illness.
The "Le Kang Worry-Free" refundable hospitalization medical insurance scheme has dual functions of insurance protection and premium refund.