Features of health insurance
Compared with life insurance, health insurance has the following characteristics:
First, the coverage conditions for health insurance are more stringent. The reason is that many factors affect health, of which disease is the main factor affecting health insurance. Therefore, insurance companies often conduct stricter assessments based on the insured’s medical records, occupations, living environment, and lifestyle.
Secondly, the payment conditions of health insurance are also different. In the event of a health insurance insured event, for reasonable and necessary expenses; the insurer will pay the insurance money. This mainly includes outpatient expenses, medical expenses, hospitalization expenses, nursing expenses, handling fees, etc. However, coverage for such medical expenses often specifies a maximum coverage and a minimum deductible within a certain range.
Medical expense insurance
(1) Definition of medical protection expense insurance: Medical expense insurance is often referred to as medical insurance, which refers to the insurance that provides medical expense. It is one of the main contents of health insurance. Medical expenses mainly include doctor’s outpatient expenses, drug expenses, hospitalization expenses, nursing expenses, hospital miscellaneous expenses, operation expenses, various inspection expenses, etc. The expenses covered by various health insurance products are generally one or a combination of them.
The role of medical insurance is to provide financial help when the insured has large medical expenses. As for the small medical expenses paid for suffering from general diseases, it can be regarded as daily living expenses.
In real life, there is often a social medical insurance system provided by the government social security department, which often cooperates with the commercial medical insurance discussed here to jointly serve people to bear the risk of medical expenses.
(2) Common types of medical insurance: The common types of medical insurance provided by insurance companies include general medical insurance, hospitalization insurance, surgery insurance, special disease insurance, hospital allowance insurance, and comprehensive medical insurance.
General medical insurance: Provides the insured with general medical expenses related to the treatment of diseases, mainly including outpatient expenses, medical expenses, examination expenses, etc. This kind of insurance premium cost is relatively low, and it is more suitable for the general public. Due to the difficulty in controlling the expenditure of medical expenses and inspection expenses, such policies generally have provisions on deductibles and cost-sharing. The insurer pays a certain percentage of the above deductible, and the insurance costs need to be based on the situation year by year. Adjustment. The insurance is no longer liable when the accumulated cost of each illness exceeds the assured amount.
Hospitalization Insurance: As the cost of hospitalization is often high, the cost of hospitalization is treated as separate insurance. The expenses of hospitalization insurance mainly include daily hospitalization expenses (bed expenses), expenses for using hospital equipment, operation expenses, medical expenses, etc. The length of hospital stay will directly affect the level of its cost, therefore, the insurance amount of this kind of insurance should be determined according to the average hospitalization cost of the patient. To control unnecessarily long hospital stays, hospital insurance generally stipulates that the insurer only covers a percentage of all costs, but not all.
Surgical Insurance: This type of insurance covers the entire cost of the patient for necessary surgery.
Special disease insurance: Some special diseases often bring catastrophic expenses to patients, which are unbearable for ordinary residents’ families, such as cancer, heart disease, etc., people usually require that the insurance amount of this kind of policy is relatively large to cover the various expenses caused by special diseases. Critical illnesses that provide coverage to policyholders, can be a single item, such as a malignant tumor, or even some types of malignant tumors; it can also be multiple, listing several major diseases agreed upon one by one, such as a malignant tumor, myocardial infarction, uremia, important organ transplantation, Quadriplegia, stroke, and coronary artery bypass surgery.
Comprehensive medical insurance: It is comprehensive medical expense insurance provided by the insurer for the insured, and its expenses include all expenses such as medical treatment, hospitalization, and surgery. The premiums of such policies are higher, and a lower deductible is generally determined, as well as an appropriate sharing ratio.
