Starter: Wenwen Dabao Belle.
An insurance company that can directly contact the public owner.
Hello everyone, I'm Wenwen Dabao Belle, your heel insurance blogger.
There are many million medical insurance products on the market, and they are becoming more and more subdivided, and there has been a million medical insurance for children.
All ages can apply for people's insurance and medical insurance: 20 years of guaranteed renewal of millions of medical insurance, and then a new one!
Children's Exclusive Medical Insurance Children's Edition: 0 deductible for hospitalization, an excellent alternative to small medical insurance
So, the million medical insurance product also produced by Chinese Insurance, should the child choose the "Golden Medical Insurance" with a deductible of 10,000 and a reimbursement ratio of 100% for the remaining part, or the "Golden Medical Insurance Children's Edition" with a 0 deductible and a reimbursement ratio of 80% for the remaining part for the child?
Wenwen Dabao Belle first said and drew conclusions:
There is no contradiction, and if the budget allows, you can buy both.
We can think of the "Golden Medical Insurance Children's Edition" as a small medical insurance that guarantees renewal, and then on this basis, we can buy a million-dollar medical insurance with a higher reimbursement ratio for our children.
There is not an "exclusive" relationship between different types of medical insurance.
Although medical insurance is based on the actual reimbursement of medical invoices and cannot be reclaimed, different types of medical insurance can be superimposed to make our protection more comprehensive.
Let's talk about the difference between "Golden Medical Insurance" and "Golden Medical Insurance Children's Edition" in terms of protection content.
The difference between the two
(1) Deductibles are different
The deductible of the Golden Medical Insurance is 10,000 yuan, and the deductible of the Golden Medical Insurance Children's Edition is 0 yuan.
(2) The age at which the policy can be insured is different
Gold medical insurance requires 28 days of birth to buy, and gold medical insurance children's version can be bought at birth.
(3) The renewal time is different
Golden Medical Insurance is guaranteed to be renewed for 20 years, and Golden Medical Insurance Children's Edition is guaranteed to be renewed until the age of 18.
For children, the younger the annual quota, the smaller the difference between "guaranteed renewal for 20 years" and "guaranteed renewal up to the age of 18".
But if the child is older, such as already.
Ten. At the age of three or four, then the Golden Medical Insurance Children's Edition, which is only guaranteed to be renewed to the age of 18, is not as good as the Golden Medical Insurance that is guaranteed to be renewed for 20 years in terms of the length of time guaranteed to be renewed.
(4) Proton and heavy ion guarantees are different
Golden Medical Insurance comes with proton and heavy ion protection, and the renewal is guaranteed for 20 years.
The children's version of the Golden Medical Insurance 0-13 years old does not have this protection, and only the initial insurance age is over 14 years old, there is this responsibility, and there is no guarantee of renewal.
But this actually didn't have much impact, because Shanghai Proton Heavy Ion Hospital does not accept patients under the age of 14 in the first place.
(5) Outpatient medical coverage for specific diseases is different
The children's version of the Golden Medical Insurance can be attached to the outpatient liability for specific diseases, while the Golden Medical Insurance does not include this responsibility.
However, "Outpatient Medical Care for Specific Diseases" does not cover all diseases, and only covers 32 specific diseases, including 3 common diseases and 29 infectious diseases.
In the case of claims, the limit is 50,000 yuan, and the remaining part will be reimbursed at 80% after being reimbursed by medical insurance.
As an outpatient benefit, 50,000 yuan a year should be enough for most children.
Although this benefit does not cover all outpatient and emergency diseases, it is sufficient to cover influenza A, influenza B, hand, foot and mouth disease, and pneumonia, which are highly common in children.
If there is a disadvantage, it is that the outpatient medical treatment for specific diseases is an additional insurance and does not guarantee renewal.
(6) The hospital for critical illness is different
If the 120 critical illnesses agreed in the contract are diagnosed and the claim standard agreed in the contract is met, the special needs department of the public hospital will be expanded.
100% reimbursement for treatment in the special needs department (including the special needs medical department, the international medical department, the cadre ward, the VIP medical department, the foreign guest medical department and the VIP department) can be reimbursed regardless of whether the social security settlement is used or not.
However, the scope of medical treatment is limited to the general department of public hospitals.
(7) The special outpatient benefits for tumors are different
Golden Medical Insurance is applicable to malignant tumors - severe, malignant tumors - mild, carcinoma in situ, while Golden Medical Insurance Children's Edition is only for malignant tumors - severe.
(8) The proportion of compensation for general medical insurance is different
This is the biggest difference and the most important thing to consider when choosing a product.
In terms of common diseases (non-major diseases), there is a certain difference in the reimbursement ratio between the Golden Medical Insurance and the Golden Medical Insurance Children's Edition.
Golden Medical Insurance has a deductible of 10,000, and the maximum reimbursement ratio can reach 100%, and the Golden Medical Insurance Children's Edition has 0 deductible, but the maximum reimbursement ratio is only 80%.
So I said, everybodyThe children's version of the Golden Medical Insurance can be regarded as a small medical insurance product that can be guaranteed to be renewed, mainly to protect the risk of minor diseases;
Then, on this basis, the child is equipped with a million-dollar medical insurance product with a higher reimbursement ratio to transfer the medical risk of serious illness.
Don't think that 100% reimbursement and 80% reimbursement look similar, in fact, after reimbursement, the gap between the two is still very large.
To name a few chestnuts:
If we spend less than 10,000 yuan after the social security reimbursement for medical treatment:
Because the deductible has not been reached, there is no way to reimburse a penny;
The children's version of the Golden Medical Insurance can reimburse 80% of the amount we paid, for example, if you spend 8,000 yuan, you can reimburse 6,400 yuan.
If we spend between 10,000 yuan and 50,000 yuan after the social security reimbursement for medical treatment:
Golden medical insurance needs to deduct the deductible of 10,000 yuan first, and then the remaining part will be reimbursed 100%, such as spending 30,000 yuan, and gold medical insurance can reimburse 20,000 yuan;
There is no deductible for the children's version of the Golden Medical Insurance, and 80% is directly reimbursed, and in the case of spending 30,000 yuan, the Children's version of the Golden Medical Insurance can be reimbursed 540,000 yuan.
If we spend more than 50,000 yuan after the reimbursement of social security:
Golden medical insurance needs to deduct the deductible of 10,000 yuan first, and then reimburse the remaining part 100%, such as spending 200,000 yuan, and gold medical insurance can reimburse 190,000 yuan;
There is no deductible for the children's version of the Golden Medical Insurance, and 80% of the reimbursement is direct, and in the case of spending 200,000 yuan, the Children's version of the Golden Medical Insurance can be reimbursed for 160,000 yuan.
We can see:
In the case of spending 50,000 yuan, the reimbursement results of the Golden Medical Insurance and the Golden Medical Insurance Children's Edition are the same, both reimbursing 40,000 yuan.
This also means that whether the out-of-pocket part of medical treatment exceeds 50,000 yuan is the dividing line between the reimbursement of the golden medical insurance and the golden medical insurance children's version.
If the self-payment does not exceed 50,000 yuan, the children's version of the gold medical insurance will be reimbursed more;
In the case of self-payment of more than 50,000 yuan, the gold medical insurance will reimburse more.
The more the out-of-pocket part is spent, the greater the reimbursement advantage of the Golden Medical Insurance.
My advice
If you look at the Golden Medical Insurance Children's Edition as a small medical insurance product, this product is really, absolutely amazing.
First, it guarantees renewal.
Small medical insurance is often taken off the shelves and stopped selling, and the renewal is very unstable;
The children's version of the Golden Medical Insurance guarantees the renewal of the insurance until the child is 18 years old, and this product is invincible based on this alone.
Secondly, he is very well protected.
Medical expenses inside and outside the social insurance can be covered, and the compensation ratio is as high as 80%, which is high enough for a small medical insurance.
Thirdly, it is possible to take into account outpatient benefits.
Although not all diseases can be covered by outpatient visits, it covers common diseases with high incidence in children, such as influenza A, influenza B, pneumonia, etc., and the practicability is sufficient;
In addition, it also covers outpatient and emergency expenses for 30 days before and after hospitalization.
For example, if you go to the outpatient clinic for gastroenteritis and you don't get well for several days, and you are finally hospitalized, then as long as you are hospitalized, the outpatient and emergency expenses related to this hospitalization for 30 days before and after the hospitalization can also be compensated.
Finally, take into account the special needs medical insurance.
Golden Medical Insurance Children's Edition not only provides small medical insurance, but also takes into account the special medical protection for major diseases.
If you really suffer from a major illness, you can live in a special needs ward in a big hospital in Beijing and Shanghai**, and the children's version of the Golden Medical Insurance can achieve 100% compensation.
You don't have to spend the premium of high-end medical insurance, but you can enjoy the treatment of high-end medical insurance, where can you find such a good thing?
So,From the perspective of a small medical insurance, the children's version of Golden Medical Insurance is really very, very good.
Of course, if you use it as a million-dollar medical insurance, it's not impossible.
The biggest problem is that the average routine illness payout rate is 80%.
If you suffer from a certain disease, which is not a critical illness or a specific disease, even if the cost is more, you can only pay 80% of the regular illness.
20% out of pocket isn't actually too much, but if it's really expensive, 20% can be a bit stressful.
If you are not worried about the 20% out-of-pocket payment, then it is completely okay to buy the Golden Medical Insurance Children's Edition as a million medical insurance.
Wenwen Dabao Belle's suggestion is to buy the Golden Medical Insurance Children's Edition as a small medical insurance with guaranteed renewal, in addition to supplementing another million medical insurance products.
Supplementary medical insurance can also be used, supplementary medical care can also enjoy worry-free (blue medical insurance), and supplemental Changxiangan can also be used, these million medical insurance products are good.
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Write at the end
In fact, for medical insurance products, the biggest significance of 0 deductible is reflected in general medical insurance.
It means that if we are hospitalized for a minor illness like pneumonia, even if it only costs three or five thousand, we can compensate, and the internal and external expenses of medical insurance can be compensated, and the compensation ratio is 80%, which is not low.
From this point of view, the children's version of Golden Medical Insurance can indeed be used as a perfect substitute for small medical insurance products, after all, he guarantees to renew the insurance until the child is 18 years old, and there is no need to worry about the problem of not being able to renew the insurance after the claim is made halfway.
But we must also be soberly aware that the greatest use of insurance is to transfer the risk of serious illness that we cannot bear, which is the key, so millions of medical insurance also have its meaning of existence, and we must not ignore it.