Recently, a series of articles on fund-raising for a leukemia have been continuously forwarded in the circle of friends.
Lovely little girl, leukemia, [can’t afford money], touching tears of writing, these key words, let the whole circle of friends love flood.
Has anyone in your circle of friends forwarded such an article? As a doctor, you think of what first when you read the article?
In our country, it is not uncommon for a small probability disease to directly bring down the whole family. Some even call it “returning to poverty due to illness”-this is also one of the public’s grievances against the medical industry.
However, in the face of disease, we really can’t do it in what? Do we have to do some what to make the sudden natural disaster docile?
Today, Dingxiangwang (Micro Signal: Dingxiangwang) will give you a little introduction from a medical point of view.
Is there anything in what that can provide protection?
Once the disease occurs, there will be several mechanisms to start the guarantee for us. They are respectively the medical insurance for urban workers, residents’ medical insurance, the new rural cooperative medical system and serious illness insurance under the existing national medical insurance system. In addition, if there is a purchase of commercial health insurance, this mechanism will also start to operate.
For example-
Our country’s existing medical insurance system will cover basic medical services, conform to the medical expenses in the list of essential drugs and the list of basic diagnosis and treatment, and will have corresponding national compensation. Patients will pay lower costs for basic medical care. However, the coverage of the basic list is limited, and some [good drugs] and [imported drugs] may not be available or need to pay for them at their own expense.
If there is serious illness insurance for cities and towns and residents, they can get a higher reimbursement rate after suffering from serious illness. However, due to the higher total medical expenses, the remaining personal payment is generally not small.
Commercial health insurance can provide better treatment protection at this time. For example, critical illness insurance can generally receive full compensation and an additional financial support after pathological diagnosis.
Another example is that the scope of compensation for high-end supplementary medical insurance is very wide, especially for drugs with less side effects that need to be purchased at one’s own expense. Generally, a high proportion of compensation can be obtained through commercial insurance. With the latest targeted therapeutic drugs on the market, the cost of these self-funded drugs may sometimes reach 200,000 yuan or more.
Is critical illness insurance what?
Critical illness insurance came out in South Africa in 1983 and was introduced into China in 1995. In order to make the insurance content more objective and scientific, in 2007, Insurance Association of China and the Chinese Medical Association cooperated across borders to launch China’s first industry normative operation guide for critical illness insurance-Critical Illness Insurance’s Disease Definition Use Standard (hereinafter referred to as [Standard]).
Since then, critical illness insurance has a more scientific and accurate definition.
Does critical illness insurance cover some what?
The incidence of diseases has an important relationship with the pricing of this type of insurance by insurance companies.
Generally speaking, the higher the incidence of diseases, the higher the risk borne by the insurance company, so the insurance types including the disease, pricing should be increased accordingly. Judging from international experience, among the various diseases protected by heavy disease insurance, there are three to six diseases with the highest incidence and claim rate.
Therefore, the [Code] requires that if named after [critical illness insurance], the coverage must include the following 6 diseases:
1. Malignant tumors-excluding some early malignant tumors;
2. Acute myocardial infarction;
3. Sequelae of cerebral apoplexy-permanent dysfunction;
4. Major organ transplantation or hematopoietic stem cell transplantation-allotransplantation is required;
5. Coronary artery bypass grafting (or coronary artery bypass grafting)-thoracotomy is required;
6. End-stage renal disease (or uremic stage of chronic renal failure)-dialysis treatment or kidney transplantation is required.
How many major diseases are there?
This is a question that is difficult for conscientious professionals to answer, Because different diseases have different opportunities for different genders and ages. If the question to be answered is [how likely I am to suffer from these diseases], it should also include factors such as personal habits, location, heredity, etc.
Is it impossible to know the risks of these diseases? Not necessarily. In 2013, the CIRC published a “Table of Experienced Incidence of Major Diseases in China’s Life Insurance Industry (2006-2010)”, which is the first table of experienced incidence of major diseases in China’s life insurance industry. The table said:
1. People of different ages and genders have different probability of [major diseases];
2. This [occurrence probability] refers to the probability of suffering from [major diseases] confirmed according to the diagnostic criteria stipulated in the insurance contract.
For example, the experience incidence rate of 45-year-old men, the main financial support of the family, is 0.003997. The incidence rate of experience of small white-collar workers and 25-year-old women [six major diseases] who have just graduated to work is 0.000540. The empirical incidence rates of [six major diseases] for 60-year-old men and women were 0.017274 and 0.010487.
If the above answer still does not satisfy you, or can you try to recall, have you ever had at least one family member or friend with [six serious diseases]?
Which company has the best critical illness insurance?
In addition to the above-mentioned 6 [compulsory] major diseases, there are 25 diseases with a high incidence rate. The [Standard] requires that the exclusion liability listed in the contract by the insurance company cannot exempt these 25 diseases.
In short, the [six major diseases] mainly refer to cancer, severe coronary heart disease, end-stage nephritis and severe stroke. On this basis, 25 diseases cover the most common diseases such as hepatitis, sensory disorders and nervous system and blood system.
The 36 kinds and 42 kinds boasted by various families are actually more numerical concepts. 95% of the compensation for major diseases is concentrated in these 25 kinds of diseases. Therefore, there is little difference in which one to buy.
Does what not compensate for major disease insurance?
Many people buy insurance, the most worried is that the insurance contract is difficult to understand, afraid of being cheated because they do not understand the contract, especially the so-called exemption clauses, which are various and difficult to say, and it is difficult to understand thoroughly. So, does [heavy disease insurance] not cover what?
Generally speaking, the fundamental purpose of critical illness insurance is to provide financial support for the treatment of serious and costly diseases, so it pays for the most serious diseases and the most serious states.
Some diseases with good prognosis, low risk and low cost will not be paid by the insurance company, or they will be classified as minor diseases and will only pay a certain share in proportion. These [minor diseases] actually include malignant tumors, such as carcinoma in situ, some borderline tumors, chronic granulocytic leukemia, Hodgkin’s lymphoma, etc.
In addition, out of the understanding of the original intention of protection and the protection of the interests of insurance companies, there are also some non-claim clauses.
For example, the dog blood plot that you often see in TV plays buys insurance for your spouse and then moves bad thoughts, intentionally hurting the other party without compensation.
Because of one’s own fault, such as self-injury and suicide, intentional crime, drunk driving, no compensation;
No compensation will be paid for the injuries caused by wars and riots.
The consequences caused by nuclear explosion, nuclear radiation, etc. will not be compensated;
Due to AIDS or congenital diseases, genetic consequences, no compensation.
Special attention should be paid to informing the insurance company of their own health conditions such as thyroid gland and breast nodules before purchasing the insurance, otherwise there will be great differences and even legal disputes in the relevant compensation.
Who needs to buy heavy disease insurance?
Generally speaking, married people are more insured than unmarried people, those with children are more insured than those without children, and those with high incomes are more insured than those with low incomes. This is very related to family property reserves and upbringing responsibilities.
Most people will have the idea that it is a waste to buy insurance if you can’t compensate. However, what [can’t compensate] brings is a lifetime of health and safety. What the insurance company will never compensate is the winner in life.
The mainstay of every family, as well as the children in the family, all need insurance support.
For every additional patient who is insured, it is possible to reduce a radical medical scandal that will retaliate against the society due to the destruction of his sick family in the future… Wouldn’t it be quick?
Of course, Clove Garden also strongly suggests that doctors need to buy an accident insurance for themselves-you know.
Copyright of Clove Garden. No reprinting is allowed without permission.
Photo Source: Station Cool Hailuo Creative