Besides medical insurance, what else can share the medical expenses?

This article is about 1600 words, and the reading time is about 5 minutes.

One,

I don't know if everyone feels that medical expenses are getting higher and higher. As common as a cold and fever. Going to the hospital will cost you 2300 yuan.

Because of the reimbursement rules of medical insurance, the proportion of outpatient reimbursement is not high.

At the beginning of the year, I committed a lumbar disc herniation. I felt relieved after two days' rest, but I didn't make it. I went to the hospital.

After a CT scan, the doctor prescribed ointment 15 days of massage and physical therapy, which cost RMB.

How to reimburse outpatient medical insurance?

Outpatient reimbursement rules deductible line 1800 yuan, capped line 20,000 yuan.

It means that under 1800 yuan, more than 20,000 yuan will not be reimbursed.

What can be reimbursed? (You can see the attached yellow invoice)

Out-of-pocket (Class A) is fully reimbursed, out-of-pocket (Class B) is partially reimbursed, and out-of-pocket (Class C) is not reimbursed.

How much can I reimburse?

90% for community hospitals and 80% for other hospitals.

Example: (Waist keyboard protruding)

Reimburseable portion-1800 yuan (deductible) = RMB.

The actual reimbursement part is RMB *80%= RMB (at its own expense) = RMB.

Medical insurance reimbursement yuan

Self-funded yuan

Second,

Let's talk about medical insurance hospitalization reimbursement first.

My husband's heart rate was irregular last year. Because he couldn't find the reason, he had a heart ablation outside Fuwai.

I don't know if the operation was unsuccessful or other reasons, but it recurred in less than half a year. I had no choice but to undergo minimally invasive surgery again in March this year. I was hospitalized for 3 days and spent RMB.

Reimbursement rules for hospitalization, deductible line 1300 yuan, capped line 500,000 yuan.

It is also divided into three categories: self-payment (Class A), self-payment (Class B) and self-payment (Class C).

The reimbursement rate shall be reimbursed in four grades: 65,438+0, 300 yuan-30,000, 30,000-40,000, 40,000-65,438+0,000 and 65,438+0,000-500,000.

Major illness co-ordination: This second reimbursement mainly for major diseases is divided into two reimbursement grades: less than 50,000 and more than 50,000.

Example: (Cardiac Ablation Surgery)

Total cost: yuan

1300 yuan-30,000 yuan, reimbursed 85%, 24,395 yuan.

30,000-40,000 yuan, 90% reimbursement, 9,000 yuan.

More than 40,000 yuan, 95% reimbursement, RMB.

Medical insurance reimbursement yuan

Self-funded yuan

Third,

How to reimburse the rest of the medical insurance report?

1, unit supplementary medical insurance

Unit supplementary medical insurance belongs to group medical insurance, which is the insurance insured by the unit for employees, mainly for the second reimbursement of some medical insurance.

Suppose my unit is insured with supplementary medical insurance, outpatient service 1 10,000, hospitalization 50,000, deductible 0, and reimbursement ratio 90%.

Cost: 1094 yuan/year

1) Second reimbursement for outpatient service

After social security reimbursement, the individual pays RMB = RMB.

Social Security Supplementary Medical Reimbursement RMB -0 (self-payment line) *90%= RMB.

At one's own expense = yuan

2) Second reimbursement for hospitalization:

After social security reimbursement, the individual pays RMB = RMB.

Social Security Supplementary Medical Reimbursement RMB -0 (self-payment line) *90%= RMB.

At one's own expense = yuan

Medical insurance needs to be paid at your own expense.

Supplementary medical care needs to be paid at your own expense.

Greatly reduced the personal payment fee, from 1 10,000 to 2,800 yuan.

Then the problem comes again. Not all units have supplementary medical insurance. What should we do?

2. Commercial medical insurance

Take the middle-aged medical insurance of Fosun and Lejian as an example.

30-year-old male, choose outpatient service quota of 654.38+00,000, hospitalization quota of 300,000, no compensation, 65,438+000% reimbursement, including the treatment expenses of malignant tumor, such as outpatient radiotherapy and chemotherapy, immunotherapy, targeted therapy, tumor endocrine therapy, etc.

Cost yuan/year

Medical insurance needs to be paid at your own expense.

Le Jian needs to pay his own expenses all his life: 0 yuan

Fourth, summary.

Medical insurance, supplementary medical insurance and commercial medical insurance are the three major medical expenses reimbursement.

Medical insurance is the basic fund, and there is no limit on insurance, but there are restrictions on reimbursement, and the proportion of reimbursement is relatively low.

Supplementary medical insurance is mainly a self-paid item for supplementary reimbursement of medical insurance, which requires the unit to insure employees and belongs to welfare insurance. If you leave this unit, this guarantee will be gone, and not all units have this benefit.

Commercial medical insurance can reimburse the rest of medical insurance, which is not restricted by medical insurance rules. And as long as the products you choose are stable, you can always have this guarantee.

Finally, the small coup to buy commercial medical insurance: product stability+strong company strength.

On this basis, if you look at the insurance liability and price clearly, you will definitely not buy it wrong.