Data:2009-12-12 2:34
Category: Insurance tips Release Date: 2006-08-01
Participated in the "social security" option to have a fixed subsidy based work, and where companies are bought for "social security", Mr. Chang, recently purchased by the insurance company 20,000 yuan of commercial health insurance, he was hospitalized during the period of responsibility to spend more than 12,000 yuan, according to insurance terms, he should be nearly 9,000 insurance payment. However, because of his basic social medical insurance from more than 7,000 yuan in reimbursement of medical expenses, the insurance company finally paid his actual costs and reimbursement of the difference between the cost of more than 5,000 yuan. Payment of insurance companies so that Mr. Wang did not understand, he told this reporter complaints: whether the insurance company for fraud?
According to insurance industry experts, currently on the market the way commercial medical insurance payment can be divided into two kinds, one is the cost-based insurance, a kind of a subsidy-based insurance, Mr. Zhang is the cost-based insurance to purchase. The so-called fee-based insurance, insurance company refers to the ratio stipulated in the contract, according to the insured in the medical receipts in the total amount of all costs to carry out payment, if the basic social medical insurance claims, insurance companies can only be compensated in accordance with the principles of insurance , make up the difference between the costs incurred; vice versa, if the insurance company for reimbursement, the cost of social security could only make up the difference. The subsidy-based insurance, also known as a fixed payment based insurance, has nothing to do with the actual medical expenses, claims, when not required to provide invoices, insurance companies, according to the contract subsidy standards, payment to policyholders. No matter how much he was in the treatment of the money, come what disease, the benefit remains unchanged.
Commercial health insurance as a kind of social medical insurance, a good complementary way, more and more attention has been paid. Insurance industry experts Tip: In the purchase of medical insurance, should be targeted at their own whether or not to participate in Social Security to decide what to buy insurance, if not participate in the social basic medical insurance, compare insurance costs for type insurance; participated in the "social security", then should choose subsidy-based insurance, which is a fixed payment type insurance.
