On November 2, the Beijing News Shell Finance reporter was informed that the "Beijing Inclusive Health Insurance" in 2023 will be released within 12 hours, and the number of people participating in the insurance has exceeded 500,000.
On November 2, the Beijing News Shell Finance reporter was informed that the "Beijing Inclusive Health Insurance" in 2023 will be released within 12 hours, and the number of people participating in the insurance has exceeded 500,000.
The annual premium is 195 yuan per person, and the maximum coverage is 3 million yuan. How about the “Beijing Inclusive Health Insurance” protection in 2023?
Who can buy it?
How do new citizens participate in insurance?
The "Beijing Inclusive Health Insurance" project team specially sorted out some hot issues that everyone cares about.
1. Who can participate in the "Beijing Inclusive Health Insurance" in 2023?
The first is the insured people who are closely connected with the basic medical insurance in this city: the insured people with the basic medical insurance in this city (basic medical insurance for urban employees, basic medical insurance for urban and rural residents); the second is the insured population expanded this year: Beijing medical insurance Specific groups of people managed by the Security Bureau and other relevant government departments, new citizens of Beijing who have Beijing household registration or Beijing residence permit and have participated in the basic medical insurance in other places.
2. Which new citizens of Beijing can participate in the insurance? How to enroll
?
New citizens in Beijing who have Beijing household registration or a Beijing residence permit and have participated in the basic medical insurance in other places can participate in the insurance. New citizens who meet the insurance requirements can follow the official designated insurance platform "Beijing Pratt & Whitney Health Insurance" WeChat public account. On the home page, click [Enroll Now] in the bottom menu bar, follow the prompts, fill in the relevant information of the insured and the insured, and carefully read the "Insurance Instructions" and "Important Tips", and select [New Citizen] when confirming the identity. ], click [Confirm] to complete the payment.
Whether it is a courier brother working hard in Beijing, an online car-hailing master, or a grandparent who comes to Beijing with grandchildren from other places, as long as they hold a Beijing residence permit and have medical insurance in other places, they can also apply for the "Beijing Inclusive Health Insurance" in 2023.
3. How can an individual participate in the "Beijing Inclusive Health Insurance"?
Citizens in Beijing can follow the WeChat official account of the official designated insurance platform "Beijing Pratt & Whitney Health Insurance". On the homepage of the official account, click [Enrollment Entry] in the bottom menu bar, and fill in the relevant information according to the prompts to quickly enroll online.
You can also search for "Beijing Pratt & Whitney Health Insurance" on Alipay to apply for insurance online, or consult the professional staff of 6 insurance companies to apply for insurance. The insurance period ends on December 31, 2022, and the guarantee period is from January 1, 2023 to December 31, 2023.
4. Can I use the balance of my medical insurance account to pay the premiums of "Beijing Inclusive Health Insurance"?
Can!
Beijing employee medical insurance participants can use the balance of their medical insurance account to insure themselves; starting from December 1, after completing the mutual aid object filing in the medical insurance account (which can be handled on the medical insurance public service platform or medical insurance agencies in various districts), they can use the medical insurance The balance of each account is for the spouse, parents and children who can enjoy the basic medical insurance treatment in Beijing, and one person can pay for the insurance for the whole family.
5. Last year, I applied for "Beijing Pratt & Whitney Health Insurance" as a healthy group, and I was diagnosed with a specific pre-existing condition during the insurance period. Can I still enjoy the benefits of a healthy group when I renew the insurance this year?
Can!
In the first year, if you are insured with a healthy body, even if you suffer from specific pre-existing conditions during the insurance period, you can still receive compensation according to the treatment standard for healthy people after the renewal in 2023; this year, the standard for specific pre-existing conditions has also been adjusted, and people with diabetes who have no complications are no longer recognized as specific pre-existing conditions. , it can be paid in proportion to the healthy population, and the health population/specific pre-existing condition compensation standard. You can learn more through the WeChat public account of “Beijing Pratt & Whitney Health Insurance”.
6. The "Beijing Pratt & Whitney Health Insurance" insurance purchased last year has not expired. Do you still want to participate in the insurance this year?
Must be insured!
Friends who participated in the "Beijing Pratt & Whitney Health Insurance" last year, the coverage will expire on December 31, 2022, and the "Beijing Pratt & Whitney Health Insurance" in 2023 will enjoy the benefits from January 1, 2023 to December 31, 2023 Guarantee during the day, to realize the seamless connection of the guarantee, and you will not be able to make up the payment if you miss this centralized insurance participation time.
7. What are the guarantee contents of "Beijing Inclusive Health Insurance"?
One is the self-payment liability in the medical insurance (the medical expenses paid by the outpatient and inpatient in the basic medical insurance catalogue): ①The insured amount is 1 million per year.
②The deductible is the same as the standard amount of basic medical serious illness insurance in Beijing in the current year of the coverage period.
③Individuals pay medical expenses above the threshold of basic medical insurance and serious illness insurance, and the payment ratio is 80% for healthy people and 40% for people with specific pre-existing conditions.
The second is the out-of-medical hospitalization liability: ①The insured amount is 1 million yuan/year.
② The deductible is 15,000 yuan (20,000 yuan for specific pre-existing conditions).
③ The benefit ratio is 70% for healthy people and 35% for people with specific pre-existing conditions.
The annual reimbursement ceiling for a single drug is 300,000 yuan; for a single implant or consumable, the annual reimbursement ceiling is 100,000 yuan.
The third is the responsibility for special medicines (special medicines purchased by domestic special medicines in outpatient clinics or pharmacies of designated medical institutions of medical insurance; special medicines prescribed by foreign special medicines in designated medical institutions in Boao Lecheng, Hainan): ①The insured amount of domestic special medicines is 500,000 RMB/year, foreign special drug insurance coverage is 500,000 yuan/year, and the total insurance coverage is 1 million yuan/year.
②The deductible is 0 yuan.
③ The payment ratio is 60% for healthy people and 30% for people with specific pre-existing conditions.
Beijing Municipal Medical Security Bureau and other relevant government departments manage specific groups of people, who have participated in basic medical insurance in other places and hold a Beijing residence permit or Beijing household registration. The medical insurance responsibility of "Beijing Inclusive Health Insurance" only covers hospitalization. Other benefits are the same.
8. What diseases are included in specific pre-existing conditions?
In 2023, the scope of specific pre-existing conditions agreed in the “Beijing Inclusive Health Insurance” has been adjusted. People with diabetes who have no complications are no longer identified as specific pre-existing conditions, and can be paid in proportion to the healthy population.
The specific pre-existing conditions agreed by the "Beijing Inclusive Health Insurance" in 2023 include:
(1) Malignant tumors (including leukemia, lymphoma, carcinoma in situ) (2) Liver and kidney diseases: ① Renal insufficiency: chronic renal insufficiency, chronic renal failure.
② Hepatic insufficiency: chronic hepatic insufficiency, cirrhosis, chronic hepatic failure.
(3) Cardiovascular and cerebrovascular diseases and glucose and lipid metabolism diseases: ①Heart diseases: coronary heart disease, myocardial infarction, cardiac rupture, cardiac stroke, chronic cardiac insufficiency, chronic heart failure.
② Cerebrovascular disease: cerebral embolism, cerebral infarction, cerebral hemorrhage, stroke.
③ Hypertension: hypertension grade III.
④ diabetes: diabetes with complications.
(4) Pulmonary diseases: ① chronic obstructive pulmonary disease ② chronic respiratory failure.
(5) Other diseases: ① systemic lupus erythematosus; ② aplastic anemia; ③ ulcerative colitis.
"Beijing Pratt & Whitney Health Insurance" is not limited to health conditions, and certain pre-existing conditions can be covered and compensated. In addition to the above specific pre-existing conditions, people suffering from breast nodules, uterine fibroids, thyroid nodules and other diseases can be compensated according to the proportion of healthy people , to benefit more sick people, pay attention to the "Beijing Pratt & Whitney Health Insurance" WeChat public account for more details.
Citizens can follow the official designated insurance platform "Beijing Pratt & Whitney Health Insurance" WeChat public account to apply for insurance online, or search for "Beijing Pratt & Whitney Health Insurance" on Alipay to apply for insurance online, or apply for insurance through professional staff of 6 insurance companies. , and can also be purchased through the offline outlets of Industrial and Commercial Bank of China, Agricultural Bank of China, Bank of China, China Construction Bank, Bank of Communications, Postal Savings Bank of China, Bank of Beijing, and Beijing Rural Commercial Bank.
Enrollment ends on December 31, 2022, and the guarantee period is from January 1, 2023 to December 31, 2023.