How to buy suitable health insurance
Li Chenyang, reporter of Economic Daily and China Economic Net
With the accelerated development of my country's aging population and the rapid growth of health demand, commercial health insurance has attracted more and more attention.
Each stage of life faces different risks, and insurance plans are also different-how to buy the most suitable health insurance at different ages?
According to data released by the China Banking and Insurance Regulatory Commission, in the first half of this year, the original insurance premium income of the insurance industry increased by 6.46% year-on-year. Compared with the first half of 2019, the growth rate dropped by 7.7 percentage points.
However, health insurance premium income was 476 billion yuan, a year-on-year increase of 19.72%, and it was one of only three insurance businesses with double-digit growth in the first half of the year.
"In fact, since the outbreak of the new crown pneumonia epidemic, more and more consumers have begun to pay attention to the risk protection brought by insurance products, especially the sharp increase in demand for health insurance." An insurance sales manager said that in the first half of this year, consulting The number of customers for medical insurance and critical illness insurance has increased significantly. Some customers not only insure themselves, but also help their families purchase health insurance.
However, there are many types of health insurance products currently on the market, and the coverage of different types of products is different.
For consumers, what aspects should be paid attention to when choosing health insurance?
Can buying more insurances really get more protection?
There is no need to repeat medical insurance
In November last year, the China Banking and Insurance Regulatory Commission issued a new version of the "Health Insurance Management Measures." Health insurance refers to insurance companies that pay insurance money to the insured for health reasons or medical behaviors, including medical insurance, sickness insurance, and loss Income loss insurance, nursing care insurance, medical accident insurance, etc.
Among them, medical insurance is an insurance that provides protection for the medical expenses agreed in the insurance contract.
It mainly includes outpatient expenses, medicine expenses, hospitalization expenses, nursing expenses, surgical expenses, various inspection expenses, etc.
Under normal circumstances, according to the nature of the insurance payment, it can be divided into cost-compensation medical insurance and fixed-payment medical insurance.
For cost-compensated medical insurance, the payment amount shall not exceed the amount of medical expenses actually incurred by the insured.
Simply put, cost-compensating medical insurance should follow the principle of compensation. No matter how many medical insurances the insured has insured, the medical expenses can only be reimbursed once.
Fixed-benefit medical insurance usually guarantees hospitalization allowances, surgical allowances, subsidies, etc. It pays insurance money according to the amount agreed in the contract. The insured only needs to prove that the contractual medical behavior has occurred, regardless of the amount of medical expenses, the insurance company Both will pay insurance money in accordance with the amount agreed in the contract.
In other words, consumers usually do not need to buy medical insurance repeatedly.
The essence of insurance is that protection is not financial management. The most fundamental purpose is to implement financial compensation for risk events that occur.
At present, many insurance products on the market can meet the protection needs of most people in terms of insurance coverage.
Pay attention to the number of critical illness insurance payments
In addition, after consumers purchase medical insurance, they can reasonably configure critical illness insurance according to their own conditions.
"Critical diseases will bring a heavy blow to individuals and families. When considering insurance protection, it is necessary for consumers to prepare financial protection against critical illnesses in advance." According to industry insiders, at present, many insurance companies provide protection for critical illness insurance products. The scope includes hundreds of diseases, and some products can be paid multiple times.
It is reported that there are two main types of critical illness insurance that are currently popular in the market. One is to claim multiple claims for minor illnesses in the insurance contract and one claim for severe illnesses.
It usually promises that during the period of insurance coverage, if the insured suffers from a mild illness, the insurance company will pay 30% of the contract’s basic insurance for major illnesses, and the insured will continue to enjoy two mild illness protection and one Critical illness protection.
Another product is to group multiple diseases, any group of which can be compensated as long as they are diagnosed.
However, the major diseases of the same group can only be paid once, and the insurance company will no longer pay for the same diseases next time.
Critical illness insurance premiums are relatively low, but the insured amount is high, and the coverage is also very comprehensive. If the insurance is out of danger, the remaining premiums can be waived and the contract continues to be valid.
If consumers choose to protect life-long critical illness insurance, they will be insured until the death of the insured; if there is no critical illness claim, they can die according to the larger of the accumulated premiums paid and the cash value at the time of death. Insurance.
For example, an insurance company has a serious illness insurance product that pays multiple times. The coverage includes 100 serious illnesses and 50 mild illnesses, of which the mild illness can be paid twice, and the maximum insured amount is 500,000 yuan.
If you choose a basic insurance coverage of 500,000 yuan and pay 30 years of protection to life, the annual premium is about 8,500 yuan.
After the consumer is insured, once a mild illness is diagnosed, he can get a mild insurance premium of 100,000 yuan, and the remaining premiums do not need to be paid, and the contract continues to be valid.
It is worth noting that some critical illness insurance products that have been paid multiple times will have intervals and lifetime restrictions.
The interval period means that at least one year after the occurrence of a certain group of serious illness responsibilities, the other groups can be compensated; the survival period means that if the insured person is diagnosed with a serious illness and dies during the survival period (usually within 30 days) , There will be no second or third compensation.
For consumers, pay attention to the interval when choosing critical illness insurance. The shorter the interval between each payment, the more beneficial to consumers.
In addition, in March this year, the Insurance Association of China issued the "Revision of the Standards for the Use of the Definition of Critical Illness Insurance (Draft for Comment)."
This revision of the definition of critical illness is based on the original definition of critical illness, adding three new severe diseases: severe chronic respiratory failure, severe Crohn’s disease, and severe ulcerative colitis; at the same time, it also provides protection for malignant tumors, acute myocardial infarction, The three core serious diseases of stroke sequelae have been scientifically graded, and the corresponding 3 kinds of mild disease definitions have been newly added, and the coverage of serious disease insurance has been expanded.
Tax premium health insurance is worthy of attention
In addition to medical insurance and critical illness insurance, tax-excellent health insurance is also cost-effective.
The so-called tax-friendly health insurance means that taxpayers can pay less tax after purchasing such commercial health insurance.
This is equivalent to buying a medical insurance for yourself at a lower price, or increasing your own tax threshold by purchasing tax-excellent health insurance.
According to regulations, the expenditures for individuals purchasing eligible commercial health insurance products are allowed to be deducted before tax up to a limit of 2,400 yuan per year.
The annual limit of 2,400 yuan is distributed to the monthly expenditure limit of 200 yuan. This 200 yuan pre-tax expenditure limit can be understood as an increase in the monthly personal income tax threshold by 200 yuan.
Calculated based on the personal threshold of 3500 yuan plus 200 yuan, if an individual purchases a commercial health insurance premium of more than 2400 yuan, the monthly tax threshold is 3700 yuan.
Not only that, compared with general commercial health insurance, in addition to tax-exempt health insurance products, tax-exempt health insurance products will not be refused because the insured has a history of illness in the past, and can be insured with illness without a waiting period. Insurance companies Guarantee that the insurance can be renewed, which breaks through the previous rule that health insurance products refuse to cover pre-existing conditions.
What needs to be reminded is that although insurance is good, it is not necessary to be greedy.
First of all, consumers should formulate an insurance plan for themselves based on their own health status, economic level, and insurance requirements.
Under the premise of not affecting their own quality of life, consumers should choose the products they need and the appropriate payment period and payment amount.
As the older you get, the premium rates of insurance products become more and more expensive, so you must plan in advance as much as possible.
Second, beware of misleading sales.
For the sake of performance, some sales staff will tell consumers to buy more and get more. Consumers should be cautious. They must see whether the insurance products they buy belong to the type of superimposable compensation, and do not be deceived by some false propaganda.
At the same time, you must choose formal channels for insurance.
When signing a contract, consumers should carefully read the provisions of each clause in the insurance contract, pay attention to the exemption clauses and the ratio of compensation, and the relevant provisions of the waiting period.
In addition, consumers must tell the truth before applying for insurance.
According to my country's "Insurance Law", insurance companies have the right to terminate the insurance contract directly without refunding the premiums if they discover that consumers have deliberately misrepresented them within 2 years, which are sufficient to affect the conclusion of the insurance coverage.