Ordinary people really can't understand the list of hospitalization expenses. If you haven't experienced it yet, open the statement and you will find a pile of expenses, which are reimbursed by medical insurance and which have to be borne by yourself. Why do you have to bear it? There are eight expenses, which ordinary people need to pay special attention to.
first, the total medical expenses. This is all the medical expenses when you are in hospital.
second, the actual payment deductible. Medical insurance has the limitation of deductible, and the part below deductible will not be reimbursed by the medical insurance fund. The deductible is different for different types of medical insurance in different regions.
third, pay the amount in advance. For medical expenses within the scope of reimbursement, some drugs, patients need to bear a part of their own proportion, and then included in the reimbursement list, which is reflected in the amount paid in advance.
Fourth, there are some treatments that exceed the price limit, and the medical insurance implements price limit payment. For example, some consumables are priced at 1, yuan, but the medical insurance can only reimburse 8 yuan, and the extra 2 yuan will have to be borne by the patients themselves.
Fifthly, there are many treatment methods for all out-of-pocket expenses, which are not reimbursed at all outside the scope of medical insurance catalogue. These expenses also need to be paid by patients themselves.
Sixth, the expenditure amount of the overall fund, that is, how much was reimbursed by the hospitalization medical insurance fund. Seventh, the amount of personal account expenditure, because medical insurance is divided into overall planning and personal account, can also be paid by using medical insurance personal account when hospitalized.
Eighth, the amount of personal cash payment, all the medical expenses spent minus the expenses of medical insurance reimbursement, and the rest of the money needs to be paid by the patients themselves.
So we will find that even if we have medical insurance, we still have to bear part of the expenses. You must want to know about the proportion that we have to bear. Unfortunately, this problem is not easy to solve, because each project also stipulates different reimbursement rules in medical insurance. If we only look at the expenses within the scope of medical insurance, the proportion of medical insurance reimbursement for urban workers is about 8% and that for residents is about 7%. However, if the self-funded part is taken into account, there will be great differences among different diseases. < P > Generally speaking, the more serious and expensive the disease, the lower the proportion of medical insurance reimbursement will be. After all, from the goal of medical insurance design, it is to ensure the basic medical level of most people, and the cost of a high-spending patient is enough to cure many ordinary patients. With limited resources, medical insurance must be chosen.
that's why commercial medical insurance is meaningful. Whether it's Huimin insurance led by the government and built by insurance companies, or millions of medical insurance promoted by commercial insurance companies, mid-to-high-end medical insurance makes up for the expenses that medical insurance can't reimburse to some extent. No medical insurance can completely cover all the expenses, even the high-end medical insurance with hundreds of thousands a year still has its limitations. Which one do you choose? Knowing clearly beforehand, which way will you choose to build your own medical security?