How to buy the insurance you really need? How to buy emergency medical doctors and supervisors who know the best about insurance, cancer, accidents, and actual payments

Editor: Real payment, cancer, disability, and long-term care... I bought a lot of insurance policies, but I wonder if my old age can be sent to the store? Lin Yiting, an emergency clinician and insurance administrator, analyzed the purchase focus and precautions of different insurance policies from the perspective of medical professionalism. Buy the insurance clearly and you will be guaranteed only after you are old!

Can the insurance policy I bought at a young age, after paying for such years, really provide our security for the rest of our lives?

"The insurance purchased for 50 generations was mostly planned a long time ago and may not be used now. It is recommended to re-examine the insurance policy before retirement." said Lin Yiting, attending physician of the Emergency Clinic Department of Taichung Hospital of the Ministry of Fuli. She also has an EMBA financial judiciary degree and has research on insurance. She is called "an emergency clinician who knows insurance best."

When seeing people suffering from illness in the hospital, Lin Yiting believes that buying insurance policies and medical decisions will not be a big deal. She took her mother as an example and bought a lot of savings in her early years, but the medical insurance plan was insufficient. Later, my mother had to do surgery because of the stones, so she was reluctant to use better self-service materials because of budget considerations.

She observed that most of the policy plans for generations over 50 are mainly for sanitation, savings, and end-type medical care. The end-type insurance policy launched by insurance companies in the early stage is usually a fixed amount of time payment, such as a one-day payment of 2,000 yuan per day. However, with the progress of the times, the number of hospitalization days required for medical relocation today has become smaller, the number of self-paying items, and inflation may alleviate the protection of endogenous medical insurance.

Insurance does not have to buy much, but it needs to be good. There are many medical insurance projects, how to buy the insurance you really need? Lin Yiting analyzed the eyebrow angle when purchasing:

1. Actual payment: Pay attention to the trend of increased medical field self-paying items and reduced hospital days due to the trend of increasing medical field self-paying items and reducing hospitalization days. Lin Yiting believes that when purchasing actual payment, you can first confirm whether the amount of door medical surgery and difficulty fees is sufficient. For example, cataracts and dental implants performed by many mature people are all clinics that do not require hospitalization.

However, she also reminded that if it is not an actual medical need, it is only because insurance and insurance payment requirements require the use of self-cost items in the door clinic, which may cause physiological compensation. For example, in the past, cancer patients have requested to be hospitalized at their own expense, and the doctor will ask for an oral target drug to apply for hospitalization fees. "Because the frequency is too high, and the target drug can be diagnosed at the door, the insurance company suspected that he was hospitalized for insurance premiums and refused to handle payments."

Another important thing to note is that the insurance policy for individual companies to pay for insurance has different definitions on "surgery". There are currently three common surgical authentication methods:

1. According to the insurance company's "surgery project payment table", multiply the ratio by the protection limit, and pay within the amount.

2. In accordance with the procedures listed in Section 7 of Part 2, Chapter 2, Chapter 2, Chapter 2, issued by the Health Insurance Agency (simplified "Health Insurance Terms 2-2-7").

3. Use a wide-ranging method to explain it. As long as the course has procedures such as cleavage, anesthesia, and synthesis, it can be considered surgery.

"How to determine surgery, depending on how to write the insurance policy, of course, the broader the definition, the better." Lin Yiting said that using the third identification method, the chance of injury, removal of phlegm tumors, and polyps can be considered surgery. However, this type of insurance policy has been quite complicated in the past because of the wider surgical identification method. She suggests that insurance companies can pay attention to the past filing records of each insurance company. There are many cases of application, which means that the application and payment are more difficult.

2. Cancer: The insurance premiums for middle and high-age groups are high. Before purchasing, measure your own financial preparation.

The current accounting regulations for cancer are mostly paid by the insurance company after confirming that the insurance company has cancer. However, many cancer patients are not responsible for taking target drugs and new cancer drugs at the end of the disease, and even develop again after several years of treatment. How to plan the amount of cancer risk?

Lin Yiting pointed out that most early cancer treatment courses are paid with health insurance, so that they will not cause too much financial burden. However, if it is advanced cancer or recurrence, and the use of Line 2 and 3 treatment or self-paid medicines is required, the drug alone costs 500,000 to 1.2 million yuan per year. In addition to the loss of unemployed work and the cost of hiring for care, the cost of advanced cancer patients a year is about 1 million to 1.5 million yuan.

The existing data show that when patients with advanced cancer start using Line 2 and 3 treatment or self-paid medicines, the average survival period is about 3 to 5 years. After counting, the average cost of patients from the course of cancer to the end of their lives is about 3 million to 5 million yuan.

Lin Yiting suggested that before hesitating whether he wants to buy a cancer insurance, he might as well think about his financial situation: the amount of payment paid for a cancer insurance is about 1 million to 2 million yuan. If he unfortunately suffers from cancer, can he make this money? Social freshmen with financial uncertainty may need such a policy. But if middle-aged people already have a considerable deposit and consider the protection will increase with age, cancer may not be the most cost-effective investment.

3. Accidental: The CP value is high, but only the accident caused by majeure and external forces

Among the many insurance policies, Lin Yiting believes that the accident can be said to be the highest insurance with "CP value": the insurance price, but the amount of the payment is relatively high. For a million-dollar insurance policy, the one-year insurance may only cost hundreds of yuan. However, because the minimum living allowance can be exchanged for high insurance, there are many accidental compensation disputes.. What kind of "accident" can you apply for accidental insurance?

Lin Yiting pointed out that the most important thing in applying for accidental insurance is to prove that the accident is an accident caused by external forces, not caused by personal illness. She takes the common fall accidents in the elderly as an example. If you are dizzy, lose blood, or even have a wind-like fall, it will not meet the requirements for accidental injury. On the contrary, if the floor is slippery, step on the stone, or falls due to other majeure external factors, you may have the opportunity to apply for an accidental insurance payment.

She reminded that if you want to apply for accidental insurance, you should pay attention to how you explain the situation when you are in the doctor. If the patient is telling the condition, he says, "I was in a head and had a unclear vision at that time, and accidentally fell down." and other statements similar to "individual disease causes accidents", it may affect the success and failure of subsequent accounting.

4. Long-term care: The conditions for handling payment are relatively serious. If you have a family medical history and risk factors, you can consider that

As the disability insurance continues to be suspended, the market currently focuses on rating the long-term care risk policy, with long-term care as the largest case. However, as the older you get, the higher the insurance coverage for longer care. How do you evaluate whether you need this insurance?

Lin Yiting pointed out that compared with disability, the standard for long-term care is more strict. The insured must meet the Papton Scale or other clinical professional evaluation scales, at least 3 of the six items of changing clothes, eating, shifting, such as toileting, bathing, and flat moving can't be taken into account before applying for a payment. To put it simply, "People probably have to degenerate to the state of needing to live in a nursing facility, and long-term care will be handled."

She suggested that if you have a family history of bone dysfunction, spinal degeneration, Alzheimer's disease, sports neuronal disease, or have other risk factors that may lead to disability, you can consider buying long-term care. If you are unfortunately disabled in the future and meet the requirements for compensation, you will be paid monthly according to the contract.

However, she also reminded ethnic groups over 50 to evaluate by themselves if they need to stay in a nursing center one day, can existing financial regulations create a monthly cash flow of 30,000 to 50,000 yuan? In addition, with inflation, whether the planned insurance amount is sufficient to cover the maintenance agency in the future is also a variable that needs to be carefully considered.

Regardless of which type of insurance policy, if the insurance company believes that there is a dispute over the payment, it can apply to the insurance company or apply to the Financial Evaluation Center.

Before buying insurance, understand the requirements for making payments and evaluate your own risks, so that you can accurately buy the insurance you need most!

Original text: Must view before retirement! Emergency clinicians who know how to use insurance best: How to buy the senior care, cancer, accident, and actual payment that the seniors get?