How to buy health insurance

How to buy health insurance

Health insurance is mainly based on the human body as the object of insurance. When the insurer suffers from illness or accident resulting in additional expenses or losses, the insurer can obtain a certain amount of compensation. Each stage of life faces different risks, so the insurance plan for each stage is also different. How to buy the most suitable health insurance for you at different ages? 

Workplace rookie – low salary, optional disease insurance

For those who are new to the workplace, a series of conditions such as job instability and relatively low salary levels determine their weak ability to resist economic risks. The protection needs at this stage focus on personal basic protection and family economic responsibility, that is, to avoid the insured’s parents depleting their life savings due to risks when the insured is unfortunate.

When the insured has a risk, the relevant insurance can relieve the economic pressure, so they urgently need to use insurance to spread the risk. At this stage, priority should be given to low-cost insurance types such as accident insurance and health insurance. In addition, because the younger the insurance is, the lower the rate is, so if the funds permit, the critical illness protection can be added in time.

Newly-built family—the family has a large burden, mainly focusing on maternal and child insurance

In such an era of high housing prices and high prices, the newly formed family has to face the situation of supporting 4 elderly people and 1 child at the same time, which can be described as “a lot of pressure”. Young and middle-aged couples, as the “pillars” of the family, should build comprehensive protection for themselves at this stage to ensure the continuation of family responsibilities.

Products with high protection can be considered first. Generally speaking, accident insurance, health insurance, and term life insurance have relatively high protection and can be considered and arranged first. On this basis, consider the child’s accident and health protection.

Middle-aged people—mainly pension and health insurance

Middle-aged people are at the peak of their careers. In addition to necessary health insurance, family pension planning should increase risk prevention type insurance.

The elderly group – due to age restrictions, buy insurance as early as possible

According to the survey, in addition to the daily consumption of the elderly, general medical care accounts for about 40% of the monthly expenditure. Therefore, it is very important to purchase health insurance. For the vast majority of the elderly, it is more appropriate to purchase hospital medical insurance or comprehensive medical insurance.

Development status

On November 17, 2014, the State Council officially issued the “Several Opinions on Accelerating the Development of Commercial Health Insurance” (hereinafter referred to as “Several Opinions”), which proposed to give full play to the role of market mechanisms and the professional advantages of commercial health insurance to expand the supply of health insurance products. , enrich health insurance services, and enable commercial health insurance to play a “new force” role in deepening the reform of the medical and health system, developing the health service industry, and promoting economic quality and efficiency upgrades. The health insurance market may usher in another spring of industrial development.

Judging from the current situation, there are four professional health insurance companies in my country, and many insurance companies that operate health insurance businesses have also set up special business departments. The industry has established a health insurance management system with certain professional characteristics. Since 2002, the average annual growth rate of health insurance premiums has reached 27%, exceeding the average growth rate of the national economy and insurance industry. From January to September 2014, the premium income of commercial health insurance was 126.036 billion yuan, a year-on-year increase of 46.97%. More than 100 insurance companies have launched commercial health insurance businesses, with more than 2,300 health insurance products sold on record. From 2009 to the first three quarters of 2014, 194.9 billion yuan of indemnity was paid accumulatively, accumulating more than 329.6 billion yuan of medical insurance funds for policyholders. In the third quarter of 2014, a total of 13 insurance companies launched 373 major disease insurance plans in 27 provinces across the country, covering 650 million urban and rural residents. The problem of the masses “being impoverished due to serious illness and returning to poverty due to serious illness”.From 2009 to the first three quarters of 2014, the total entrusted management of medical insurance funds was 70.9 billion yuan, and the compensation was 42.5 billion yuan; the commercial insurance premium income was 61.4 billion yuan, and the indemnity was 47.4 billion yuan, serving more than 160 million people.

Despite this, with the aging of the population and the accelerated development of urbanization in my country, the spectrum of diseases is also undergoing profound changes, resulting in a rapid increase in the individualized and diversified health needs of the people. Unfortunately, on the one hand, the public has a huge demand for health insurance and health management services such as medical treatment, disease, nursing, and disability; on the other hand, the development of commercial health insurance in my country is relatively sluggish. Relevant statistics show that my country’s commercial health insurance premiums account for less than 7% of the total premiums, while mature markets generally account for 20%-30%; my country’s health insurance expenditures account for less than 2% of the total medical and health expenditures, while Developed countries are generally around 10%.

Facing the “gap” between the people’s health protection needs and the development of commercial health insurance, the “Several Opinions” for the first time positioning the commercial sector from the perspective of deepening the reform of the medical and health system, developing the health service industry, and promoting the improvement of economic quality and efficiency. The functional role of health insurance and the inclusion of medical accident insurance and medical liability insurance into the category of commercial health insurance further reflects the comprehensive consideration of the policy. The premium income of medical liability insurance is 1.164 billion yuan, the insurance amount is 17.97 billion yuan, the number of insurance policies is 39,100, and the compensation amount is 1.279 billion yuan (including settled and pending claims). From 2010 to In 2013, the medical dispute mediation committees participated by insurance institutions mediated a total of 222,000 medical disputes, with a success rate of 86%.

It is worth noting that the “Several Opinions” not only pointed out the development direction of commercial health insurance but also highlighted the government’s concept and determination to use the insurance mechanism to improve the national health level. It goes without saying. According to the development goals set in the “Several Opinions”, by 2020, my country will establish a modern commercial health insurance service industry with a complete market system, rich product forms, and business integrity and standardization, to achieve a relatively complete commercial health insurance operating mechanism and obvious service capabilities. Improvements, wider service areas, a substantial increase in the number of insureds, and a significant increase in the proportion of commercial health insurance claims in total health expenses. The development of the health service industry and the promotion of economic quality, efficiency, and upgrading are of great significance for the development of the insurance industry and for serving the overall economic and social situation.

At present, the compensation expenditure of commercial health insurance only accounts for 1.3% of the total national medical and health expenses, while the world average is about 10%; the premium income of commercial health insurance accounts for less than 7% of the insurance premium income of the whole industry. The ratio is generally 30%. Since the penetration rate of commercial health insurance is so low at this stage, this leaves a huge room for imagination for its future development. Industry insiders believe: “Aging, urbanization, the emergence of the middle and wealthy classes, the support of national policies, the lack of medical insurance coverage, and the shortage of high-quality medical resources are all opportunities for the development of China’s commercial health insurance.” On the one hand, medical care Health, an annuity will be the real growth of the insurance market in the future. With the increase in demand for medical insurance brought about by urbanization, the integration of urban residential insurance and the new rural cooperative medical system, the improvement of medical insurance cost control, and the promotion of real-time settlement services for medical treatment in other places are gradually improved. All open space for commercial insurance institutions to enter the field of basic medical insurance, and critical illness medical insurance is its breakthrough. On the other hand, different from the compulsory and inclusive nature of basic medical insurance, commercial health insurance can provide differentiated services for people with different consumption capabilities, risk awareness, and protection needs through the commercial operation mechanism and is designed based on the probability of disease occurrence of healthy people. product. The insurance industry will develop from simple expense reimbursement and economic compensation to comprehensive health insurance management before, during, and after illness, improve the health of insured persons, reduce morbidity, and actively carry out major disease insurance to explore Introduce long-term care insurance.

However, for the commercial health insurance industry, due to lack of experience and environmental constraints, the task of enriching product lines and improving service capabilities is still arduous. At the same time, the industry competition is also intensifying and deepening, from primary personal sales to product development, from channel deep cultivation to brand accumulation competition. Given the different security needs of various groups, developing health insurance products with distinct differentiated characteristics is an urgent priority for the development of health insurance. Industry insiders believe that preferential tax policies are the most critical lever for promoting the development of commercial health insurance and an important driving force for insurance companies to expand their business. It is understood that the China Insurance Regulatory Commission is striving to implement three preferential tax policies for health insurance, including protection preferential tax policies for individuals purchasing commercial health insurance, insurance fund policies for critical illness insurance business for urban and rural residents, and business tax relief for basic medical insurance. The China Insurance Regulatory Commission is also coordinating with relevant ministries and commissions to study the use of funds from the personal medical insurance accounts of urban workers to purchase commercial health insurance, revitalize the funds in the medical insurance personal accounts, and transform simple savings into mutual assistance, hoping to greatly improve the security capability and level of security.

By aamritri

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