Is it worth buying?How to buy?"Well You Insurance" is coming to the insurance strategy

On the morning of July 5th, the "Welling You Bao" in 2022 was officially launched. As a strong supplement to the basic medical insurance, the "Welling You Insurance" product is not expensive, and the claims are in place, which is widely praised by the public. Is it worth buying "Wei You Guard"? How should I buy it? Let's take a look at this insurance guide!

Question: What is "Well You Bao"?

Answer: "Welling and You Insurance" is an inclusive commercial insurance product under the guidance and supervision of government departments, and a number of insurance companies co -owned to further reduce the burden of medical treatment. In 2021, Weihai City launched the "Welling You Insurance" for the first time, setting a record of exceeding 665,000 insured in the first year, with a single person with a maximum of 167,800 yuan and a cumulative compensation of 620,000 yuan. Economic burden of disease patients. In 2022, the Weihai Medical Insurance Bureau, the Finance Bureau, and the Banking Insurance Supervision Bureau joined hands with 12 insurance companies to fully upgrade the "Welling You Insurance".

Question: Is it necessary to participate in the medical insurance? Is it necessary to participate in "Well You Insurance"?

Answer: It is necessary. Because medical insurance, as a basic medical security system, has restrictions on the payment line, capacity line, self -funded project, reimbursement ratio, etc., and the "Weiyu Insurance" connects with medical insurance. Insulting people's more important guarantees other than medical insurance, reducing the burden of medical expenses in the face of serious illness and serious illness.

Question: Who can participate in the "Welling You Guarantee"?

Answer: Any basic medical insurance for employees or residents of our city, that is, the medical insurance system can check the insured as the basic medical insurance identity of Weihai during the insurance. If you do not limit your age, occupation, and health, you can all be able to insurance insurance.

Question: What is the premium of "Wee You" this year?

Answer: Like last year, that is, 89 yuan/person/year/year, 139 yuan/person/year, 60 years old and over 60 years old, and the insurance target is paid at one time annual. The product premium standards are dynamically adjusted according to the premium revenue and expenditure situation and the economic and social development level of our city.

Question: What upgrades did this year's "Weea Guard" make this year?

Answer: This year's "Welling and You Insurance" is mainly upgraded in the following aspects of the following aspects: reducing the exemption of hospitalization expenses (from 20,000 to 18,000), improving the level of special drug protection, new increase Outpatient medication guarantees, expand the scope of the participating population (can be the insured in Weihai's basic medical insurance insured), and enjoy the health management value -added services.

Question: When is "Well You Guarantee" start to insure? How long is the guarantee time?

Answer: The insurance participation time is from July 5, 2022 to September 25, 2022, and the guarantee time is from 0:00 September 26, 2022 to 24:00 September 25, 2023.

Question: Where can I see the introduction and insurance link of the "Well You Insurance" product?

Answer: You can pay attention to the WeChat public account of "Welling You" to understand the relevant information; by clicking on the "Insurance Entrance" at the bottom menu bar, enter the "Welling You Insurance" insurance page.

Question: Can I buy "Well You Insurance" with a personal account of medical insurance?

Answer: Encourage the insured object to use medical insurance electronic vouchers and use medical insurance personal accounts to be purchased by my parents, spouses, children and other relatives. If the amount of personal account history is insufficient, you can use WeChat and Alipay to pay.

Question: What is the service call of "Well You Guarantee"?

Answer: The consultation phone for "Well You Insurance" is 96717006 (0531 outside the province), providing a 24 -hour telephone consultation service for the insurer.

Question: What are the guarantee of "prestige"?

Answer: Inpatient medical expenses with a maximum amount of insurance and outpatient medical expenses with a maximum of 500,000 insurance are guaranteed.

(1) Residential costs. Institute of insured targets included in the scope of compensation scope (including chronic diseases of employees, chronic diseases and high -value drug costs of specific outpatient clinics), according to the expenses within the scope of medical insurance policy and expenses of medical insurance policies (the division of the internal and external medical insurance and treatment projects Single alone), classified segments are paid simultaneously. The exemptions of the two parties are 18,000 yuan, 18,000 yuan (including, the same below) -100,000 yuan to give 60%of the compensation; 100,000 yuan to 300,000 yuan to give 70%of the compensation; 300,000 yuan The above part is given 80%of the compensation, and the maximum compensation limit is 1 million yuan.

The cumulative insurance object is insured for every 5 years, and the proportion of segmented compensation for two parties increases by 2 percentage points, up a maximum increase of 10 percentage points. For medical expenses incurred outside Weihai City, the proportion of segmented compensation for two parties was reduced by 10 percentage points.

(2) Outpatient and special medicine costs. Insured targets During a product compensation period, ordinary outpatient drug expenses and residents' general outpatient chronic special disease costs (not included in pharmacies) (excluding pharmacies) (excluding pharmacies) (excluding pharmacies) (for outpatient medical records, expenses, medical insurance settlement forms, medical insurance settlement forms, medical insurance settlement forms at the designated medical institution The audit of invoices and other special medicines occurred in designated medical institutions or designated pharmacies, and the personal burden of personal burden after reimbursement of various medical insurance policies is not included in the part of the "prestige you guarantee". The amount of compensation is 10,000 yuan, and the compensation ratio of the delegated amount or above is 60%. Among them, the special medicine costs incurred by the responsible physician in a fixed -point medical institution or a designated pharmacy, with a deductible pay of 70%. Outpatient and special medicine cost insurance payments have paid 500,000 yuan in annual.

Question: What are the online value -added services of "Welling You" this year?

Answer: Online health management services "Well You Guarantee" include:

(1) 3 basic health services (including online questioning, outpatient appointment, health consultant); (2) 3 items of specific disease risk management (AI smart pharmacist, nutritional guidance, health risk assessment);

(3) Two critical illness projects (the second medical opinion, pathology expert consultation).

Q: What do offline value -added services include?

Answer: "Welling You Guard" set up a convenient service window at key hospitals and county -level people's hospitals, and is responsible for arranging full -time personnel. The service content includes:

(1) Insured period, provide insured consulting services to everyone;

(2) During the guarantee period, the insured provides claims consulting, medical guidance, old, weak and disabled care services, pharmaceuticals, reports, claims information collection services;

(3) Handling medical insurance -related businesses.

Question: How to pay "Well You Guarantee"? When can I initiate claims?

Answer: If you are hospitalized in the Weihai area, when you implement one -stop settlement, when you are discharged and settled, you can automatically settle the "Welling You Guarantee" at the same time.

Before the one -stop settlement, after the local hospitalization was discharged and settled, you can initiate a claim on the WeChat public account of WeChat or "Taishan Insurance" WeChat public account. Among them, if the case is "to be applied", fill in the name, ID number, telephone number, medical insurance settlement list on the campaign, and upload your ID card and bank card on the medical insurance settlement form. If you do not generate a "application for application", you can also apply for claims at the "claim application". Settlement orders, invoices, medical record homepage, admission records, discharge records are recommended to be uploaded.

Disted medical insurance, disconnection of medical insurance, and special medicines need to provide the original material to offline outlets, or mail the following addresses: No. 128, Xinwei Road, Weihai City-3.9 billion Telong Decoration City Welling Customer Service Center (Contact Telephone Telephone Tel : 0631-5972300).

Question: If the medical insurance relationship is transferred to the country after the "prestige and you insurance" or the medical insurance is broken, can you still apply for a claim?

Answer: If the medical insurance relationship is transferred to Weihai or the medical insurance from the medical insurance or the medical insurance is disconnected from September 25, 2023, you can continue to apply for product compensation. During the product compensation period, if the basic medical insurance relationship is transferred to other cities, the insured target can be reimbursed by policies such as local basic medical insurance, major illness insurance, and medical assistance. The medical expenses shall be paid shall be paid in accordance with the provisions of this product in accordance with the relevant expenses of the reimbursement in accordance with the relevant expenses of the reimbursement in accordance with the policies such as basic medical insurance, major illness insurance, and medical assistance in Weihai.

Question: How long does it take for the material to provide "Way You" can allocate the compensation?

Answer: The case of medical treatment within the area of ​​Weihai, with complete medical insurance data, pay within 2 working days. If the case of medical treatment is complete, the medical insurance data is complete, and it pays within 7 working days. If the medical insurance data is incomplete, the medical insurance data needs to be paid at the above time.

Question: How to calculate the deduction of outpatient insurance liability?

Answer: The exemption of insurance liability for ordinary outpatient drug expenses and residents' general outpatient clinics is cumulatively exempt from the insurance liability for the insurance year (2022-09-26 to 2023-09-25). That is, each medical expenses occur, and the corresponding insurance liability exemption amount is deducted, and the cumulative calculation of multiple medical expenses deductions on multiple occurred, until the 10,000 amount deduction is completed and the claims are triggered to pay for the proportion.

Question: What materials do outpatient claims need for the implementation of the basic medical insurance outpatient protection mechanism?

Answer: (1) Calcus application (fill in when the claims are applicable);

(2) Valid ID of the insured person (copies of the front and back);

(3) Invoice, medical insurance overall settlement form, detailed costs, outpatient cases, all need the original.

(4) Account information of the insured: account opening bank, household name, account number (payable to non -patient's own needs to provide a relationship certificate)

Question: What are the exemption responsibilities of "Wee and you guarantee"?

Answer: The following situation "Well You Guarantee" will not pay:

(1) Some expenses that are not reimbursed in accordance with medical security policy due to personal reasons.

(2) Non -drug costs that need to be fully paid in the hospital.

(3) Non -drug costs incurred by outpatient clinics (except for general medical insurance for residents' medical insurance).

(4) The fee paid from the work injury insurance fund should be paid.

(5) The cost shall be borne by a third person.

(6) The cost shall be borne by public health.

(7) The cost of medical treatment abroad.

(8) The cost of sports, fitness, health care consumption, and health examination.

(9) Chinese medicine tablets and Chinese medicine particles that are not included in the scope of the medical insurance fund.

(10) Drugs purchased without the doctor's prescription.

(11) Other non -payment fees stipulated in laws, regulations, policies, etc. (Hi Weihai client correspondent Gong Xiaodong)

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