Overview of hospitalization insurance: the core choice of medical insurance

Hospitalization insurance is an insurance product that specifically provides protection for hospitalization medical expenses. It mainly covers bed fees, surgery fees, medicine fees and other expenses during hospitalization. Its core value is to reduce the financial burden caused by illness or accidental hospitalization, which is especially suitable for people who need high-frequency medical protection. In terms of content structure, this article will start fromDefinition and function,Coverage,Applicable people,Key points for purchasingandMarket product analysisFive aspects are developed to help readers systematically understand the practical value of hospitalization insurance.

The definition and core role of hospitalization insurance

Hospitalization insurance is a branch of health insurance, with the core function of reimbursement of hospitalization medical expenses. Different from ordinary medical insurance, its coverage focuses more on hospitalization scenarios and usually includesOutpatient and emergency expenses for the 7 days before hospitalization and 30 days after discharge(Some products). For example, the average cost of a single hospitalization in a tertiary hospital is about 15,000 yuan, and 60%-100% can be reimbursed through hospitalization insurance (depending on the terms). Its role is not only in cost compensation, but also in providing green channels, advance payment services and other additional rights and interests, significantly easing patients' medical pressure.

Coverage and common disclaimers

Mainstream hospitalization insurance usually coversbed fee,Surgical material fee,ICU costand other basic projects, and some products are extended to special outpatient clinics (such as kidney dialysis). However, please note the disclaimers, such as plastic surgery, pre-existing conditions, and childbirth-related expenses, which are usually not covered. Take Ping An e-Life Insurance as an example. Its hospitalization medical coverage reaches RMB 3 million, but it clearlyoccupational diseasesandHigh risk sports injurieslisted as a disclaimer. Consumers need to read the terms carefully to avoid claims disputes.

Applicable groups and insurance strategies

Hospitalization insurance is especially suitable for three groups of people:children(low immunity),Middle-aged and elderly(high risk of chronic diseases),Groups without social security. It is recommended to pay attention to three points when purchasing insurance: First,Waiting period(usually 30-90 days), the second isReimbursement ratio(Whether to distinguish between inside and outside social security), the third isRenewal conditions(Guaranteed renewal terms are better). For example, Pacific Medical Insurance provides a 20-year guaranteed renewal policy, but if you are over 55 years old, you need a physical examination and the age limit is obvious.

Market product comparison and purchasing suggestions

Comprehensive suggestions for priority selectionbig brands,Stable renewalproducts, pay attention to health and inform the authenticity. Small-sum hospitalization insurance (such as a sum insured of 10,000 yuan) is suitable for supplementing social security, while high-value products (medical insurance worth 1 million yuan) are suitable for dealing with major disease risks.

Citing sources

1. Insurance Association of China’s “2022 Health Insurance Market Development Report”
2. China Banking and Insurance Regulatory Commission’s “Measures for the Administration of Information Disclosure of Personal Insurance Products”
3. Product data comes from the public terms on the official websites of various insurance companies (as of Q2 2023)