What Are the Different Types of Family Health Insurance?

Family health insurance, also known as family member medical and health insurance, is a type of protection insurance for family members' health created by insurance companies.

Family Health Insurance

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Family health insurance, also known as family member medical health

Family health insurance refers to family health insurance for family members. It takes the body of the insured (family member) as the subject of insurance, and enables the insured to be compensated for expenses or losses incurred in the event of injury caused by a disease or accident An insurance. ^[1]

(1) Insurance period: The insurance period for family health insurance is usually one year, except for major illness insurance.

(II) Actuarial technology: The pricing of home health insurance products mainly considers the disease rate, disability rate and duration of the disease (disability). The calculation of the family health insurance rate is based on the loss of insurance amount. At the end of the year, the reserve for unexpired liabilities is generally deposited at a certain percentage of the premium income for the year. In addition, the waiting period, exemption period, deductible, copayment ratio, payment method, and payment limit will also affect the final rate.

(3) Benefits of family health insurance: According to different payment methods, family health insurance can be divided into compensation payment type and fixed payment type. The payment amount of the former is directly linked to the cost of the insured's illness; the latter is paid according to the amount agreed in the insurance contract, which may be higher or lower than the cost of the illness.

(IV) Particularity of business risk: Family health insurance deals with the risk of injury and illness. Its influencing factors are far more complicated than life insurance, and adverse selection and moral hazard are more serious. In addition, the risks of family health insurance also come from medical service providers. The quantity and price of medical services are largely determined by them, and it is difficult for insurance companies as payers to control them.

(5) Cost sharing: Family health insurance has three major characteristics: high risk, difficult to control, and difficult to predict. Therefore, family health insurance has more restrictive clauses on the liability of the insurer to the medical insurance insured.

(6) The special nature of contract terms: Family health insurance does not need to specify a beneficiary, and the insured and beneficiary are often the same person.

In the family health insurance contract, in addition to the irrefutable clauses of general life insurance, grace periods, and no loss of value clauses, some unique clauses are also used, such as existing conditions clauses, conversion clauses, coordinated payment clauses, medical examination clauses, and exemptions Amount clause, waiting period clause, etc.

(7) Excluded liability of family health insurance: Excluded liability of family health insurance generally includes war, military operations, diseases, deaths and disability caused by intentional suicide or attempted suicide, diseases, disability, abortion, death, etc. caused by abortion.

First, regardless of age, first of all, with the assistance of a professional insurance agent, understand the health protection status that you already have and analyze the gaps in your own health risks;

The second is to analyze your own financial situation and choose the appropriate family and family health insurance coverage based on your financial ability;

The third is to pay attention to the practicability of family health insurance, not to blindly chase high coverage. Different people and different families face different risks, different financial situations, and different choices of family health insurance.

First, pay attention to the insurance age limit. Depending on the type of insurance, the minimum insurance age generally ranges from 90 days after birth to 16 years of age, and the highest insurance age is between 60 and 70;

The second is to pay attention to the scope of insurance coverage. It is necessary to distinguish which diseases are covered by insurance coverage and which are not covered. If an insurance cannot protect the risk of this disease, you can choose some insurance coverage that can protect special diseases;

The third is to pay attention to the exclusion liability. The exclusion liability of the family health insurance mainly has two aspects: First, the degree of loss caused by war and military operations is high and it is difficult to predict. In formulating normal family health insurance rates, it is not possible to take into account the factors of injury and medical expenses of war and military operations, so they are excluded. On the other hand, family health insurance only covers the risk of accidents, and it is not the responsibility of family health insurance for diseases, deaths and disability caused by intentional suicide or attempted suicide.

The fourth is to pay attention to the deductible, because insurance companies generally adopt deductible provisions for some lower medical expenses, which generally range from 50 yuan to 200 yuan.

Fifth, pay attention to hospitalization medical insurance.