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花几百元就占“百万医疗”大便宜?

2018年06月10日 11:02来源:网络整理手机版

原标题:花几百元就占“百万医疗”大便宜?

  花几百元就占“百万医疗”大便宜?

  银保监会明确禁止“百万医疗”保险产品盲目设立高额给付限额 夸大产品功能

  自2016年8月,众安在线推出第一款“百万医疗险”尊享e生,不到两年时间,各家主流健康险公司相继推出类似产品。据不完全统计,市场上已有超过30多个“百万医疗险”产品,保费低至百元至数百元,保额则高达100万、300万、600万,最高已飙升到1000万。“百万医疗险”是宣传噱头,还是创新型“爆款”产品,引发了业内讨论。

  打开支付宝、微信,或者其他互联网平台,一种叫作“百万医疗险”的产品正在成为“网红”。尊享e生、好医保、微医保等,一两百元的保费,保额五六百万,对于有需求的中青年职场人来说,极有吸引力,花几分钟的时间便会决定购买。但同时,也有不少人对这样的短期产品表示担忧。

  现象

  保额最高已飙升到1000万元

  自2016年8月,众安在线推出第一款“百万医疗险”尊享e生,不到两年时间,包括众安财险、平安健康、人保健康、安联财险、安心财险、太平洋人寿、新华人寿、阳光人寿、国华人寿等多家健康险公司相继推出类似产品。据不完全统计,市场上有超过30多个百万医疗险产品。

  北京青年报记者调查发现,2017年“百万医疗险”如雨后春笋般面市,保额逐步升级,早已突破百万限制,保费低至百元至数百元,保额则高达100万、300万、600万。其中,国华人寿推出的“小米千万医疗”产品的保额最高已飙升到1000万元。

  与传统保险不同,通过互联网平台销售,消费者从了解产品到支付完成保单,最短只需要几分钟时间。35岁的消费者王女士在支付宝上看到,某款产品年龄计算保费,她只需花300多元,可享受最高保额600万元的医疗保险。从事财务工作的王女士比较细致,逐一翻看了保险条款、免赔条框等合同具体内容。她注意到这款医疗险的优点是不需要体检,只需承诺未患病,按照条款投保人有一个月的等待期,超过等待期之后如果不幸生病,在二级及以上公立医院普通门诊发生的医疗费用,在扣除社保报销后,再扣除1万元免赔额,剩余部分100%报销。例如,花费了10万元医疗费,医保报销30%为3万,减去1万元免赔额,“百万医疗险”给报销6万元。

  花费几万元,看球直播,一旦患病可获得除医保外的100%保险,保额最高可达600万元。王女士动心了,从看到这款产品的介绍,到支付完成用时不到10分钟。

  隐忧

  年轻买了用不上 老了想用买不了

  “百万医疗险”作为一年期的短期健康险产品,属于保障型、消费型产品。由于“百万医疗险”覆盖自费部分,作为社会医疗保险的补充,且通过设置1万元的免赔额度,可有效地控制赔付水平,降低保险费,所以受到市场青睐。

  “我给自己和家人在今年都购买了百万医疗险,我身边不少朋友、亲属也都购买了类似的产品。我一个懂保险的朋友提出一个担忧,万一产品停售该如何解决今后的保障问题?产品大幅调价怎么办?我超过60岁、甚至更老了,买不到短期产品了怎么办?”王女士告诉北青报记者,“担心年轻时买了用不上,年老时想用买不了”。

  按照保监会2006年颁布的《健康保险管理办法》规定,“保证续保条款是指在前一保险期间届满后,投保人提出续保申请,保险公司必须按照约定费率和原条款继续承保的合同约定”。我们可以看出,“保证续保”必须满足两个条件,一个是条款不变,极速体育,一个是费率不变。

  目前,市场没有任何百万医疗保险承诺可永远“保证续保”。人保健康好医保承诺6年“保证续保”,是保证续保最长的一款产品了。对于投保人来说,短期险会随着投保人年龄增加、风险增加而涨价。险企可以通过涨价,让“贵到不能买”屏蔽掉风险高的人群。

  精算

  短期医疗保险最大风险是无法续保

  对于消费者,每年几百元的投入,是否真能撬动百万级杠杆?高保额能带来实实在在的保障吗?

  有资深精算师指出,如果是短期医疗保险,消费者面临的最大风险是无法续保。如果一位消费者在30岁时,花200元购买“百万医疗险”,连续投保五年后,这家公司下架了这款产品,保险公司不需要承担续保责任。这位消费者如果在5年间发生过疾病,在选择其他产品时可能被拒保;再购买长期医疗险,则会因为年龄增加,保费飙升。这种情况如发生在超过60岁的消费者身上则更为不利,可能无法买到短期健康险产品,或者需要高额保费支出。

  目前,有险企在“连续续保”“保证续保”上混淆视听。其中,“保证续保”是指,在前一保险期满前,投保人提出续保申请,保险公司必须按照原条款和约定费率继续承保。这就意味着保险公司不能将已经理赔过的病症列为既往症来除外责任,同时不能够调整产品费率,投保人还可按原保险费率来续保。而“连续投保”条款上将已经发生理赔过的病症列为既往症,使其在新保单年度成为除外责任;且费率也较上年会有动态调整。如果赔付率较高,产品还面临着停售的可能,投保者也可能出现保障中断等问题。

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