Judging the past illness through the late discharge list and previous treatment records.
What diseases did the past diseases include?
(1) Liability Agreement for Hospitalization Medical Expenses (Responsibility I and Responsibility II)
The insured suffers from the following five diseases before insurance, and is regarded as a group with hospitalization responsibility. After the policy came into effect, the proportion of compensation for hospitalization expenses incurred by people with past diseases dropped to 35%. The identification of past diseases is based on discharge diagnosis.
Specific diseases include:
① Tumors: malignant tumors (including leukemia and lymphoma);
② Liver and kidney diseases: renal insufficiency; Liver cirrhosis and abnormal liver function;
③ Cardiovascular and cerebrovascular diseases, glucose and lipid metabolic diseases: ischemic heart disease (including coronary heart disease and myocardial infarction) and chronic cardiac insufficiency (cardiac function above Grade 3); Cerebrovascular diseases (cerebral infarction, cerebral hemorrhage); Grade ⅲ hypertension; Diabetes with complications;
④ Lung diseases: chronic obstructive pulmonary disease, chronic respiratory failure;
⑤ paralysis.
(2) Liability agreement on specific self-funded drugs and CAR-T treatment expenses (Liability III and Liability IV)
The insured who suffered from the drug indications in the Catalogue of Specific Self-paid Drugs before the insurance is regarded as a sick person in the past and is responsible for the specific drugs and CAR-T treatment expenses. After the policy came into effect, the proportion of out-of-pocket drug expenses for original patients to buy specific out-of-pocket drugs dropped to 35%; Medical expenses arising from CAR-T treatment will not be paid.