Medical Insurance Comparison Guide: How to Choose the Most Suitable Plan?
Medical insurance is a vital foundation for personal and family health protection. But when facing options like basic social insurance, commercial insurance, and high-end medical plans, how can one scientifically compare and choose the most suitable insurance plan? This article provides you with the latest cross‑sectional comparison of medical insurance, covering differences between social and commercial insurance, reviews of popular products, pitfalls to avoid when purchasing, and claims‑filing tips, helping you build a comprehensive medical risk protection network.
1. Comparison of Mainstream Medical Insurance Types
1. Basic Social Medical Insurance
| Type | Coverage | Reimbursement Rate | Annual Limit |
|---|---|---|---|
| Employee Insurance | Inpatient + Outpatient | 70%–90% | ¥200,000–500,000 |
| Resident Insurance | Inpatient + Select Outpatient | 50%–70% | ¥100,000–200,000 |
| New Rural Cooperative | Mainly Inpatient | 40%–60% | ¥50,000–150,000 |
Advantages: Mandatory coverage, insurable with pre‑existing conditions, lifelong renewability
Limitations: Only covers medicines listed in the social insurance formulary (self‑pay for items like anticancer drugs)
2. Commercial Medical Insurance (Recommended as Supplemental)
(1) “Million Medical” Plans (Best Value Choice)
- Typical Products: Ping An e‑Shengbao, ZhongAn Zunxiang e‑Sheng
- Coverage: Inpatient + special outpatient + proton/heavy‑ion therapy
- Price Reference: ~¥300/year at age 30; ~¥1,500/year at age 60
- Reimbursement Rule: After social insurance payout, 100% coverage above a ¥10,000 deductible
(2) Mid‑Tier Medical Insurance (Enhanced Experience)
- Typical Products: MSH XinXiang Life, Axa Smart Hospitalization
- Core Advantages:
✅ Coverage for VIP/International Departments
✅ Cashless direct billing
✅ Includes outpatient services - Price Reference: ~¥2,000/year at age 30
(3) High‑End Medical Insurance (Global Coverage)
- Typical Products: Bupa Global, Cigna “ChunXiang” Life
- Top‑Tier Services:
Direct billing at global hospitals (including United Family Healthcare)
Includes checkups/vaccines/dentistry - Price Reference: ~¥30,000/year at age 30
3. Specialized Medical Insurance
- Cancer‑Protection Plans (e.g., “Haoyi Bao Lifetime Cancer Protection”): available for high‑risk groups
- Special‑Drug Insurance (e.g., “Yaoshen Bao”): covers 120 types of anticancer specialty drugs
- Overseas Medical Insurance: treatment at designated hospitals in Japan/USA
2. In‑Depth Comparison by 5 Dimensions
1. Coverage Scope Comparison
| Benefit | Million Medical | Mid‑Tier | High‑End |
|---|---|---|---|
| Standard Inpatient | ✔ | ✔ | ✔ |
| VIP/International Department | ✘ | ✔ | ✔ |
| Outpatient Surgery | ✘ | ✔ | ✔ |
| Dental/Check‑up | ✘ | ✘ | ✔ |
| Overseas Treatment | ✘ | ✘ | ✔ |
2. Renewable Terms Comparison
- Guaranteed Renewability: “Haoyi Bao 20‑Year Plan” (can renew even if delisted within 20 years)
- No Guarantee to Renew: Most annual‑term products (may be declined after a claim)
3. Hospital Network Comparison
- Million Medical: Tier‑2 and above public hospitals (standard departments)
- Mid‑Tier Medical: + VIP/International departments in public hospitals
- High‑End Medical: + private hospitals (e.g., United Family Healthcare)
4. Claims Convenience Comparison
| Service Type | Document Reimbursement | Cashless Direct Billing | Advance Payment Option |
|---|---|---|---|
| Million Medical | ✔ | ✘ | Available in some products |
| Mid‑Tier Medical | ✔ | ✔ | ✔ |
| High‑End Medical | ✘ | ✔ | ✘ |
5. Recommended for Different Groups
| Demographic | Recommended Plan Type | Annual Budget Reference |
|---|---|---|
| Young & Healthy | Million Medical | ¥200–500 |
| Middle‑aged Family Provider | Million Medical + Special‑Drug Insurance | ¥800–2,000 |
| Corporate Executives | High‑End Medical | ¥20,000–50,000 |
| Elderly | Cancer‑Protection Plan | ¥1,000–3,000 |
3. Top 5 Popular Products Reviewed
1. Ping An e‑Shengbao (Guaranteed Renewability for 20 Years)
- Highlights: Includes outpatient drug purchases + proton/heavy‑ion therapy
- Downside: VIP ward requires additional rider
2. ZhongAn Zunxiang e‑Sheng 2024 Edition
- Innovation: Covers internet‑hospital prescriptions
- Note: Cannot renew if discontinued
3. PICC “Haoyi Bao” Long‑Term Medical Plan
- Advantage: Shares a ¥10,000 deductible over six years
- Limitation: Strict health questionnaires
4. MSH XinXiang Life (Mid‑Tier Benchmark)
- Services: Covers dental care/traditional Chinese medicine
- Price: ~¥2,100/year at age 30
5. Bupa Elite Plan (Top‑Tier High‑End)
- Privileges: Global emergency rescue/maternity coverage
- Requirement: Financial underwriting required
4. Pitfall‑Avoidance Tips When Purchasing
1. Health Disclosure Traps
- Always disclose truthfully: inpatient records, nodules/polyps, hypertension/diabetes/hyperlipidemia
- Underwriting Tips: Some products support online underwriting (non‑standard physiques accepted)
2. Exclusion Clause Interpretation
❌ Not covered:
- Pre‑existing conditions (diagnosed before purchasing)
- Cosmetic surgery (unless for accidental injury repair)
- High‑risk sports (e.g., rock climbing, skydiving)
3. Renewal Risk Warning
- Warning: “Renewable until age 99” ≠ guaranteed renewability
- Prefer: Policies that explicitly state guaranteed renewability period in contract
4. Identifying Sales Misleading Statements
- Typical misleading pitches:
✘ “You can buy even if you’re already sick” (no‑claims = no coverage)
✘ “Any hospital is covered” (must check contract’s hospital list)
5. Practical Tips for Claims
1. Document Preparation Checklist
- Required Documents:
Medical records (including admission and discharge notes)
Hospital receipts (with official seal)
Social insurance payment records
2. Fast‑Track Claims Options
- Online Claims: Use apps like Ping An or ZhongAn to upload photos
- Advance Payment: Available for claims over ¥50,000 (must notify in advance)
3. Dispute Resolution Channels
- File complaint with insurer (must respond within 30 days)
- Contact China Banking and Insurance Regulatory Commission at 12378
- File lawsuit (for disputes over ¥10,000)
6. Insurance Purchase Recommendations
- Foundation Level: Social insurance + Million Medical (covers major illness risks)
- Intermediate Level: + Mid‑Tier Medical (better hospital experience)
- High‑Net‑Worth Level: Add High‑End Medical (global resources)
Important Reminder: People over 50 are recommended to prioritize a cancer‑protection medical plan!