Detailed explanation of mild symptoms of Taikang le Ankang
There are 22 kinds of mild diseases defined in this contract.
Very early malignant tumor or lesion
It refers to one or more of the following malignant lesions diagnosed by histopathological examination and received corresponding treatment.
(1) carcinoma in situ;
(2) Chronic lymphoblastic leukemia corresponding to stage A of Binet staging scheme; (3) Hodgkin's disease equivalent to Ann Arbor stage I; (4) Skin cancer (excluding malignant melanoma and metastatic skin cancer); (5) Prostate cancer has a TNM stage of 5)t 1n0m 0 or less.
Pituitary tumor, brain cyst, brain aneurysm and brain hemangioma refer to one or more of the following diseases diagnosed by CT, MRI or other imaging examinations, and actually received surgery or radiotherapy.
(1) Pituitary tumor;
(2) brain cyst;
(3) Cerebral aneurysm and cerebral hemangioma.
Atypical acute myocardial infarction
Refers to the clinical diagnosis of acute myocardial infarction and after treatment, although it does not meet the payment standard of major disease "acute myocardial infarction", it meets all the following conditions:
(1) Diagnostic increase of troponin;
(2) There were some traumatic ST segment changes in ECG, but no pathological Q wave appeared.
If the insured satisfies both atypical acute myocardial infarction and coronary intervention (non-thoracotomy), only one of them will be paid.
Coronary intervention (non-thoracotomy)
In order to treat obvious coronary artery stenosis, coronary balloon angioplasty, coronary stent implantation, coronary atherosclerotic plaque resection or laser coronary angioplasty were actually implemented for the first time.
If the insured satisfies both atypical acute myocardial infarction and coronary intervention (non-thoracotomy), only one of them will be paid.
Interventional heart valve surgery (non-thoracotomy)
In order to treat heart valve diseases, non-thoracoscopic surgery or percutaneous interventional surgery through chest wall is actually implemented for heart valve replacement or repair.
Intra-aortic surgery (non-thoracotomy)
In order to treat aortic diseases, percutaneous intra-arterial surgery was actually performed. Aorta refers to thoracic aorta and abdominal aorta, excluding branch vessels of thoracic aorta and abdominal aorta.
Vascular interventional therapy for specific peripheral arterial diseases
Refers to vascular interventional therapy for the treatment of one or more of the following arterial stenosis:
(1) Arteries supplying blood to lower limbs or upper limbs;
(2) renal artery;
(3) mesenteric artery.
All the following conditions must be met:
(1) Angiography confirmed that the degree of stenosis of one or more arteries above 50%; (2) Interventional vascular therapy, such as angioplasty and/or stent implantation or atherectomy, is performed on one or more arteries.
The diagnosis of the above-mentioned arterial diseases and the necessity of related treatment must be determined by vascular disease experts.
Primary pulmonary hypertension
Refers to the right ventricular hypertrophy caused by the progressive development of primary pulmonary hypertension, which has caused permanent irreversibility (see physical activity limitation, reaching Grade III and above of new york Cardiology Association, but not Grade IV, and the average pulmonary artery pressure at rest is greater than 25mmHg, but not greater than 30mmHg.
Biliary reconstruction operation
Due to biliary tract injury, biliary tract reconstruction including common bile duct and small intestine anastomosis was performed. When the specialist thinks it is necessary to carry out medical treatment, surgery must be carried out. Biliary atresia is not covered.
Severe visual impairment
Refers to the permanent and irreversible loss of binocular vision due to illness or accidental injury. Although it does not meet the compensation standard for "blindness" of major diseases, it meets one of the following conditions:
(1) The corrected visual acuity of good eyes is lower than the international standard visual acuity chart, and it should be converted if other visual acuity charts are used); (2) The visual field radius of eyes with good eyes is less than 20 degrees.
The insured's eyesight was seriously damaged due to illness before he was 3 years old, which was not covered.
Monocular vision loss
Refers to the permanent and irreversible loss of monocular vision caused by illness or accidental injury. Although it does not meet the standard of "binocular blindness", the affected eye must meet at least one of the following conditions:
(1) Loss or enucleation of eyeball;
(2) The corrected visual acuity is lower than the international standard visual acuity chart, and it should be converted if other visual acuity charts are used); (3) The visual field radius is less than 5 degrees.
The loss of monocular vision caused by illness before the insured is 3 years old is not covered.
Mild brain surgery
The insured has indeed done skull drilling under general anesthesia or craniotomy through nasal sphenoid sinus due to illness. Brain surgery caused by trauma is not covered.
Facial reconstruction surgery
Plastic surgery or reconstruction surgery was indeed performed (the facial structure above the neck was incomplete, missing or damaged, and its shape and appearance were repaired or reconstructed). At the same time, specialists must think that facial disfigurement needs hospitalization and then surgery, and the treatment of facial disfigurement is also necessary for medical treatment. Surgery for purely cosmetic reasons, independent dental restoration, independent nasal bone fracture or independent skin wound are not covered.
For minor third-degree burns, minor facial burns and facial reconstruction operations, if two or more of the above conditions are met at the same time for the same reason, the related burns or operations can only be compensated once in this policy.
Bilateral orchiectomy
Complete bilateral orchiectomy due to illness or accidental injury. Partial orchiectomy is not covered.
nephrectomy
Unilateral nephrectomy at least due to illness or accidental injury. Nephrectomy required for kidney donation is not covered.
Lose a limb
Refers to a limb whose wrist joint or ankle joint (near the trunk end) is completely severed, but it does not meet the standard of "multi-limb loss" of major diseases.
lobectomy of liver
At least one complete liver lobe has been removed due to illness or accidental injury.
Diseases or disorders caused by alcohol or drug abuse and/or liver surgery required for liver donation are not covered.
pneumonectomy
At least one pneumonectomy due to illness or accidental injury. The pneumonectomy required for lung donation is not covered.
Monoear deafness
Refers to the permanent and irreversible hearing loss in one ear caused by illness or accidental injury. At the speech frequencies of 500 Hz, 1000 Hz and 2000 Hz, the average hearing threshold is greater than 90 dB, which is confirmed by pure tone hearing test, acoustic immittance test or auditory evoked potential test.
Unilateral deafness caused by illness of the insured before the age of 3 is not covered.
Small area third degree burn
It means that the degree of burn is degree III, and the area of degree III burn is larger than 10% or 10% of body surface area, but it has not reached 20%. The body surface area is calculated according to China's new nine-point method.
For minor third-degree burns, minor facial burns and facial reconstruction operations, if two or more of the above conditions are met at the same time for the same reason, the related burns or operations can only be compensated once in this policy.
Mild facial burn
It means that the degree of burn is ⅲ, and the area of ⅲ burn reaches more than 30% of the facial surface area, but it does not reach 80% of the facial surface area.
For minor third-degree burns, minor facial burns and facial reconstruction operations, if two or more of the above conditions are met at the same time for the same reason, the related burns or operations can only be compensated once in this policy.
Degree atrioventricular block
It refers to a kind of heart conduction disease in which atrial excitation is blocked at the atrioventricular junction, atrioventricular bundle and its branches and cannot spread to the ventricle normally. All the following conditions must be met:
(1) ECG showed that the atrioventricular beats were independent of each other, and the ventricular rate
(3) It is necessary to continuously rely on a pacemaker to maintain the normal function of the heart, and a pacemaker has been placed.