Insured must provide a doctor’s certificate to prove the examinations are out of medical
necessity.
3．产前检查、产前处方补充维生素和钙剂、自然分娩、医学必要的手术分娩、流产、产后检查、孕产期并
发症治疗费用； 每一保单年度因流产给付的女性生育保险金仅限一次。
Pre-natal examinations, prescribed pre-natal vitamins and minerals, natural childbirth, delivery by
caesarean section out of medical necessity, miscarriage, post-natal examination, pregnancy and
pregnancy complications treatment expenses;
We will only pay maternity benefits for miscarriage once per policy year.
被保险人因患牙科疾病，每次在医院治疗发生的下列合理且必要的牙科门诊医疗费用，本公司按约定给付比
例在年限额范围内给付牙科医疗保险金：
5.牙科医疗保险金
Dental care
benefits
If the Insured receives dental outpatient treatment due to dental disease, we will cover the
following reasonable and necessary outpatient dental treatment expenses. The dental care
benefits shall be paid after subtracting the deductibles at the agreed benefit ratio within the
annual limits:
年度分项限额
Annual Limit
基本牙科治疗
Basic dental
treatments
2,000
2,000
2,000
80%
80%
80%
指简单补牙(包括银汞合金或复合树脂充填)、简单拔牙、牙周治疗(包括牙周刮治及牙根平整术)
simple dental fillings (including dental amalgams or composite resin fillings), simple tooth
extractions and periodontal treatments (including periodontal scaling and root planting, etc).
责任简述：
Description:
重大牙科治疗
Major dental
treatments
80%
80%
80%
指根管治疗(包括麻醉和拍片费用)、牙冠修复、桥式义齿(包括化验和麻醉费用)、智齿拔除
root canal therapy (including anesthesia and X-ray expenses), crowns repairs, dentures (including
laboratory and anesthetic expenses), and wisdom teeth extractions.
责任简述：
Description:
6.住院津贴
hospitalization cash
subsidy
100/Day
100/Day
100/Day
被保险人因疾病或遭受意外伤害事故，经医院确诊必须住院治疗的，本公司按其合理住院日数乘以住院日额
津贴给付住院日额津贴保险金。
住院日额津贴保险金累计给付日数最多为 180 日，累计给付住院日额津贴保险金的日数达到 180 日
时，对该被保险人该项保险责任终止。
责任简述：
Description:
If the insured needs hospitalization treatment through hospital diagnosis due to Accidental
injury or illness the insurer will pay hospitalization cash subsidy according to the actual days of
hospitalization of the insured.
The maximum days for benefit payment within each policy year are 180 days.
7.特定医院赔付比例
Specified hospitals
Reimbursement
Rate
0%
0%
0%
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平安健康保险股份有限公司 Ping An Health Insurance Co., Ltd.