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税收优惠健康险将推开 投保人医疗费用自付比例降低

2017-06-30 09:39:50   经济参考报

根据财政部、税务总局、保监会联合发布的通知,自今年7月1日起,商业健康保险个人所得税试点政策将推广到全国范围实施。

根据政策,纳税人投保商业税收优惠型健康险后,可以在当年(月)计税时,按照2400元/年或200元/月的限额标准,对个人应纳税所得额予以税前扣除。该政策的适用对象为取得工资薪金所得、连续性劳务报酬所得的个人,以及取得个体工商户生产经营所得、对企事业单位的承包承租经营所得的个体工商户业主、个人独资企业投资者、合伙企业合伙人和承包承租经营者。与普通商业健康险不同,该险种除了可以在限额内免交个税,税优险还可带病投保,且保证续保,保险公司不得设置免赔额、犹豫期。

对于投保过程中具体操作,业内人士解释,对于投保人一次趸交一年保费的,分摊在各个月份,按月扣除。比如张三购买一年期商业健康险,一次性交费2200元,则平均每月可以从个人应税收入中减去183元。他同时提醒,个人直接购买税优商业健康险产品的,取得税优识别码后,应及时向扣缴单位提供保单信息,扣缴义务人依法对其进行税前扣除。“个人购买商业健康保险未获得税优识别码,以及购入其他保险产品的,不能享受税前扣除政策。因此,纳税人要辨别一款保险产品是否可以享受个人所得税扣除政策,主要看购买时能否取得税优识别码。”上述人士表示。

此外,该险种报销比例高。已经参加公费医疗或有基本医保人群投保税优健康险后,医疗费用支出在前两项已经报销的基础上,余下自费部分税优健康险简单赔付率不低于80%。

如广东省投保人王某购买了新华保险的一款个人税收优惠型健康保险,此后因病住院治疗,新华保险为其赔付税优健康保险金983.19元。因为王某同时缴纳了社会医疗保险,其所在单位还为其购买了团体住院补充医疗保险,加上新华保险的税优健康险赔付,按照相关手续办理报销和理赔,王某住院治病个人仅需花费40多元,自付比例只有2%。

目前国内获得税优健康险销售资格的保险公司超过20家。《经济参考报》从人保健康、阳光保险等公司的赔付案例显示,税优健康险二次理赔后,个人自付比例一般从40%降至2%—5%,医疗开支负担大为减轻。

“税优健康险能够覆盖基本医疗保险和补充医疗保险之间的空白地带,成为医疗保险体系的有效补充。商业健康保险的发展对建立完善医疗保险‘第三支柱’具有积极意义,税收优惠政策出台,有助于加快构建我国多层次医疗保险体系。”业内人士表示,税收优惠商业健康险进行产品设计时,遵循“保障为主、合理定价、收支平衡、保本微利”的原则,这类保险产品有一定的社会半公益性质,这项政策的出台不仅可以提高人民群众医疗保障水平,同时可以提高公众对商业健康险认知,吸引更多市场主体参与。

业内人士预计,尽管眼下税优健康险市场只在起步阶段,但税优健康险前景值得期待。2012年起,我国健康保险进入快速发展阶段,成为保险业增速最快的板块。机构预测,到2020年健康险保费有望达到7000亿至10000亿元,成为与财险、寿险并列的三大业务板块之一。

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