惠民保变革：差异化定价众口难调，衔接商保创新药目录有“时差”

Core Viewpoint - The recent notification from the National Financial Supervision Administration emphasizes the need for high-quality development of urban commercial medical insurance, particularly focusing on the "Hui Min Bao" insurance, which serves as a bridge between social security and commercial insurance [1][2]. Group 1: Regulatory Changes - The notification outlines that urban customized commercial medical insurance should incorporate new medical technologies, drugs, and devices into its coverage [1][8]. - It stresses the importance of differentiating between commercial insurance and social insurance to avoid confusion and promote reasonable expectations for social security [1][2]. Group 2: Market Dynamics - Experts express concerns about the positioning of "Hui Min Bao" following the implementation of differentiated pricing, questioning whether it will still meet the needs of the public [2][5]. - The notification aims to prevent low-price, chaotic competition and monopolistic sales practices in the market [6][7]. Group 3: Pricing Strategies - Some regions are experimenting with differentiated pricing for "Hui Min Bao," with premiums set at 69 yuan for individuals aged 0-22, 99 yuan for those aged 23-50, and 149 yuan for individuals over 50 or with pre-existing conditions [2][3]. - The concept of differentiated pricing is seen as a way to balance risk and affordability, potentially stabilizing the market [3][4]. Group 4: Product Integration and Innovation - The upcoming commercial insurance innovation drug directory is expected to be integrated into "Hui Min Bao," enhancing its coverage of innovative drugs [1][9]. - The directory aims to include high-innovation, clinically valuable drugs that exceed basic medical insurance coverage, with a focus on reducing patient costs for expensive treatments [9][10]. Group 5: Challenges and Concerns - There are concerns regarding the effective implementation of the notification's requirements, particularly in terms of achieving consensus among various stakeholders [2][5]. - The high overlap of coverage between "Hui Min Bao" and basic medical insurance, estimated at 40%, indicates a need for better alignment and design of insurance products [10][11].