Group 1 - The core point of the article is the introduction of a commercial health insurance innovative drug directory in the 2025 national medical insurance catalog adjustment, marking the first time the National Healthcare Security Administration has established such a directory [1] - The adjustment aims to enhance the availability of innovative drugs through commercial insurance, addressing the diverse medication needs of the population [1] - The basic medical insurance coverage rate in China has stabilized around 95%, but the overall funding level remains low, necessitating the inclusion of more innovative drugs in commercial insurance [1] Group 2 - There is a lack of collaboration between basic medical insurance and commercial insurance, leading to issues such as "duplicate insurance" and "coverage gaps" for the public [3] - The National Healthcare Security Administration is exploring ways to support the differentiated development of commercial health insurance alongside basic medical insurance [3] - In the past year, several cities have implemented "commercial insurance + medical insurance" one-stop settlement payment platforms, facilitating automatic recognition of patients' insurance qualifications [5] Group 3 - A national "medical insurance + commercial insurance" clearing settlement center has been launched in Beijing to address the challenges faced by patients seeking cross-province medical services [7] - Patients can now achieve one-stop settlement for both medical and commercial insurance at pilot hospitals in Beijing, such as Peking Union Medical College Hospital and Xuanwu Hospital [7]
国家医保局首次制定商业健康保险创新药目录 “医保+商保”同步结算惠民生
Yang Shi Wang·2025-09-02 03:01