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重磅新规落地!账户医疗险、分红健康险来了
Di Yi Cai Jing Zi Xun·2025-09-30 14:59

Core Viewpoint - The "Guiding Opinions on Promoting the High-Quality Development of Health Insurance" released by the Financial Regulatory Bureau emphasizes the significant role of health insurance in the national health security system by 2030, outlining development goals and innovative points for commercial health insurance [1][2]. Group 1: Development Goals and Market Structure - By 2030, a multi-level health insurance market structure will be established, with coordinated development of group and individual health insurance to meet diverse needs across the population and lifecycle [2]. - The health insurance regulatory system will be more robust, reflecting improved regulatory effectiveness [2]. Group 2: Challenges and Opportunities - Current challenges in the health insurance sector include product homogeneity, insufficient operational capacity, and inadequate collaboration with the medical and pharmaceutical sectors, which hinder service improvement [2]. - Despite these challenges, there is a consensus that commercial health insurance has substantial growth potential in the medium to long term, with innovation being a key driver for high-quality development [2]. Group 3: Innovations in Health Insurance Products - The introduction of personal account-based long-term medical insurance and dividend health insurance are highlighted as significant innovations in the sector [3][4]. - Personal account medical insurance will allow for investment returns and can be used for health management and medical expenses, aligning with the trend of integrating health insurance with health management [3]. - Dividend health insurance will expand the sources of returns beyond fixed income, incorporating factors like disease incidence rates, thus enhancing the product's appeal [4]. Group 4: Integration with Innovative Medical Solutions - The Opinions stress the importance of integrating new medical technologies, drugs, and devices into health insurance coverage, promoting collaboration with pharmaceutical companies for innovative payment methods [5]. - The commercial health insurance sector is increasingly recognized for its role in supporting the payment for innovative drugs, with a projected sales figure of 162 billion yuan for innovative drugs in 2024, where commercial health insurance is expected to contribute approximately 12.4 billion yuan [5][6]. Group 5: Policy Support and Future Directions - The Opinions provide favorable policies for various health insurance products, including long-term care insurance and critical illness insurance, aiming to enhance consumer protection and service offerings [6]. - Future efforts will focus on creating a conducive policy environment for health insurance development, expediting the introduction of floating yield health insurance, and strengthening regulatory oversight to protect consumer rights [6].