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新规落地!账户医疗险、分红健康险来了
Di Yi Cai Jing·2025-09-30 15:02

Core Viewpoint - The "Guiding Opinions on Promoting the High-Quality Development of Health Insurance" issued 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 the industry [1][2]. Summary by Sections Development Goals - By 2030, health insurance is expected to play a crucial role in the national health security system, with a multi-level health insurance market structure that meets diverse needs across the entire population and lifecycle [2]. - The regulatory framework for health insurance will be more robust, enhancing regulatory effectiveness [2]. Industry Challenges - Despite rapid growth, the health insurance sector faces challenges such as product homogeneity, insufficient operational capacity, and inadequate collaboration with the medical and pharmaceutical sectors [2][5]. - The need for innovation is highlighted as a key factor for the high-quality development of commercial health insurance [2]. Innovative Products - The introduction of personal account-based long-term medical insurance and dividend health insurance is a significant innovation, allowing for a richer service offering and aligning with the trend of integrating health insurance with health management [3][4]. - The personal account model is expected to function alongside primary medical insurance, enabling investment returns and covering health management expenses [3]. Regulatory Support - The Opinions support well-rated insurance companies in launching dividend-based long-term health insurance, expanding the sources of returns beyond fixed income [4]. - The cap on health management costs in net premiums is set to increase for certain health insurance companies, allowing them to develop unique offerings [4]. Integration with Innovative Medical Solutions - The Opinions stress the importance of integrating new medical technologies, drugs, and devices into insurance coverage, promoting collaboration with pharmaceutical companies for innovative payment methods [5]. - The commercial health insurance sector is increasingly recognized for its role in facilitating access to high-cost treatments, such as CAR-T therapy, which are not covered by national insurance [6]. Future Directions - The Financial Regulatory Bureau plans to enhance communication with other departments to create a favorable policy environment for health insurance development and to implement detailed regulations for floating yield health insurance [6].