报告：健康险覆盖率达77.51%，保障的“匹配度”有待提高

Core Insights - The report indicates that the health insurance coverage rate has reached 77.51%, but the "matching degree" of the coverage needs improvement [1][2] Group 1: Health Insurance Coverage - The basic medical insurance participation rate is stable at 95.85%, with 72.73% participating in employee basic medical insurance and 18.79% in urban and rural resident basic medical insurance [1] - 77.51% of respondents hold at least one type of commercial health insurance, primarily medical insurance (45.38%) and critical illness insurance (41.24%) [2] Group 2: Health Status and Insurance - The self-reported health level of those purchasing "惠民保" (a type of urban customized commercial medical insurance) is lower (mean 3.81) compared to those with critical illness insurance (mean 4.02) and medical insurance (mean 3.96) [2] - The chronic disease prevalence among "惠民保" purchasers is 45.49%, significantly higher than those with critical illness (26.33%) and medical insurance (30.93%) [2] Group 3: Insurance Matching Degree - Despite high health insurance coverage, the report notes a low score for the "matching degree" of coverage, indicating a mismatch between premium spending and actual income and risk needs [2] - The report suggests a shift in the insurance industry from providing standardized products to offering dynamic coverage plans that align with users' income levels, family structures, and health statuses [2] Group 4: Health Insurance Protection Index - The health insurance protection index for 2024 is calculated at 0.6241, indicating a well-established basic network for national health protection [3] - The highest protection score is observed in the 36-40 age group (0.6416), while younger individuals (under 25) and older adults (over 50) show lower scores, highlighting opportunities for market refinement and product innovation [3] Group 5: Occupational and Marital Status Impact - There are structural differences in health insurance protection levels across occupational groups, with civil servants scoring the highest (0.6424) [3] - Married individuals have the highest protection score (0.6356), while unmarried individuals score slightly lower (0.6024), and those who are divorced or widowed score even lower [4] Group 6: Future Directions - The industry is expected to transition from "having protection" to "enjoying precise and secure services," focusing on product design precision and health service ecosystem development [4] - Insurance institutions are encouraged to leverage technology and data to develop more adaptable products for different life stages and risk profiles, while also integrating health management services [4]