2026年度“北京普惠健康保”上线，首次将CAR—T疗法、高值慢病用药纳入保障范围

Core Viewpoint - The "Beijing Universal Health Insurance" is a government-guided supplementary medical insurance aimed at providing affordable healthcare, with over 15 million participants in four years [1][2] Group 1: Product Features - The insurance is available to all Beijing basic medical insurance participants, regardless of age, occupation, or health status, with a premium of 195 yuan per person per year and a total coverage amount upgraded to 3.5 million yuan [2][3] - Key enhancements include a reduction in the self-payment threshold for healthy individuals from 30,404 yuan to 15,000 yuan, and an additional 25% reimbursement for expenses between 15,000 yuan and 30,404 yuan [3][4] - The range of special drug coverage has expanded to 87 diseases and 159 drugs, including 57 domestic and 65 overseas special drugs, improving accessibility and affordability for patients [3][4] Group 2: Service Improvements - The reimbursement ratio for special drugs has increased by 5 percentage points, with healthy individuals now reimbursed at 65% and those with pre-existing conditions at 35% [3] - New health services include a 10% discount on online and offline drug purchases and exclusive services for loyal users, such as free health services and equipment [3][4] - The insurance has processed 419,000 claims over the past four years, with a maximum single claim amount of 761,100 yuan and a fast claim process where 89% of claims are settled quickly, often within 1-2 working days [4]