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

Core Viewpoint - The 2026 edition of "Beijing Inclusive Health Insurance" has been launched, providing a government-supervised supplementary health insurance option that has already covered over 15 million participants in four years, with significant claims processing achievements [1][2]. Group 1: Insurance Coverage and Benefits - 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]. - The claims threshold has been lowered, with the self-payment responsibility for healthy individuals reduced 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 covered special drugs has expanded to 87 diseases and 159 drugs, including both domestic and overseas special medications, enhancing accessibility and affordability for the public [3][4]. Group 2: Additional Services and Features - Continuous participants with no claims for three years will benefit from reduced deductibles and free annual health services, including a choice of health management devices [4][5]. - The program emphasizes inclusivity, allowing participation from various demographics, including newborns and the elderly, and ensuring that individuals with pre-existing conditions can still receive coverage [4][5]. - The quick claims process has been implemented, with 89% of claims processed through fast compensation, significantly reducing the time for participants to receive funds [5][6].