2026年度“北京普惠健康保”上线，特药报销比例提高5个百分点

Core Insights - The "Beijing Inclusive Health Insurance" for 2026 was launched, emphasizing its role as a government-guided supplementary medical insurance aimed at alleviating high medical costs and preventing poverty due to illness [1][2] - The insurance has seen over 15 million participants since its inception in 2021, maintaining a low premium of 195 yuan per person per year while increasing the total coverage to 3.5 million yuan [1][2] Summary by Sections Product Features - The insurance maintains a low premium of 195 yuan per person per year and has upgraded the cumulative coverage to 3.5 million yuan [1] - The product features include low thresholds for participation, high coverage, and quick claims processing, with a focus on inclusivity and broad coverage [1] Service Enhancements - The deductible for healthy individuals has been reduced from 30,400 yuan to 15,000 yuan [2] - The coverage for innovative drugs outside the medical insurance directory has been expanded to 159 types [2] - Reimbursement rates for special drugs have increased by 5 percentage points for both healthy individuals and those with pre-existing conditions, reaching 65% and 35% respectively [2] - New benefits include a 10% discount on medication purchases for both insured and uninsured individuals, and an extended sales period allowing for year-round enrollment [2] Additional Benefits - For individuals with three consecutive years of enrollment and no claims, the deductible for healthy individuals is further reduced to 5,000 yuan, and for specific pre-existing conditions, it is lowered to 15,000 yuan [2] - Participants can access free annual health services, including emergency kits, health check-ups, and weight management equipment [2] - The regulatory body emphasizes the importance of commercial health insurance in enhancing public welfare and encourages continuous product optimization and efficient claims processing [2]