二〇二六年度北京普惠健康保开放参保

Core Points - The "Beijing Inclusive Health Insurance" has opened enrollment for the 2026 plan, with a premium of 195 yuan per person per year, and the self-payment threshold for healthy individuals reduced to 15,000 yuan [1][3] - The coverage for diseases has expanded to 87 types, and the list of reimbursable drugs has increased to 159, including 57 domestic special drugs and 65 overseas special drugs [2][3] - The total coverage amount has been raised to 3.5 million yuan, and the reimbursement ratio for special drugs has increased by 5 percentage points [1][2] Summary by Category Insurance Features - The insurance period for the 2026 plan is from January 1 to December 31, 2026, with a total coverage amount of 350 million yuan [1] - The self-payment threshold for healthy individuals has been lowered from 30,404 yuan to 15,000 yuan, with reimbursement of 25% for expenses between 15,000 yuan and 30,404 yuan after basic medical insurance [1][3] Drug Coverage - The list of reimbursable drugs now includes 159 items, with the addition of 37 innovative drugs, including high-value chronic disease medications [2] - The reimbursement ratio for healthy individuals has increased from 60% to 65%, while for individuals with pre-existing conditions, it has risen from 30% to 35% [2] Health Services - New online and offline 10% discount on drug purchases has been introduced, allowing for an annual subsidy of 1,800 yuan [2] - For insured individuals with no claims in the past three years, the deductible for out-of-pocket expenses has been reduced significantly [2][3] Enrollment Conditions - The enrollment conditions remain flexible, with no restrictions on age, residency, occupation, or health status, covering various groups including those with specific pre-existing conditions [3] - The program has seen over 15 million enrollments and processed 419,000 claims since its launch, with the fastest payouts occurring within 1-2 working days [3]