医保商保“双拼”，市民买账吗？

Group 1 - The introduction of the commercial health insurance innovation drug directory significantly lowers the threshold for innovative drugs to enter hospitals, although it does not equate to reimbursement by basic medical insurance [1][2] - The "three exclusions" policy allows hospitals to confidently include these drugs, as they are not subject to basic medical insurance self-payment rate assessments or included in collective procurement monitoring [2] - The commercial health insurance directory serves as an official "menu," enabling insurance companies to package these drugs into health insurance products without the need for additional screening [1][2] Group 2 - The "Sui Suikang" insurance, designed by the Guangzhou Municipal Medical Insurance Bureau, covers all drugs listed in the commercial health insurance directory, with an annual premium of only 180 yuan and a maximum coverage of 2.45 million yuan [3][4] - The "Sui Xin Bao," launched in March, is the first commercial health insurance specifically covering high-value innovative drugs and devices, with over 100 innovative drugs included [3] - Both "Sui Suikang" and "Sui Xin Bao" allow for one-stop settlement at discharge, reducing the financial burden on patients by enabling multiple insurance claims [4] Group 3 - The acceptance of commercial insurance among citizens remains low, with many unaware of the differences between various insurance types, leading to a high dropout rate [5] - The misconception that not using insurance equates to a loss poses a risk to the sustainability of many beneficial insurance products, as healthier individuals may opt out [5][6] - The commercial health insurance market in China is still developing, with a low penetration rate and density, indicating significant room for growth [6] Group 4 - The commercial health insurance innovation drug directory provides a nationally recognized payment pathway for high-value innovative drugs, which is beneficial for companies' commercialization efforts [7] - Companies are particularly focused on whether patients can reduce out-of-pocket expenses and how many hospitals will include these drugs in their offerings [7] - There is a need for improved coordination between different departments to fully realize the potential of commercial health insurance for innovative drug development [8]