万亿商业健康险结构重置究竟多“逆天”？财险公司医疗险暴涨11%，重疾险承压难见“第二波繁荣”

Core Insights - The Chinese commercial health insurance market is at a crossroads, experiencing both low premium growth and high demand driven by policy support [1][2][3] Group 1: Market Overview - As of November 2025, the commercial health insurance premium reached 944 billion yuan, with a year-on-year growth of 2.39%, marking the lowest growth rate in five years [8] - The medical insurance segment continues to dominate, accounting for approximately 46% of the total premiums, with a growth rate of nearly 7% [8] - The industry is expected to surpass the trillion yuan mark in total premiums for the first time in 2025, despite the low growth rate [8] Group 2: Product and Business Types - Medical insurance remains the primary growth driver, while long-term care and disability insurance are experiencing stable growth [9] - The C-end (individual) business dominates the market, accounting for nearly 70% of the total, while B-end (enterprise) and G-end (government) businesses make up about 14% to 16% [12] - The online health insurance market is growing rapidly, with a scale of 77 billion yuan and a year-on-year growth rate of approximately 16% as of September 2025 [12] Group 3: Regulatory Environment - 2025 is a significant year for policy releases aimed at promoting commercial health insurance, with multiple departments introducing various supportive measures [17] - Key policy documents include the "Guiding Opinions on Promoting High-Quality Development of Health Insurance," which emphasizes the need for collaboration between group and individual insurance [17][18] - The establishment of a long-term care insurance system is set to be fully implemented, with expectations for the national long-term care fund to exceed 250 billion yuan in revenue over the next five years [19] Group 4: Growth Drivers - The demand for high-quality medical services is expected to rise, driven by the aging population and increasing healthcare costs [16] - Medical and long-term care insurance are identified as the main growth points, with a focus on product innovation and service integration [20][21] - The trend of "payment + service" integration is accelerating, with hospitals increasingly embracing commercial insurance [33] Group 5: Technological Impact - AI is reshaping industry efficiency, with significant developments in health management applications that enhance user engagement and data collection [35][36] - The integration of electronic health records and AI-driven solutions is seen as a key factor in improving healthcare delivery and insurance services [35][36] Group 6: Future Outlook - The health insurance market is expected to navigate uncertainties while anchoring on five key growth points, including the demand for high-quality medical services and the integration of health payment and services [37]