平安健康险2025年赔付79亿元，院外药品费用持续攀升

Core Insights - Ping An Health Insurance reported a total of 6.22 million claims and 1.71 million claimants in 2025, with a total payout amounting to 7.9 billion yuan, averaging 4 claims per person and a maximum payout of 4.56 million yuan per client [1] - The report highlights a significant increase in the use of special drugs, with a 105% rise in usage instances and a 50% increase in total billing amounts for special drugs compared to the previous year [1][2] - The report indicates a growing trend in cross-province medical treatment, with 8% of clients seeking treatment outside their home province, reflecting an ongoing improvement in nationwide network collaboration and seamless claims processing [2] Claims and Payouts - In 2025, the average claim per client was 4 times, with the highest individual payout reaching 4.56 million yuan [1] - The fastest claim processing time was recorded at just 3 seconds, while the longest payout period extended over 17 years, demonstrating the company's commitment to long-term client support [1] - The age range for claimants spanned from 13 days to 103 years, indicating comprehensive coverage throughout the client's life cycle [1] Cancer Care Services - By the end of 2025, Ping An Health Insurance's cancer care services had served 396,000 individuals, with 14,000 receiving precise medical guidance and 350,000 accessing medical services [1] - The maximum duration of cancer care services recorded was 1,460 days, with the highest number of special drug usages per individual reaching 46 times and the maximum single special drug payout amounting to 1.29 million yuan [1] Industry Trends - The report identifies three major trends in health risk management, emphasizing the shift from price competition to value competition within the industry [2] - Ping An Health Insurance is advancing the development of a systematic health ecosystem, transitioning from passive claims to proactive health management through a digital health management platform [2]