Core Viewpoint - The 2025 version of "Hu Hui Bao" continues to enhance its medical insurance offerings for Shanghai residents, maintaining low premiums while expanding coverage and improving service experiences [1][2]. Group 1: Insurance Product Features - The 2025 "Hu Hui Bao" insurance remains open to all Shanghai basic medical insurance participants, with a premium of 129 yuan per person, covering five major responsibilities including specific hospitalization expenses, high-cost domestic drugs, proton and heavy ion medical expenses, overseas special drug expenses, and CAR-T treatment drug expenses [1][2]. - Compared to 2024, the 2025 version has increased the number of covered domestic special drugs from 41 to 48, while maintaining 28 overseas special drugs and expanding CAR-T treatment drugs from 3 to 4 [1][2]. Group 2: Service Enhancements - The service experience for the 2025 "Hu Hui Bao" has been upgraded, continuing existing benefits such as a 10% discount at over 2000 designated pharmacies and online consultation discounts with top-tier specialists, while adding a new 10% discount for original research drugs [2]. - The personal account family mutual aid has been expanded to allow the use of medical insurance personal account balances for a wider range of relatives, including siblings and grandparents [2]. Group 3: Claims and Support Services - Since its launch, "Hu Hui Bao" has continuously improved its claims services, achieving a 90% application rate for electronic medical data and optimizing average case closure time to the same day [3]. - The program has provided approximately 16.3 million yuan in advance payments for 93 insured individuals, alleviating the financial burden of high medical costs [3]. Group 4: Enrollment and Accessibility - The enrollment window for the 2025 "Hu Hui Bao" is open until June 30, 2025, with coverage effective from July 1, 2025, to June 30, 2026, allowing participants to enroll through various online platforms or by contacting service representatives for assistance [4]. Group 5: Claim Case Examples - A 26-year-old insured individual received approximately 670,000 yuan in claims for treatment of brain glioblastoma, demonstrating the program's extensive coverage for high-cost medical treatments [5]. - A 61-year-old insured individual benefited from the proactive claims service, receiving 16,700 yuan for hospitalization due to a urinary system disease, showcasing the efficiency of the claims process [6].
2025年度“沪惠保”正式开启参保通道 升级国内外特药保障 优化健康增值服务
和讯·2025-04-22 10:33