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普惠型商业补充医疗保险
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2026年度“北京普惠健康保”上线,首次将CAR—T疗法、高值慢病用药纳入保障范围
Bei Jing Shang Bao· 2025-11-03 05:21
Core Viewpoint - The "Beijing Universal Health Insurance" is a government-guided supplementary medical insurance aimed at providing affordable healthcare, with over 15 million participants in four years [1][2] Group 1: Product Features - The insurance is available to all Beijing basic medical insurance participants, regardless of age, occupation, or health status, with a premium of 195 yuan per person per year and a total coverage amount upgraded to 3.5 million yuan [2][3] - Key enhancements include a reduction in the self-payment threshold for healthy individuals from 30,404 yuan to 15,000 yuan, and an additional 25% reimbursement for expenses between 15,000 yuan and 30,404 yuan [3][4] - The range of special drug coverage has expanded to 87 diseases and 159 drugs, including 57 domestic and 65 overseas special drugs, improving accessibility and affordability for patients [3][4] Group 2: Service Improvements - The reimbursement ratio for special drugs has increased by 5 percentage points, with healthy individuals now reimbursed at 65% and those with pre-existing conditions at 35% [3] - New health services include a 10% discount on online and offline drug purchases and exclusive services for loyal users, such as free health services and equipment [3][4] - The insurance has processed 419,000 claims over the past four years, with a maximum single claim amount of 761,100 yuan and a fast claim process where 89% of claims are settled quickly, often within 1-2 working days [4]
北京普惠健康保起付线降至15000元
Core Points - The 2026 Beijing Inclusive Health Insurance will open for enrollment, with a reduced deductible for healthy individuals set at 15,000 yuan, down from 30,404 yuan, and an increase in the reimbursement rate for special drugs by 5 percentage points [1] - The coverage for special drugs has expanded to 87 diseases and 159 products, including 57 domestic and 65 overseas special drugs, along with 37 innovative drugs [1] - The annual premium remains unchanged at 195 yuan per person, with a total coverage amount upgraded to 3.5 million yuan [1] Summary by Sections Deductible and Reimbursement Changes - The deductible for healthy individuals is reduced to 15,000 yuan, with 25% reimbursement for personal expenses between 15,000 yuan and 30,404 yuan after basic medical insurance [1] - For expenses exceeding 30,404 yuan, healthy individuals will receive 80% reimbursement, while those with specific pre-existing conditions will receive 40% [1] Special Drug Coverage - The reimbursement rate for special drugs has increased from 60% to 65% for healthy individuals and from 30% to 35% for those with specific pre-existing conditions [1] - The list of covered diseases has expanded to 87, and the drug list now includes 159 products, enhancing accessibility and affordability for patients [1] Additional Benefits and Enrollment - New online and offline 10% discount on medications is introduced, covering common drugs, chronic disease medications, and original research drugs [1] - Continuous enrollment benefits include lower deductibles for those with no claims in the past three years, and a range of health management services [1] - Enrollment is open to all individuals with basic medical insurance in Beijing, including new residents and specific government-managed groups [1] - The insurance is jointly guided by the Beijing Medical Security Bureau and the Beijing Financial Committee, with multiple insurance companies involved in underwriting [1]
三载守护,重磅升级!2025年“百惠保”火热参保中
Cai Fu Zai Xian· 2025-07-16 09:31
Core Viewpoint - The "Baihui Bao" program has been upgraded and relaunched to provide supplementary medical insurance for residents of Baise City, aiming to reduce the financial burden of major medical expenses and enhance the multi-tiered medical security system in the region [1]. Group 1: Program Overview - "Baihui Bao" is a collaborative initiative involving the Baise Municipal Finance Bureau, Baise Medical Security Bureau, and ten insurance companies, including China Life and PICC, with operational support from Chenxi Health [1]. - Since its launch in 2022, "Baihui Bao" has seen 655,900 participants and total claims exceeding 36.6 million yuan, with the highest individual claim reaching over 450,000 yuan [1]. Group 2: Key Features of the 2025 Upgrade - The program maintains a low premium of 76 yuan for the basic plan while introducing a new upgraded version at 138 yuan, enhancing coverage options [2]. - The program allows the use of personal medical insurance account balances to pay premiums for family members, eliminating the need for additional cash outlay [2]. - The upgraded plan features a combined annual deductible for both in-network and out-of-network services, lowering the threshold for claims [2]. - It offers coverage regardless of age, pre-existing conditions, residency status, or occupation, making it accessible to a broader demographic, including new residents [2]. - Additional health services include dental care, traditional Chinese medicine therapy, discounts on medications, and medication reminders, enhancing the practical value of the insurance [2]. - Participants can opt for an additional 3 yuan fee for inpatient care services, allowing for up to 7 days of nursing care in designated public hospitals [2]. Group 3: Enrollment Information - The enrollment period for the 2025 "Baihui Bao" is from July 15 to August 31, 2025, with coverage starting from August 20, 2025, for new participants [3]. - Renewal coverage dates are specified, and residents are encouraged to enroll promptly through the official channels [3].