保险产品优化
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2026年度“北京普惠健康保”上线,CAR-T疗法等首次纳入保障范围
Jing Ji Guan Cha Wang· 2025-11-03 10:36
Core Points - The 2026 edition of "Beijing Universal Health Insurance" is officially launched, maintaining a premium of 195 yuan per person per year and increasing the cumulative coverage to 3.5 million yuan [1] - The insurance is available to a wide range of individuals, including those covered by basic medical insurance in Beijing, specific government-managed groups, and new residents with Beijing residency or residence permits [1] - The program has seen over 15 million participants since its inception in 2021, with a total of 419,000 claims processed [3] Summary by Categories Premium and Coverage - The premium remains at 195 yuan per person per year, with the cumulative coverage upgraded to 3.5 million yuan [1] - Participants can use their individual medical insurance account balances to pay for premiums, allowing for family coverage under one account [1] Benefit Enhancements - The claim threshold has been lowered, with the self-payment responsibility for healthy individuals reduced from 30,404 yuan to 15,000 yuan, and a new reimbursement of 25% for expenses between 15,000 yuan and 30,404 yuan [2] - The range of special drug coverage has expanded to 87 diseases and 159 drugs, including 57 domestic and 65 overseas special drugs, along with 37 new innovative drugs [2] - 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% [2] Additional Services - New health services include a 10% discount on online and offline drug purchases and exclusive services for loyal users who have been insured for three consecutive years without claims [2] - Loyal users can enjoy a range of free health services, including family first aid kits, health check-ups, and weight management equipment [2]