Core Insights - The development of urban customized commercial health insurance (惠民保) in China has transitioned from an expansion phase to a stable iteration phase, with only 9 new products launched in the first seven months of this year, indicating a shift towards more sustainable growth [1][2] Group 1: Market Development - As of July 2023, a total of 313惠民保 products have been launched, with only 9 new products introduced in the first seven months of the year, marking a significant slowdown in growth [1][2] - The number of discontinued惠民保 products has also decreased, with over 70 products discontinued in 2023, but only 12 in the first seven months, suggesting a move towards a stable development phase [2] - Experts believe that the market is transitioning from a rapid expansion phase to a rational development phase, which is seen as a healthy adjustment process [2] Group 2: Pricing and Coverage - Currently, 141惠民保 products adopt a "single pricing" model, with an average price of 95 yuan, a significant increase from approximately 60 yuan in 2021 [3] - The average惠民保 product covers 41 types of special drugs and 28 types of conditions, with over 80% of traditional惠民保 products including special drug coverage, primarily focusing on malignant tumors and rare diseases [3] Group 3: Challenges and Future Directions - The惠民保 system faces challenges such as adverse selection risk, where high-risk individuals are more likely to enroll due to low entry barriers, while healthier individuals are less inclined to participate [4] - Experts suggest that a differentiated pricing strategy could enhance risk matching while maintaining inclusivity, with some cities already exploring this approach [4] - The National Financial Regulatory Administration has emphasized the need for differentiated pricing based on factors like age and health status to improve fairness and adaptability of products [5] - Some惠民保 products are experiencing declining enrollment rates and mismatched operational revenues, primarily due to gaps between product offerings and consumer expectations, particularly among younger demographics [5]

惠民保增速放缓，迈入"存量优化"阶段。 10月18日召开的第五届复旦大学普惠保险与创新论坛上，许闲教授团队发布《2025年城市定制型商业医疗保险（惠民保）知 识图谱》（下称报告）显示，2025年新增惠民保产品9款，市场增速为2.96%，较2024年同期进一步放缓。截至7月31日，全国 累计推出313款地方性惠民保产品。 惠民保，即城市定制型商业医疗保险，是商业保险参与多层次医疗保险体系的服务创新，最早于2015年在深圳推出，近年来 成为了席卷全国的现象级保险产品。 2023年以来，惠民保增长态势明显放缓。报告显示，2017年—2025年，惠民保数量分别为1款、2款、5款、102款、185款、 257款、290款、304款和313款。 其中，2025年以来新增惠民保产品仅9款，市场增速为2.96%，较2024年同期进一步放缓。 复旦大学经济学院副院长、风险管理与保险学系主任许闲表示， 当市场覆盖达到一定程度后，重点就会从高速增长转向高质 量发展。 报告显示，2025年正常运营的惠民保产品为202款，较2023年的211款减少9款，但较2024年的199款增加3款。 与此同时，新上线产品呈现"双轮驱动"特点。一方 ...

所幸，小星星参保了珠海居民医保和"大爱无疆"项目。在得知小星星的情况后，珠海市医保局 和"大爱无疆"项目工作人员迅速介入，在珠海市多层次医疗保障体系的有力支持下，小星星顺利完成了 手术。 截至2025年5月底，中国人寿广东省分公司已累计承办珠海"大爱无疆"、广州"穗岁康"、佛山"健康· 佛医保"、汕头"惠民保"、中山"博爱康"、江门"邑康保"等17个城市定制型商业医疗保险项目，承保项 目累计参保人次超5000万，为200余万人次提供了高效便捷的理赔服务，累计赔付金额超20亿元。 "感谢珠海市多层次医疗保障体系，在关键时刻给予了极大的帮助，让我们这个家庭未被拖垮。"在 珠海市中山大学附属第五医院，小星星的父亲对《金融时报》记者介绍说，2024年，女儿进行了肝脏和 肾脏移植手术，医疗费用高达79.8万元，珠海居民医保、大病保险和"大爱无疆"项目三重保障共报销了 66.9万元，家庭仅花了12.9万元。此外，因为符合 "大爱无疆"项目定额现金补偿赔付条件，小星星还得 到了4万元现金补偿。 为解决基本医疗保险难以覆盖人民群众更多类别、更多层次的医疗需求，特别是在重大疾病治疗方 面个人负担过重的问题，中国人寿珠海分公司与 ...