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2025年度“北京普惠健康保”特药清单升级至121种
Zheng Quan Ri Bao· 2025-06-10 05:43
Group 1 - The "Beijing Universal Health Insurance" project will upgrade its special drug list from 106 to 121 drugs in 2025, allowing for reimbursement of more special drugs [1] - The new special drug list will be effective from June 10, 2025, and retroactive compensation will be available for eligible claims from January 1 to June 9, 2025 [1] - The updated list retains drugs already included in the medical insurance directory, such as six drugs including Vitekai, and five drugs with certain indications that have been added to the medical insurance directory [1] Group 2 - The new special drug list will add 15 new drugs, focusing on high-incidence cancer medications and covering the entire treatment cycle and target drug types [2] - The list will expand the indications for ten drugs, including Cuirida, based on the new medication guidelines, allowing for a broader range of reimbursable indications [2] - The list will replace drugs that have no claims, such as Hejie Kang, with newly listed non-medical insurance drugs like Yihe Lai, enabling more patients to access effective medications [2]
全新升级,更懂你心——2025版“沪惠保”已在“随申办市民云”APP重磅上线
Sou Hu Wang· 2025-04-23 02:02
Core Points - The "Huibao" 2025 version has been launched on the official insurance platform "Suishenban Citizen Cloud" APP, maintaining the price at 129 yuan per person per year while upgrading the coverage to 3.1 million yuan for medical expenses [1][5] - The family coverage scope has been expanded to include not only immediate family members but also siblings, grandparents, grandchildren, and other close relatives [3][7] - The insurance is available for all individuals who are already enrolled in Shanghai's basic medical insurance, with no restrictions on age, occupation, residency, or health status [7][9] Coverage Details - The insurance provides specific coverage for self-paid medical expenses during hospitalization, including self-paid drug costs, examination fees, surgical materials, and treatment fees [9] - The 2025 version includes enhancements such as an increase in the number of covered high-cost domestic drugs to 48 and updates to the overseas special drug coverage [9][10] - The insurance also covers proton and heavy ion therapy with a direct compensation of 300,000 yuan and CAR-T therapy with a coverage of 500,000 yuan [6][9] Enrollment Process - Enrollment can be completed through the "Suishenban Citizen Cloud" APP, allowing users to select insured individuals from a wide range of family members [12][14] - Payment can be made using the individual's medical insurance account, eliminating the need for additional out-of-pocket expenses [7][14] Claims Process - A detailed claims guide is available on the "Suishenban Citizen Cloud" APP, outlining the steps for submitting claims [21][22] - Users can apply for claims related to various responsibilities, including hospitalization and specific high-cost drug expenses [23] Case Studies - Several case studies illustrate the effectiveness of the "Huibao" insurance, showing significant reimbursements for individuals with pre-existing conditions and those who have been continuously insured [24][25][27]