项目组还提到，特药费用保障今年实现升级，健康人群赔付比例提升至65%，既往症人群赔付比例提升至35%，保险金额 提升至150万元，药品清单增至159种，病种覆盖扩展至87种，为患有重大疾病的参保人提供有力的用药保障支持。自2021年推 出以来，"北京普惠健康保"始终坚守普惠和便民利民的原则，赢得了市民的广泛关注。截至2025年12月份，"北京普惠健康 保"累计受理理赔案件超48万件，最高单笔赔付金额超过76万元，受益人群中年龄最大的104岁，最小的不足1个月。 （编辑 张伟） 本报讯 （记者苏向杲）1月31日，记者从"北京普惠健康保"项目组获悉，作为北京市唯一由政府指导监督的普惠型商业补 充医疗保险产品，2026年度"北京普惠健康保"参保通道将于今晚24时正式关闭。 项目组表示，2026年度"北京普惠健康保"聚焦参保人核心医疗需求。在医保内自付费用保障方面，健康人群免赔额降至 15000元，特定既往症人群免赔额为当年北京市基本医疗大病保险起付标准金额（30404元）；健康人群在15000元—30404元费 用区间新增25%的报销比例，30404元以上费用仍保持80%的报销比例，特定既往症人群报销比例为40%， ...

Core Viewpoint - The 2026 Beijing Inclusive Health Insurance has surpassed 4.45 million participants, with the enrollment deadline approaching on January 31, 2026, leaving only 4 days for new sign-ups [1][4]. Group 1: Exclusive Services - The 2026 plan offers a selection of six exclusive services for eligible participants, which include dental check-ups, traditional Chinese medicine massage, health screening, a daily medicine kit, a family first aid kit, and weight management devices [1][4]. - Eligible participants can choose one service for free once a year, provided they hold a valid policy and have not reached the payout threshold by December 31, 2025 [2][5]. Group 2: General Health Services - In addition to exclusive services, the plan provides general health services such as medical accompaniment and home nursing, along with new medication benefits that include discounts on purchases [2][5]. - Participants can enjoy a 10% discount on medications, with an annual subsidy of 1,800 yuan, allowing for a maximum of 400 yuan per single purchase and a total of 12 uses throughout the year [5][6]. Group 3: Enrollment Process - Individuals eligible for enrollment include those with valid basic medical insurance, specific groups managed by the Beijing Medical Security Bureau, and new residents with Beijing residency or permits [3][6]. - Enrollment can be completed through the official WeChat account, Alipay, and various banks' physical branches, with the coverage period set from January 1 to December 31, 2026 [3][6].

Core Points - The "Beijing Inclusive Health Insurance" program for 2026 has officially commenced on January 1, 2026, with the enrollment period extended to January 31, 2026, to accommodate public demand [1] - The program aims to provide affordable supplementary medical insurance, closely integrated with basic medical insurance, to meet the core health protection needs of citizens [1] - The project team has received numerous inquiries from citizens and businesses regarding enrollment, indicating strong recognition and trust in the program [1] Enrollment and Claims Process - The program has established a convenient method for insured individuals to check their insurance status, apply for claims, and access health services through the "Beijing Inclusive Health Insurance" WeChat official account [2] - For claims, a dual-channel process is available for medical liability claims, with notifications sent to eligible insured individuals, simplifying the claims process significantly [2] - Non-local insured individuals can also apply for claims online, and there are options for direct payment and reimbursement for special medications [2] Health Services Offered - The 2026 program provides two main categories of health services: medication discount benefits and general services, aimed at reducing the financial burden of medication and medical care [3] - Insured individuals can enjoy a 10% discount on medications, with an annual subsidy of 1,800 yuan and a maximum single subsidy of 400 yuan, usable up to 12 times a year [3] - Additional services include free access to professional care such as home nursing and rehabilitation, with five free uses available per year [3] - Continuous insured individuals with no claims history can access exclusive services like health screenings and dental check-ups starting mid-January [3] Important Dates - The enrollment deadline for the 2026 "Beijing Inclusive Health Insurance" is January 31, 2026, with coverage lasting from January 1 to December 31, 2026 [4]

Core Viewpoint - The "Jiangsu Medical Insurance 1" policy is a supplementary health insurance scheme in Jiangsu Province, which is set to close its enrollment for the 2026 year on December 31, 2025, at midnight, and has already attracted over 5.3 million participants [1][6]. Group 1: Policy Features - The policy offers low premiums, low entry barriers, and high coverage, with the basic plan costing only 158 yuan per year and the upgraded plan costing 258 yuan per year, providing up to 1 million yuan in medical expense coverage [3]. - It covers a wide range of medical expenses, including out-of-pocket costs within the medical insurance directory and certain non-covered drugs and medical supplies, effectively alleviating the financial burden of serious illnesses [3]. - The upgraded version includes coverage for advanced medical technologies such as proton therapy and CAR-T drugs, and it does not exclude patients with pre-existing conditions, ensuring comprehensive protection [3]. Group 2: Impact and Performance - Since its launch, "Jiangsu Medical Insurance 1" has attracted over 20 million participants and has paid out more than 3 billion yuan in claims, with an average payout of 10,000 yuan per person [6]. - The policy has significantly improved the sense of security and happiness among the public, with the highest single claim reaching 981,400 yuan and the highest individual payout totaling 1,455,400 yuan [6]. - The policy is designed to complement the basic medical insurance, addressing the gaps in coverage and further reducing the financial burden of medical expenses for residents [6]. Group 3: Enrollment and Claims Process - The enrollment for the 2026 policy year will close at midnight on December 31, 2025, with coverage starting from January 1, 2026, for a duration of one year [9]. - Participants can use their medical insurance individual account balance to pay for the policy premiums, allowing for family coverage under a single policyholder [7]. - Claims can be made at designated medical institutions across the country, and the policy allows for cumulative deductible amounts over the year, rather than requiring each claim to exceed the deductible [7].

Core Viewpoint - "Jiangsu Medical Insurance 1" is a supplementary medical insurance program in Jiangsu that connects closely with basic medical insurance, allowing residents to secure health coverage without restrictions on pre-existing conditions. The enrollment period ends on December 31, and over 5 million people have already signed up [1]. Group 1: Enrollment and Coverage - The insurance has a low enrollment threshold, covering all ages and demographics in Jiangsu, as long as residents have basic medical insurance [2]. - The program offers two premium options: the basic plan at 158 yuan per year with a total coverage of 3.2 million yuan, and the upgraded plan at 258 yuan per year with a total coverage of 4 million yuan [3]. Group 2: Benefits and Claims - "Jiangsu Medical Insurance 1" connects with the "dual-channel" policy, allowing insured patients to purchase "dual-channel" drugs at designated retail pharmacies, with additional compensation provided after basic medical insurance reimbursement [4]. - The program covers self-paid drugs used in hospitals that are outside the basic medical insurance directory, as long as they meet the usage guidelines [5]. - Insured individuals can use their medical insurance account balance to cover premiums for themselves and their family members without additional cash outlay, enhancing family coverage [6]. Group 3: Enrollment FAQs - The program is open to all residents in Jiangsu with basic medical insurance, regardless of age, medical history, residency, or occupation. Family members can also purchase coverage for each other [7]. - Individuals with previous health issues can still enroll without needing a medical examination or health disclosure [8]. - Those who enrolled in the previous year's program must re-enroll for the 2026 coverage to ensure continuous protection, as the previous coverage will expire on December 31, 2025 [9].

Core Viewpoint - The 2026 Beijing Inclusive Health Insurance has surpassed 3.3 million participants, with the enrollment window closing on December 31, 2025, emphasizing the urgency for citizens to secure this comprehensive medical coverage [1][4][5]. Group 1: Medical Coverage - The insurance covers both out-of-pocket expenses within the basic medical insurance and self-paid hospital expenses outside of the insurance, providing relief from economic pressure on families [1][4]. - The insurance includes a reimbursement mechanism where expenses are paid after deducting the corresponding deductible, ensuring that patients can receive compensation for both hospitalization and self-paid medical treatments [1][4]. Group 2: Specialty Drug Coverage - The list of covered specialty drugs has expanded to 159, addressing various high-incidence cancers and rare diseases, including innovative treatments like CAR-T therapy [1][4]. - Specialty drug coverage has no deductible, with a compensation ratio of 65% for healthy individuals and 35% for those with pre-existing conditions, raising the cumulative coverage limit to 1.5 million yuan [1][4]. Group 3: Enrollment Information - The enrollment is open to a wide range of participants, including those covered by Beijing's basic medical insurance, specific groups managed by the Beijing Medical Security Bureau, and new residents with Beijing residency or permits [3][5]. - Enrollment can be completed through various official platforms, including the "Beijing Inclusive Health Insurance" WeChat account, Alipay, and designated insurance companies and banks [3][6].

Core Points - The "Beijing Inclusive Health Insurance" has opened enrollment for the 2026 plan, with a premium of 195 yuan per person per year, and the self-payment threshold for healthy individuals reduced to 15,000 yuan [1][3] - The coverage for diseases has expanded to 87 types, and the list of reimbursable drugs has increased to 159, including 57 domestic special drugs and 65 overseas special drugs [2][3] - The total coverage amount has been raised to 3.5 million yuan, and the reimbursement ratio for special drugs has increased by 5 percentage points [1][2] Summary by Category Insurance Features - The insurance period for the 2026 plan is from January 1 to December 31, 2026, with a total coverage amount of 350 million yuan [1] - The self-payment threshold for healthy individuals has been lowered from 30,404 yuan to 15,000 yuan, with reimbursement of 25% for expenses between 15,000 yuan and 30,404 yuan after basic medical insurance [1][3] Drug Coverage - The list of reimbursable drugs now includes 159 items, with the addition of 37 innovative drugs, including high-value chronic disease medications [2] - The reimbursement ratio for healthy individuals has increased from 60% to 65%, while for individuals with pre-existing conditions, it has risen from 30% to 35% [2] Health Services - New online and offline 10% discount on drug purchases has been introduced, allowing for an annual subsidy of 1,800 yuan [2] - For insured individuals with no claims in the past three years, the deductible for out-of-pocket expenses has been reduced significantly [2][3] Enrollment Conditions - The enrollment conditions remain flexible, with no restrictions on age, residency, occupation, or health status, covering various groups including those with specific pre-existing conditions [3] - The program has seen over 15 million enrollments and processed 419,000 claims since its launch, with the fastest payouts occurring within 1-2 working days [3]

Core Insights - The "Beijing Inclusive Health Insurance" for 2026 was launched, emphasizing its role as a government-guided supplementary medical insurance aimed at alleviating high medical costs and preventing poverty due to illness [1][2] - The insurance has seen over 15 million participants since its inception in 2021, maintaining a low premium of 195 yuan per person per year while increasing the total coverage to 3.5 million yuan [1][2] Summary by Sections Product Features - The insurance maintains a low premium of 195 yuan per person per year and has upgraded the cumulative coverage to 3.5 million yuan [1] - The product features include low thresholds for participation, high coverage, and quick claims processing, with a focus on inclusivity and broad coverage [1] Service Enhancements - The deductible for healthy individuals has been reduced from 30,400 yuan to 15,000 yuan [2] - The coverage for innovative drugs outside the medical insurance directory has been expanded to 159 types [2] - Reimbursement rates for special drugs have increased by 5 percentage points for both healthy individuals and those with pre-existing conditions, reaching 65% and 35% respectively [2] - New benefits include a 10% discount on medication purchases for both insured and uninsured individuals, and an extended sales period allowing for year-round enrollment [2] Additional Benefits - For individuals with three consecutive years of enrollment and no claims, the deductible for healthy individuals is further reduced to 5,000 yuan, and for specific pre-existing conditions, it is lowered to 15,000 yuan [2] - Participants can access free annual health services, including emergency kits, health check-ups, and weight management equipment [2] - The regulatory body emphasizes the importance of commercial health insurance in enhancing public welfare and encourages continuous product optimization and efficient claims processing [2]

Core Points - The 2026 "Beijing Inclusive Health Insurance" was officially launched, supported by various government departments and representatives from six member units of the mutual insurance body [1] - This insurance product aims to provide affordable and accessible supplementary medical insurance for residents of Beijing, with over 15 million participants in the past four years [1] - The annual premium remains at 195 yuan per person, with total coverage increased to 3.5 million yuan, featuring optimized benefits such as lower claim thresholds and expanded coverage for specific medications [1][2] Summary by Sections - **Insurance Features** - The insurance maintains a low premium of 195 yuan per person per year and increases the cumulative coverage to 3.5 million yuan [1] - Key enhancements include reduced claim thresholds, expanded coverage for specific medications, and a 5% increase in reimbursement rates for special medications [1] - Continuous participants with no claims for three years will benefit from reduced deductibles for out-of-pocket expenses and one free health service annually [1] - **Enrollment Conditions** - The 2026 plan continues the "inclusive coverage" philosophy, with no restrictions on age, residency, occupation, or health status, allowing coverage for specific pre-existing conditions [2] - Participants who initially enrolled as healthy individuals can continue to receive benefits even if they develop specific pre-existing conditions during the coverage period [2] - **Claims Process** - The insurance offers a proactive and expedited claims process, with 89% of claims processed quickly since the fast claims feature was introduced [2] - Eligible claimants receive SMS notifications for claims, and the process requires minimal documentation, allowing for payments to be received within 1-2 working days [2] - **Enrollment Deadline** - The enrollment deadline for the 2026 plan is December 31, 2025, with coverage effective from January 1 to December 31, 2026 [2]

Core Points - The 2026 "Beijing Universal Health Insurance" was officially launched, marking a significant development in the city's healthcare offerings [1][4] - This insurance is the only government-guided supplementary medical insurance in Beijing, emphasizing accessibility and public welfare [5] Product Features - The annual premium remains at 195 yuan per person, with total coverage upgraded to 3.5 million yuan [6] - The threshold for claims has been lowered, with the self-payment responsibility for healthy individuals reduced from 30,404 yuan to 15,000 yuan, and an additional 25% reimbursement for expenses between these amounts [6] - The range of covered special medications has expanded to 87 diseases and 159 drugs, including both domestic and international options [6] - Reimbursement rates for special medications have increased by 5 percentage points for both healthy individuals and those with pre-existing conditions [6][7] Accessibility and Coverage - The insurance is available to all Beijing residents regardless of age, occupation, or health status, promoting inclusivity [8] - Individuals can use their personal medical insurance accounts to pay for premiums, facilitating family coverage [8] Claims and Support - The program has processed 419,000 claims over four years, with a maximum single claim amount reaching 761,100 yuan [9] - The quick claims process allows eligible individuals to receive payments within 1-2 working days, significantly reducing the financial burden during medical emergencies [9] - The insurance aims to provide comprehensive support for all age groups, ensuring that everyone can access necessary medical care [9][10]