11月3日，2026年度"北京普惠健康保"上线发布会在北京举行。 作为北京市唯一一款由政府指导监督的 普惠型商业补充医疗保险，"北京普惠健康保"坚守"普惠公益为核心、便民利民为根本"的初心，凭借低 门槛、高保障、广覆盖、理赔快、服务优的特点，四年累计参保超1500万人次。 针对近三年连续参保且无出险记录的被保险人，和去年一样，不仅医保目录外自费责任免赔额下调，健 康人群免赔额由1.5万元降至0.5万元，特定既往症人群免赔额由2万元降至1.5万元；还可继续享受一年 一次的免费专属健康服务，包括家庭急救包、日常小药箱、健康体检筛查、牙科检查洁牙、中医按摩调 理和体重管理年精选设备。 朱衍生表示，作为监管部门，北京金融监管局始终高度重视商业健康保险服务民生保障的功能定位，支 持保险公司通过科学设计、规范运作，不断优化产品服务，提升理赔效率，拓展健康管理内涵，真正把 普惠保险好事办好、实事办实、难事办妥。（经济日报记者于泳） 北京金融监管局党委书记、局长朱衍生表示，"北京普惠健康保"作为基本医疗保险的有益补充，为有效 缓解人民群众高额医疗费用负担、防范因病返贫致贫、构建多层次医疗保障体系发挥了积极作用。自 2021年 ...

本报讯 （记者杨笑寒）11月3日，2026年度"北京普惠健康保"上线发布会在京举行，北京市医疗保障局、中共北京市委金 融委员会办公室、国家金融监督管理总局北京监管局等政府部门相关领导、六家共保体成员单位代表等共同见证了2026年 度"北京普惠健康保"的正式发布。 2026年度"北京普惠健康保"参保截止时间为2025年12月31日，保障期限为2026年1月1日至12月31日。 （编辑 张伟） 2026年度"北京普惠健康保"保费仍维持在195元/人/年，累计保额升至350万元，通过"一降（理赔门槛降低）、一扩（特药 保障范围进一步扩大）、一提（特药责任报销比例提高5个百分点）、二增（两方面健康服务持续调增）"全面优化产品保障内 容。近三年连续参保且无出险记录的被保险人，医保目录外自费责任免赔额下调，还可享受一年一次的免费专属健康服务。 参保条件上，2026年度"北京普惠健康保"延续"应保尽保"的理念，参保条件依旧不限年龄、不限户籍、不限职业、不限健 康状况，且特定既往症患者可保可赔。同时，连续参保人员健康状况以首次投保时为准，即首次投保时是健康人群，后续一直 持续投保未中断，即使在保险期间内罹患特定既往症，202 ...

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]

"一扩"体现在特药保障范围进一步扩大，病种覆盖扩展至87种，药品清单增至159种。其中，国内特药 57种，海外特药65种，并新增创新疗法、高值慢病用药、北京天竺先行区等创新药品37种，让老百姓在 家门口就能"买得到、用得上、用得起"全球创新药，提高药品可及性和可负担性，有效满足群众用药需 求，支持医药创新发展。 "一提"聚集在特药责任报销比例提高5个百分点，健康人群、既往症人群报销比例分别由60%、30%提 高至65%、35%，让更多参保人在使用特药时能多报销、少负担，减轻用药压力。 "二增"是健康服务持续调增，一方面新增线上线下9折购药折扣权益，日常购药更实惠，切实降低群众 用药成本；另一方面对三年连续参保且无理赔的"忠实用户"的专属服务，新增体重管理年精选设备，可 从体重秤和水杯二选一，让服务更贴心、更实用。 更加值得关注的是，针对近三年连续参保且无出险记录的被保险人，和去年一样，不仅医保目录外自费 责任免赔额下调，健康人群免赔额由1.5万元降至0.5万元，特定既往症人群免赔额由2万元降至1.5万 元；还可继续享受一年一次的免费专属健康服务，包括家庭急救包、日常小药箱、健康体检筛查、牙科 检查洁牙、中医按 ...

【#北京普惠健康保起付线降至15000元#】#北京普惠健康保特药报销比例提高#11月3日，2026年度"北 京普惠健康保"开放参保。健康人群自付费用起付线降至15000元，特药责任报销比例提高5个百分点。 特药保障病种覆盖扩展至87种，药品清单增至159种产品，并新增线上线下9折购药权益。"北京普惠健 康保"是本市唯一政府指导的普惠型商业补充医疗保险产品，紧密衔接基本医疗保险，具有低门槛、高 保障、广覆盖的特点。参保截止时间为2025年12月31日，保障期限为2026年1月1日至12月31日，保费不 变，仍为每人每年195元，累计保额升级至350万元。【健康人群自付费用起付线降至15000元】2026年 度"北京普惠健康保"健康人群自付费用起付线由30404元降至15000元，经基本医保报销后，个人自付费 用在15000元至30404元之间的部分报销25%，进一步降低理赔门槛。经大病保险报销后，个人自付费用 在30404元以上部分，健康人群报销80%，特定既往症人群报销40%。【特药报销比例提高 保障范围扩 大】同时，特药责任报销比例提高5个百分点，健康人群、特定既往症人群报销比例分别由60%、30% 提高至 ...

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].