在8月31日人身险产品利率切换时点即将来临之际，多位保险业内人士表示，重疾险价格也将迎来一轮 上涨。重疾险价格越来越贵，带来的是保险杠杆率下降，近年来这一现象持续显现，让消费者意兴阑 珊。同时，不少重疾险产品投保门槛颇高，比如一些年轻人因患有甲状腺结节等病症被拒之门外。在险 企一侧，重疾险赔付率走高、业务风险增大，叠加险企对储蓄险的押注，重疾险供给空间也受到挤压。 曾经在健康险领域扛大旗的重疾险，近几年经历了持续萎缩，让健康险整体增长乏力。同时，健康险内 部结构也在发生变化，杠杆率更高的医疗险逐步替代了重疾险的主流地位。 在健康险经历重构期以及政策鼓励健康险发展的背景下，业内人士认为，健康险需走出传统的纯保险保 障模式，同时加快从"保健康人"向"保人健康"转变，一张保单要涵盖专属保障、医疗服务、特色权益等 多个方面，发挥健康管理、支付创新、生态整合等价值，让市场供需更加适配、行业经营能力持续提 升。 ● 本报记者 薛瑾 杠杆率变化加剧内部分化 "前两年我想购买重疾险，因患有甲状腺结节，经纪人告诉我买不了，险企会拒保。最近几天又问了其 他保险中介，给出的答复依然是'不太好买'。中介说，如果切除结节后半年内未复发 ...

Core Insights - The approval of over 20 innovative Class 1 drugs by the National Medical Products Administration in the first five months of this year marks a record high for the same period in the past five years [1] - The commercial health insurance sector is accelerating innovation to ensure that advanced medical services are accessible and affordable for consumers [1][2] - The market size for innovative drugs and medical devices in China is projected to reach 162 billion yuan in 2024, reflecting a 16% increase from 2023 [1] Group 1: Market Dynamics - The personal out-of-pocket expense for innovative drugs and devices remains high at 49%, while medical insurance fund expenditures account for approximately 44%, and commercial health insurance only covers about 7.7% [1] - The expansion of commercial insurance coverage for innovative drugs aligns with policy directives aimed at enhancing health insurance service levels [2] Group 2: Insurance Innovations - New insurance products, such as Xinhua Insurance's "Medical Worry-Free Insurance," are extending coverage to medications and medical devices purchased outside of hospitals, addressing patient needs for advanced medical resources [3] - Ant Group's insurance platform has upgraded its "Good Medical Insurance" series to include reimbursement for over 1,500 advanced drugs and devices, enhancing coverage for imported and original research drugs [3] Group 3: Payment Mechanisms - A multi-tiered payment mechanism has emerged, primarily driven by market-oriented commercial health insurance, which includes various types of insurance such as inclusive insurance, million medical insurance, and critical illness insurance [4] - The total compensation amount for innovative drugs and devices from commercial health insurance is estimated to be around 12.4 billion yuan in 2024, representing 7.7% of the innovative drug market size [4] Group 4: Challenges and Considerations - The introduction of new drugs and technologies presents challenges for insurance companies, as they may increase treatment costs and claims [5] - Insurance companies are focusing on balancing the coverage of advanced drugs while keeping premiums affordable to ensure product accessibility [5]

Core Insights - The million medical insurance sector has seen significant innovation and upgrades in 2023, with major players expanding coverage to include outpatient treatments and advanced medications [1][2][3] - The competition in the million medical insurance market is intensifying, with companies striving to enhance their offerings to meet evolving consumer demands [5][9] - Despite a slowdown in growth, the market for million medical insurance is expected to continue expanding, driven by increasing healthcare costs and the need for supplementary insurance [10][17] Company Developments - Ant Group's "Good Insurance" series has upgraded its core products to include coverage for specific diseases treated in advanced hospitals and expanded outpatient medication reimbursements [1] - China Life has launched its first 10-year guaranteed renewal product, "Guoshou Kangyue Zhenxiang," which covers outpatient expenses for specific major diseases [2] - ZhongAn Insurance has upgraded its health insurance series, "Zunxiang Esheng" and "Zhongminbao," to include long-term medication coverage and expanded hospitalization benefits [1][2] Market Trends - The million medical insurance market has evolved from high-end and mid-range medical insurance to more affordable options, with products like "Zunxiang Wuyou" and "Eshengbao" gaining popularity [4][9] - The market has seen a shift towards covering outpatient treatments and advanced therapies, with many products now offering zero deductible options [7][8] - The overall scale of the million medical insurance market has grown from negligible in 2016 to approximately 600 billion yuan by 2023, accounting for about 20% of the medical insurance market [9][13] Competitive Landscape - Major players like Renbao Health, ZhongAn, and Ping An Health dominate the market, with their products collectively accounting for a significant share of the total premium income [14][15] - The competitive environment has led to a focus on improving renewal conditions and expanding coverage, with many products now offering guaranteed renewal periods [5][6] - The introduction of lower-cost alternatives like "Hui Min Bao" has created additional pressure on million medical insurance products, although its impact appears to be diminishing [13][21] Future Outlook - The potential for growth in the million medical insurance sector remains strong, with expectations that it could reach a scale of 1.7 to 2.6 trillion yuan by 2029 [18] - The increasing pressure on basic medical insurance is likely to drive demand for commercial health insurance, positioning million medical insurance as a crucial supplement [17][23] - However, challenges such as low claims payout ratios and the need for better customer satisfaction must be addressed to ensure sustainable growth [22][23]

Core Viewpoint - The health insurance sector is undergoing a transformation driven by the DRG (Diagnosis-Related Group) reform, which is pushing companies to innovate and move away from homogenization and the "pan-life insurance" dilemma [2][3]. Group 1: Market Trends and Innovations - Multiple insurance companies are launching new health insurance products, focusing on expanding coverage, enhancing service offerings, and addressing diverse consumer needs [4][5]. - The health insurance market is experiencing a recovery in scale and product innovation after a period of stagnation, with health insurance premium income from life insurance companies growing by 4.85% year-on-year and by 7.6% from property insurance companies [4][6]. Group 2: Consumer Demand and Product Differentiation - The DRG reform is recognized as a key driver for product innovation, as consumers with certain payment capabilities are shifting towards seeking higher quality medical resources and are willing to pay extra for them [6][7]. - The market is witnessing a clear trend of product stratification, with different insurance products catering to various income levels, health statuses, and coverage needs [7][8]. Group 3: Challenges and Strategic Focus - Insurance companies are challenged to enhance their data application capabilities, integrate medical resources, and build a comprehensive health service ecosystem to remain competitive [9][10]. - Companies need to adapt their product designs to cover a broader range of medical scenarios, moving beyond just hospitalization to include outpatient care and the use of medical devices [9][10].

Core Viewpoint - The article emphasizes the importance of regular health check-ups and insurance to manage health risks, particularly in the context of rising healthcare costs and the increasing prevalence of serious illnesses among younger populations [7][12][34]. Group 1: Health Risks and Costs - Serious illnesses can incur treatment costs in the millions, making insurance essential for financial protection [9][18]. - The article highlights that many health issues are becoming more common among younger individuals, contrasting with previous generations who maintained healthier lifestyles [12][13]. - The evolution of human health has reached a point where many diseases only manifest under extreme conditions, exacerbated by modern lifestyle choices [14]. Group 2: Medical Advancements - Advances in medical treatments, such as CAR-T therapy and proton therapy, have improved outcomes for serious conditions like cancer, but these treatments are often prohibitively expensive [15][24]. - The introduction of innovative therapies has made it possible to target diseases more effectively, yet the high costs remain a significant barrier for many patients [16][24]. Group 3: Insurance Solutions - The article discusses the benefits of commercial health insurance, particularly the "Good Insurance" product, which offers comprehensive coverage for serious illnesses at a low monthly premium [18][21]. - The upgraded insurance plans provide access to high-quality medical facilities and advanced treatments, reducing the financial burden on patients [23][28]. - The combination of effective insurance and advanced medical treatments allows patients to manage their health risks more effectively, ensuring they have access to necessary care without excessive costs [25][27].

Core Viewpoint - The increasing awareness of health security among residents is driving the demand for innovative medical insurance and high-end medical services, leading to upgrades in products like the "Million Medical Insurance" to include coverage for advanced hospitals and specific diseases [2][6]. Group 1: Health Insurance Market Trends - The integration of commercial insurance with basic medical insurance is creating new opportunities in the health insurance sector, as the basic medical insurance system in China has achieved extensive coverage with a participation rate of 95% in 2024 [3][4]. - The 2024 medical insurance development report indicates that the national medical insurance drug list has added 91 new drugs, with a total of 3,159 drugs, and significant increases in outpatient and inpatient service utilization [4]. Group 2: Commercial Insurance Growth - The commercial insurance sector is expected to grow significantly, as it can better meet the personalized needs of policyholders, especially with the rising focus on health among the population [5]. - Since its introduction in 2015, the "Million Medical Insurance" has gained popularity due to its low premiums and high coverage, becoming a crucial part of China's health insurance system, with medical insurance now accounting for approximately 44% of the health insurance market in 2024 [5]. Group 3: Product Upgrades and Innovations - The "Ant Insurance" platform has announced an upgrade to its "Good Medical Insurance" series, expanding coverage to include 470 top-tier hospitals and advanced medical treatments, thereby enhancing accessibility to high-quality medical services [6]. - The upgrade also includes reimbursement for over 1,500 advanced medical devices and drugs, promoting the accessibility of high-end medical services [6].

Regulatory Dynamics - The Financial Regulatory Bureau has issued guidelines to prevent excessive competition in dividend levels for insurance products, requiring justification for proposed dividend levels under certain conditions [7][8]. - The Financial Regulatory Bureau, in collaboration with the Shanghai Municipal Government, has released an action plan to support the construction of Shanghai as an international financial center [9]. - The Financial Regulatory Bureau has recognized China Reinsurance (Group) Corporation as an internationally active insurance group, aiming to enhance its risk management and international competitiveness [10]. - The Central Financial Committee has emphasized the need to innovate in shipping insurance and reinsurance businesses to align with the development of Shanghai as an international financial center [11]. - The Ministry of Human Resources and Social Security reported that the national enterprise annuity fund has surpassed 3.7 trillion, with a cumulative return rate of 7.46% over the past three years [12]. Company Dynamics - Ping An Life has increased its stake in Postal Savings Bank by acquiring 22.797 million shares, raising its holding to 12.07% [25]. - China Ping An has also increased its stake in Agricultural Bank of China by 2.58 billion HKD, bringing its holding to 13.12% [27]. - China Ping An announced a cash dividend of 1.62 CNY per share to be distributed on June 30 [32]. - Zhong Postal Insurance has been approved to increase its registered capital to 32.643 billion [29]. - China Life Insurance has launched its first guaranteed renewable 10-year medical insurance product [68]. Industry Dynamics - The Hong Kong insurance market is experiencing a surge in demand as customers rush to secure high-yield policies before new regulations take effect [56]. - New insurance products with a 1.5% guaranteed interest rate have been introduced, marking a shift in the market as companies adjust to lower interest rates [57]. - The proportion of newly launched dividend insurance products has increased to 37%, up 9 percentage points year-on-year [58]. - The IPE has released a list of the top 500 asset management companies for 2025, with 13 Chinese insurance institutions making the list [59]. - Over 90% of insurance asset management products have reported positive returns, with the highest returns exceeding 26% in the past six months [62].

Core Viewpoint - The article highlights the significant gap in accessibility to advanced medical treatments, particularly for cancer patients, despite improvements in basic medical insurance coverage and the introduction of commercial health insurance as a supplementary option [1][6]. Group 1: Accessibility of Advanced Medical Treatments - Advanced treatments like proton and heavy ion therapy are financially burdensome, with costs reaching approximately 380,000 yuan for patients, which is often unaffordable without insurance [1][5]. - The limited number of hospitals offering such advanced treatments (only about 10 nationwide) exacerbates the accessibility issue [5][6]. - Commercial health insurance is becoming a crucial safety net for families facing high medical costs, with products like "Good Medical Insurance" covering advanced treatments [6][7]. Group 2: Commercial Health Insurance Developments - The recent upgrade of the "Good Medical Insurance" series includes coverage for advanced hospitals and a wide range of innovative drugs, aiming to enhance accessibility to high-quality medical services [3][8]. - The upgraded insurance products cover over 1,500 advanced medical devices and drugs, with a zero deductible policy, allowing for full reimbursement of eligible expenses [9][11]. - The insurance aims to provide a three-tiered protection system: comprehensive basic medication, advanced medical devices for all diseases, and reduced financial burden for serious illnesses [7][9]. Group 3: Market and Policy Implications - The article emphasizes the need for policy guidance and market exploration to ensure that commercial health insurance effectively complements basic medical insurance and addresses the high costs of new drugs and treatments [2][6]. - The anticipated growth in the market for innovative drugs, projected to reach 162 billion yuan in sales by 2024, indicates a significant opportunity for commercial health insurance to expand its role [7][12]. - The upgrade of "Good Medical Insurance" reflects a broader trend towards making high-end medical services more accessible to the general public, aligning with national health improvement goals [11][12].

Group 1 - Ant Group's Ant Insurance announced an upgrade to its "Good Insurance" series, expanding coverage to 470 top-tier hospitals' international and special departments, as well as some private hospitals, providing comprehensive medical protection for patients with specific diseases like cancer [1] - The upgrade addresses three pain points in the current medical insurance system: insufficient coverage of high-end medical services by basic insurance, exclusion of some innovative drugs and treatment technologies from the insurance directory, and the long-term protection needs of major disease patients [1] - The new product includes reimbursement for over 1,500 types of drugs and medical devices, enhancing the coverage strength, and offers lifetime renewal service for cancer and 11 high-incidence cardiovascular diseases, addressing previous issues with commercial insurance renewal [1] Group 2 - The rapid development of internet insurance is making commercial health insurance an important supplement to China's medical insurance system, with significant growth potential remaining [2] - Experts suggest that commercial health insurance should optimize product structure through data-driven approaches and enhance health management services to better complement basic medical insurance [2] - Consumers are advised to focus on coverage range, renewal conditions, and claims services when selecting commercial health insurance products, and to understand the comprehensive payout rate based on their health status and medical needs [2]

从退货运费险，到服务 6 亿用户。 10 月 10 日，互联网保险优选平台蚂蚁保宣布，知名演员刘亦菲成为蚂蚁保首位全球品牌代言人。这是蚂 蚁保成立 8 年来首次启用品牌代言人，也是其少见的高调行动。 和电商、本地生活、短视频等行业相比，互联网保险行业一直相对低调。2010 年，支付宝联合淘宝推出退 货运费险，这一互联网创新险种的试水，如今已是中国数十万亿电商市场的标配，也是蚂蚁保平台的源 起。 2016 年，蚂蚁又在原先支付宝保险的基础上，成立了互联网保险优选平台蚂蚁保，陆续上线好医保、宠物 险、电诈险、惠民保等爆款产品。八年后，蚂蚁保已成长为一个一站式综合保险平台，覆盖健康险、家财 险、储蓄险、车险等全系列险种，连接近百家保险公司和 6 亿保民。 从运费险到成立蚂蚁保，再到如今签下刘亦菲冲上热搜，蚂蚁的保险业务绝大多数时候远离舆论场中心。 蚂蚁集团副总裁、蚂蚁保总经理陈冠华对我们说，保险是最复杂的金融产品之一，做保险需要坚持长期主 义，有时候得慢工出细活。蚂蚁保和保险公司已经一起走过 8 年时间，但也还只是长征路途的开始。 从爆款健康险开始，回归保障本质 运费险成功之后，大概 2012 年开始，当时的支付宝 ...