转自：新华财经 "出院扫码即结算，不用垫付一分钱，这在以前想都不敢想！"在深圳市南山区人民医院，刚办完出院手 续的李叔叔（化名）对着微信里的"保险直付码"赞不绝口。他 2万多元的住院费用，经医保报销1.2万元 后，剩余需要商保赔付的金额通过腾讯微保联合微信支付等多方打造的"商保直付"快捷通道自动核赔实 时到账，全程没有走任何额外理赔申请流程。 这一幕，正是腾讯微保2025年服务创新再升级的缩影。作为腾讯官方保险代理平台，其以"用户为本， 科技向善"为核心，通过"商保直付"打破行业数据壁垒、以大模型技术重构服务底层逻辑、用"AI+人 工"模式传递服务温度，完成了从"理赔服务升级"到"全周期保障生态构建"的跨越式发展，更成为推动 中国健康保险高质量发展的标杆力量。 直付破局：多方协同打通"医保+商保"结算最后一公里 长期以来，"先垫付、再理赔、耗时长"是商业保险的用户痛点。据行业数据显示，传统商业保险理赔的 平均耗时在3-7个工作日，部分复杂案件甚至长达数月。"提升商业保险的理赔支付效率"，是保险消费 者一直以来的呼声。 2025年，腾讯微保牵头破解这一行业顽疾，联合深圳市南山区政务服务和数据管理局、南山区卫生健 ...

Core Insights - Tencent Weibo has partnered with Taikang Online and Samsung Insurance to upgrade the "Weibo Medical Insurance" series, adding outpatient drug and equipment coverage [1] Product Overview - The "Weibo Medical Insurance" series includes four products: Weibo Medical Insurance - Million Medical Insurance, Weibo Medical Insurance - Children's Million Medical Insurance, Weibo Medical Insurance - High-end Million Medical Insurance, and Weibo Medical Insurance - Million Medical Insurance (Inclusive Version) [1] - All four products have incorporated outpatient drug and equipment coverage responsibilities [1] Claims Process - The "Weibo Medical Insurance" series has fully integrated the "WeChat Quick Claims" service, allowing users with policies to initiate claims easily after paying medical expenses through WeChat [1] - A "Claim Application" entry appears on the payment interface for users to click and start the claims process [1]

Core Viewpoint - The demand for commercial health insurance products is increasing as technology transforms the healthcare ecosystem, with users expecting comprehensive coverage that includes advanced medical resources and reimbursement for imported and specialty drugs purchased outside hospitals [1] Group 1: Product Upgrades - Tencent Weibo has partnered with Taikang Online and Samsung Insurance to upgrade the "Weibo Medical Insurance" series, adding coverage for outpatient drugs and medical devices, and expanding private hospital services [1][2] - The "Weibo Medical Insurance" series includes various products such as the Million Medical Insurance and Children's Million Medical Insurance, all of which now offer outpatient drug and device coverage, providing users with more flexible and comprehensive options [2][4] - The Million Medical Insurance covers 120 high-incidence diseases, including advanced treatment technologies and specialty drugs without a list limitation, and now includes reimbursement for outpatient purchased drugs and medical devices [4] Group 2: Targeted Offerings - The Children's Million Medical Insurance offers specific outpatient responsibilities and does not set a deductible, enhancing user experience, and includes family insurance discounts for multi-child families [4][5] - The High-End Million Medical Insurance and the Universal Million Medical Insurance have also been upgraded to meet the needs of high-net-worth individuals and provide cost-effective options for the general public [5] Group 3: Claims and User Experience - The "Weibo Medical Insurance" series has integrated the "WeChat Quick Claims" service, allowing users to initiate claims directly through the payment interface, transforming the claims process from passive to proactive [6][8] - The "Weibo Anxin Claims" service offers a range of value-added services, including video consultations and professional accompaniment during hospital visits, with a high user satisfaction rate [8] - As of April 30, 2025, the "Weibo Anxin Claims" service has assisted users in claiming over 6.8 billion, with a satisfaction rate exceeding 97% [8]