问：1月1日起，2026年度惠民保在全国多地陆续生效。惠民保到底值不值得买？ 答：惠民保到底值不值得买，要看个人需求。要根据自身的年龄健康状况和预算情况，了解产品具体的 免赔额、报销比例以及保障药品目录，作出合适的选择。如有购买需求，可以在支付宝、微信等平台搜 索各地的惠民保入口，进行详细了解。 普惠性较强 惠民保最大特点是普惠性。一方面保费不高，年保费普遍在几十元到两百多元之间；另一方面，投保条 件宽松，通常不限年龄、职业和健康状况。 老年人和已有疾病导致商业保险投保难的人、预算有限的年轻人、已购商业保险想要增加保障范围的 人，都可以考虑购买惠民保。 惠民亮点多 一些产品还附带服务项目。比如，有的带挂号陪诊，有的带上门护理，有的赠送洗牙，有的提供癌症筛 查，还有的能代煎中药。投保人可以各取所需。 此外，有的惠民保与医保结算联动，被保险人达到理赔门槛可以实现自动结算。 理赔门槛高 惠民保是一种政府指导、商保承办的普惠保险产品，但也面临理赔门槛高等问题。目前，惠民保的理赔 门槛通常在1万元至2万元之间，如果经过医保报销之后没有达到免赔额，则无法获得赔付。 惠民保是一种普惠保险，其产品逻辑是"广覆盖、低保费"，核 ...

2026.01.07 本文字数：2031，阅读时长大约4分钟 作者 |第一财经 林志吟 从本月起，首版《商业健康保险创新药品目录》（下称"商保创新药目录"）开始在各地启用。 作为普惠型商业健康保险产品代表之一，惠民保近年来得到普及。而惠民保参保者，尤其是一些重疾患 者，到底能从商保创新药目录获益多少？ 首版商保创新药目录在医保目录之外，收录了19种临床价值突出但超出医保支付能力的创新药。从治疗 领域看，这些药品覆盖肿瘤、罕见病、神经退行性疾病及代谢类疾病多个关键领域，具体包括CAR-T治 疗药物、阿尔茨海默症治疗药品、神经母细胞瘤和戈谢病等罕见病治疗药品，填补了基本医保目录空 白。 从目前看，商保创新药目录的落地，能让惠民保参保者获益多少，要取决于惠民保产品承接、相关创新 药进院情况等。 进入商保创新药目录的创新药，最后的推广使用要落实在医院端，当前看，这些高价高值创新药在打通 入院"最后一公里"上，仍有障碍。 有CAR-T药企对第一财经记者表示，他们进入商保创新药目录的CAR-T药物，目前还未看到可以直接入 院的。 有创新药进入商保创新药目录的罕见病药企对第一财经记者表示，产品能否入院，要看每家医院的要求 ...

2026.01. 07 本文字数：2031，阅读时长大约4分钟 作者 | 第一财经 林志吟 从本月起，首版《商业健康保险创新药品目录》（下称"商保创新药目录"）开始在各地启用。 作为普惠型商业健康保险产品代表之一，惠民保近年来得到普及。而惠民保参保者，尤其是一些重疾 患者，到底能从商保创新药目录获益多少？ 首版商保创新药目录在医保目录之外，收录了19种临床价值突出但超出医保支付能力的创新药。从 治疗领域看，这些药品覆盖肿瘤、罕见病、神经退行性疾病及代谢类疾病多个关键领域，具体包括 CAR-T治疗药物、阿尔茨海默症治疗药品、神经母细胞瘤和戈谢病等罕见病治疗药品，填补了基本 医保目录空白。 以CAR-T药物为例，有血液肿瘤医生对第一财经记者表示，对于一些真正难治的血液瘤患者而言， CAR-T是较好的治疗手段，在没有这类疗法之前，一些患者的中位生存期只有半年，但有了这种治 疗手段后，有部分患者的生存期可以提高到五年及五年以上，但CAR-T疗法费用高昂，无法在患者 中得到普及。商保支付的话，可以减轻患者费用负担。 从目前看，商保创新药目录的落地，能让惠民保参保者获益多少，要取决于惠民保产品承接、相关创 新药进院情况等 ...

从本月起，首版《商业健康保险创新药品目录》（下称"商保创新药目录"）开始在各地启用。 作为普惠型商业健康保险产品代表之一，惠民保近年来得到普及。而惠民保参保者，尤其是一些重疾患 者，到底能从商保创新药目录获益多少？ 首版商保创新药目录在医保目录之外，收录了19种临床价值突出但超出医保支付能力的创新药。从治疗 领域看，这些药品覆盖肿瘤、罕见病、神经退行性疾病及代谢类疾病多个关键领域，具体包括CAR-T治 疗药物、阿尔茨海默症治疗药品、神经母细胞瘤和戈谢病等罕见病治疗药品，填补了基本医保目录空 白。 以CAR-T药物为例，有血液肿瘤医生对第一财经记者表示，对于一些真正难治的血液瘤患者而言， CAR-T是较好的治疗手段，在没有这类疗法之前，一些患者的中位生存期只有半年，但有了这种治疗手 段后，有部分患者的生存期可以提高到五年及五年以上，但CAR-T疗法费用高昂，无法在患者中得到普 及。商保支付的话，可以减轻患者费用负担。 值得注意的是，该产品也标注称"必须为住院期间使用，且合并在住院医疗费用中一并结算并上传到国 家医保平台的全自费药品费用才可纳入"。 换言之，如果进入商保创新药目录的创新药无法顺利入院的话，参保的患 ...

Core Insights - The establishment of the Ping An Health Management Company marks a significant step in the transformation of the health insurance sector, reflecting a shift towards a "managed care" model and the reconstruction of a new ecosystem in health insurance [1][16] - As of November 2025, the cumulative premium for commercial health insurance reached 943.9 billion yuan, with a year-on-year growth of 2.3%, indicating a stable market but falling short of the 2 trillion yuan target set for 2025 [1][16] - The Chinese commercial health insurance market is at a crossroads, focusing on high-quality development driven by regulatory guidance and innovation in health management and product offerings [1][16] Market Structure - The commercial health insurance market is maintaining stability amid slowing growth, with a shift in focus from scale expansion to quality improvement [3][18] - In the first 11 months of 2025, life insurance companies accounted for 76.8% of health insurance premiums, totaling 725.2 billion yuan, but their growth rate has stagnated, while property insurance companies saw a 10.2% increase in premiums [3][18] - The market's stability is evidenced by a monthly premium of 49.6 billion yuan in November 2025, with life insurance companies contributing 40.2 billion yuan and property insurance companies 9.4 billion yuan [3][18] Policy Support - Regulatory measures have been pivotal in driving the transformation of the health insurance industry, with multiple initiatives launched to enhance product standards and payment reforms [4][19] - The "Guiding Opinions on Promoting the High-Quality Development of Health Insurance" issued on September 30, 2025, outlines a vision for the role of health insurance in the national health security system by 2030 [4][19] - The policy emphasizes the integration of health insurance with health management, aiming to create a new health service guarantee system that combines prevention, management, and protection [4][19] Product Innovation - The health insurance sector is entering a phase of deep product innovation, with a focus on dual attributes of "protection + returns" in dividend insurance products [7][22] - Personal account-based long-term medical insurance is highlighted as a key area supported by policy, addressing the industry's challenges with traditional short-term medical insurance [7][22] - The mid-to-high-end medical insurance market is expanding, with major players enhancing their offerings to include comprehensive solutions beyond mere reimbursement [8][23] Ecosystem Reconstruction - The competition in the health insurance industry is shifting towards building an ecosystem, with a consensus on the "insurance + health management" model [10][26] - Major insurance companies are establishing health management firms to create a comprehensive health service system, moving from post-claim reimbursement to full-cycle health management [10][26] - The establishment of health management companies by leading insurers is seen as a localized innovation of the mature "managed care" model from developed markets, aiming to enhance service quality and sustainability [12][27] Technological Empowerment - The application of new technologies such as AI, big data, and blockchain is deepening in the health insurance sector, enhancing efficiency across product design, underwriting, and customer service [13][28] - Ping An has integrated AI into its health strategy, creating a comprehensive service system that covers various health service scenarios [13][28] - The focus on digitalization and the development of personalized health management platforms are expected to improve user experience and support dynamic pricing and risk control [13][28]

1月1日起，2026年度惠民保在全国多地陆续生效。惠民保是一种政府指导、商保承办的普惠保险产品， 但也面临理赔门槛高等问题。惠民保到底值不值得买？一起来看。 问：保费贵吗？谁能买？ 一些产品还附带服务项目。比如，有的带挂号陪诊，有的带上门护理，有的送洗牙，有的提供癌症筛 查，还有的能代煎中药，投保人可以各取所需。 此外，有的惠民保与医保结算联动，被保险人达到理赔门槛可以实现自动结算。 问：惠民宝到底该不该买？ 答：目前，惠民保的理赔门槛通常在1万至2万元之间，如果经过医保报销之后没有达到免赔额，则无法 获得赔付。 惠民宝到底值不值得买，还要看个人需求，要根据自身的年龄健康状况和预算情况，了解产品具体的免 赔额报销比例以及保障药品目录，作出合适的选择。如有购买需求，可以在支付宝、微信等平台搜索各 地的惠民保入口，进行详细了解。 编辑：万政 答：惠民保最大特点是普惠性。一方面保费不高，年保费普遍在几十元到两百多元之间；另一方面，投 保条件宽松，通常不限年龄职业和健康状况。 老年人和已有疾病导致商业保险投保难的人、预算有限的年轻人、已购商业保险想要增加保障范围的 人，都可以考虑购买惠民保。 问：惠民宝有何惠民亮点？ ...

实验室的理性主义：当人生遭遇"精算"之外的风暴 在刘颖的前半生里，世界是可以用数据和逻辑来度量的。 作为上海大学材料科学与工程学院的高材生，她的职业起点令人艳羡——一家世界500强外企，一间世界一流的实验室。她的日 常，是与精密仪器为伴，在冷静的数据海洋中探寻规律。她的生活，光鲜、安稳，仿佛一层无形的玻璃，将窗外的喧嚣与人世的无 常隔绝开来。 这是一个由"理性主义"主导的世界。在实验室里，每一个变量都可以被控制，每一个结果都可以被预测。直到35岁那年，人生的"控 制变量"突然失序。 时代的指针悄然转动，企业经营战略的调整，带来了一场冰冷的裁员优化。那封通知邮件，就像一份无法辩驳的实验报告，宣告了 她过往职业生涯的终结。然而，命运的风暴往往结伴而来。几乎在同一时间，家人的重病复发通知单，成为了压在她心头的另一座 大山。 一扇门在身后关闭，另一扇门却通向风雨。 这是刘颖第一次深刻地体会到，精密的科学可以计算出材料的屈服强度，却无法精算出人生的脆弱拐点。 面对这突如其来的双重打击，刘颖没有沉溺于自怨自艾。她骨子里的"高知"特质，让她开始了一场深刻的"课题研究"——研究的对 象，是自己和更多人的未来。 她开始反思：真 ...

Core Viewpoint - The article discusses the current state of the "Hui Min Bao" insurance product, highlighting its shift from a popular choice among consumers to a situation where sales agents are incentivized to offer cash rebates to attract customers, raising concerns about the sustainability and integrity of the product [2][3][7]. Group 1: Sales Practices and Market Dynamics - Insurance agents are increasingly using cash rebates as a tactic to attract customers, with some offering rebates as high as 60% to meet sales targets [3][6]. - The competitive landscape among insurance companies has intensified, leading to a "cash rebate competition" that disrupts market order and places financial strain on the "Hui Min Bao" product [9][12]. - The pressure to meet Key Performance Indicators (KPIs) has resulted in agents resorting to personal funds to subsidize customer rebates, indicating a distorted promotional strategy [6][12]. Group 2: Product Viability and Consumer Behavior - The initial appeal of "Hui Min Bao" was its low cost and broad accessibility, but the product has seen a decline in consumer interest, with agents now actively seeking customers [7][9]. - The product's structure allows for individuals with pre-existing conditions to enroll, which has led to a deterioration in the risk pool as healthier individuals opt out, increasing operational costs [13][16]. - High claims ratios have been reported, with some products exceeding 100% in claims, leading to a cycle of rising premiums and further attrition of healthy participants [19][22]. Group 3: Regulatory and Ethical Concerns - The practice of offering cash rebates is viewed as a violation of insurance regulations, posing risks of legal repercussions for both agents and companies involved [24][25]. - The lack of transparency in rebate transactions raises concerns about potential misuse for illicit activities, such as money laundering [24][25]. - The industry faces calls for reform to address the imbalance in the distribution of profits and to ensure that "Hui Min Bao" remains a genuinely accessible product rather than a marketing tool [27][30]. Group 4: Future Directions and Recommendations - To achieve sustainable development, the "Hui Min Bao" product must focus on precise pricing strategies, dynamic adjustments, and differentiated coverage to avoid adverse selection [30][31]. - Strengthening data collaboration with healthcare providers and improving claims processing efficiency are essential for enhancing operational effectiveness [31]. - Creating a holistic ecosystem that integrates insurance with health management services can shift the focus from reactive claims to proactive health interventions, fostering a mutually beneficial cycle for all stakeholders [31].

Core Viewpoint - The article highlights the alarming trend of insurance agents offering cash rebates to attract customers for the "Hui Min Bao" insurance product, which has shifted from a widely sought-after affordable insurance option to one reliant on rebates due to intense market competition and operational pressures [2][6][9]. Group 1: Current Market Dynamics - The "Hui Min Bao" insurance product is experiencing a sales surge, with agents promoting cash rebates as high as 60% to meet sales targets, leading to a situation where agents are financially subsidizing customer purchases [3][5][6]. - The competitive landscape among insurance companies has intensified, resulting in a "rebate competition" that disrupts market order and places financial strain on the "Hui Min Bao" product, which is already operating on thin margins [9][11]. - The operational adjustments, such as the shift from city-level to provincial-level offerings, have concentrated competition among insurers, further complicating the market dynamics [11][12]. Group 2: Challenges and Risks - The low entry barrier of "Hui Min Bao" allows individuals with pre-existing conditions to enroll, but this has led to a deteriorating risk pool, with healthier individuals opting out, thereby increasing operational costs for insurers [12][14]. - The rising claims ratio, with some products exceeding 188.76% in 2023, has created a vicious cycle of increasing premiums, which further drives away healthy participants, threatening the sustainability of the product [14][17]. - The reliance on cash rebates has raised concerns about potential legal and operational risks, including the possibility of policy lapses and fraudulent activities, as agents may engage in unethical practices to secure sales [22][23]. Group 3: Strategic Recommendations - To ensure the sustainable development of "Hui Min Bao," companies need to focus on a balanced distribution of benefits, moving away from rebate-driven sales to a value-driven approach that emphasizes product viability [24][26]. - Companies should implement dynamic pricing mechanisms and enhance collaboration with healthcare providers to improve claims processing and risk management, thereby increasing operational efficiency [26][27]. - Building a comprehensive ecosystem that integrates health management services with insurance offerings can help shift the focus from reactive claims to proactive health interventions, fostering customer loyalty and reducing claims costs [26][27].

转自：新华财经 近年来，中国人寿财产保险股份有限公司曲靖市中心支公司（以下简称"公司"）深入践行金融服务实体 经济根本宗旨，以数字化转型为抓手，全方位服务曲靖经济社会高质量发展。 科技赋能，农险转型成效显著。公司构建"天空地"立体化服务体系，全面应用3D猪脸识别、AI智能点 数及卫星遥感技术。在会泽、富源等地，通过无人机与AI算法精准识别规模化养殖场387个，验标误差 率降至0.5%以内，查勘效率提升3倍以上，解决了标的信息不精准、理赔慢的难题。 精准滴灌，护航高原特色农业。针对曲靖羊肚菌等特色产业，公司创新推出"保险+企业+农户"模式。 面对2025年春季大风灾害，公司迅速启动科技理赔，快速完成羊肚菌大棚定损赔付15.81万元，为农户 恢复生产提供坚实保障，赢得了客户赞誉。 多元保障，服务实体经济发展。公司聚焦中小微企业，今年以来累计提供综合风险保障426亿元，缓解 融资压力6.45亿元。同时，大力发展绿色金融与科技保险，提供风险保障超588亿元；为高危行业提 供"安责险"保障12.09亿元；连续三年支持"惠民保"项目，护航民生福祉。 未来，公司将继续加大农业保险投入，扩大保障覆盖面，持续深化"科技+保险" ...