齐鲁保2026版
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从“卷价格”到“卷价值” 惠民保的可持续经营之“道”
Jin Rong Shi Bao· 2025-11-19 09:20
Core Insights - The recent launch of the 2026 version of the Huiminbao products emphasizes "upgraded protection" and "comprehensive enhancement," with unchanged premiums but higher coverage and lower claims thresholds [1][2] - Huiminbao, a city-customized commercial health insurance, has evolved over ten years to become a crucial part of China's multi-tiered medical security system, shifting from price competition to value competition [1][3] Product Features - The 2026 version of Huiminbao products focuses on expanding special drug coverage, including CAR-T therapy and rare disease medications, significantly enhancing their appeal to consumers [2][3] - The coverage range is extending to chronic disease management and health management services, with examples like dental services and health assessments included in the Anhui Huiminbao 2026 version [3] - Premiums remain stable while coverage limits are increasing, such as the Beijing Puhui Health Insurance maintaining a premium of 195 yuan per person per year while raising the total coverage to 3.5 million yuan [3] Pricing Strategy - Differentiated pricing is becoming a mainstream trend in new Huiminbao products, allowing for tailored premiums based on age and health status [4][5] - This approach enhances the attractiveness of Huiminbao to healthier populations and supports sustainable development by avoiding the pitfalls of uniform pricing [5][6] Market Dynamics - The transformation of Huiminbao reflects a balance between inclusivity and sustainability, with significant participation rates and increasing renewal rates indicating a positive trend [8] - The long-term positioning of Huiminbao is seen as a middle layer in the multi-tiered insurance system, complementing basic medical insurance and commercial health insurance [8] Future Directions - Future Huiminbao products are expected to evolve towards precision, ecological integration, and technological advancement, relying more on data for product design and enhancing service efficiency [9] - Recommendations for Huiminbao include maintaining its inclusive positioning, continuous innovation in products and services, and leveraging insurance technology to improve actuarial and risk management capabilities [9]
惠民保“上新”
Di Yi Cai Jing Zi Xun· 2025-11-14 02:18
Core Insights - The article discusses the evolution and challenges of the Huiminbao insurance scheme, highlighting its significant growth in premium contributions and the disparity in claims experiences among insured individuals [2][3][4] - The introduction of a new commercial insurance drug directory is expected to enhance the coverage of innovative drugs under Huiminbao, while also addressing the sustainability of the insurance model [3][5][6] Group 1: Huiminbao Overview - Huiminbao has been promoted nationwide for nearly six years, with "special drug liability" becoming a standard feature, contributing approximately 18 billion yuan in innovative drug payments last year, a ninefold increase from 2021 [2] - The scheme faces challenges due to a high proportion of elderly and pre-existing condition participants, leading to a "death spiral" in its development [2][3] - Some Huiminbao products are responding to payout pressures by increasing deductibles and reducing high-value drug payment limits, which indirectly lowers medical benefits [2][3] Group 2: Regulatory Changes and Trends - The recent notification from the National Financial Regulatory Administration emphasizes that urban commercial health insurance, including Huiminbao, should align premium collection with coverage levels and avoid chaotic low-price competition [3][8] - The 2026 version of Huiminbao is seeing a shift towards "premium stratification" rather than low premiums, with an expansion of coverage to include chronic diseases, mental health medications, and overseas drugs [3][4][5] Group 3: Special Drug Coverage Expansion - The number of drugs covered under Huiminbao is set to reach 672 by 2024, with a significant focus on cancer and rare disease medications, which account for over 40% of the innovative drugs listed [4][5] - Some regions are expanding their special drug coverage to include high-value innovative drugs for chronic diseases, with certain areas approaching the coverage levels of pure commercial health insurance [5][6] Group 4: Pricing and Risk Management - The core of commercial health insurance is the dynamic balance between funding and benefits, with low premiums slowing the growth of Huiminbao's funding and affecting benefit enhancements [8][11] - The 2026 version of Huiminbao introduces a trend of "layered" special drug and medical coverage, allowing for both standard and upgraded insurance options [8][9] Group 5: Inclusion of New Citizens and Cross-Region Medical Services - Strategies to attract healthier and younger participants include lowering claim thresholds and increasing reimbursement rates for outpatient services and common illnesses [12][13] - New policies in various regions are expanding coverage to include new citizens and those seeking medical services in different locations, enhancing the inclusivity of Huiminbao [12][13]
惠民保“上新”
第一财经· 2025-11-14 02:08
Core Viewpoint - The article discusses the evolution and challenges of the "Hui Min Bao" (惠民保) insurance scheme in China, highlighting its rapid growth in coverage and the increasing complexity of claims and benefits, particularly in relation to innovative drugs and treatments [3][4][6]. Group 1: Overview of Hui Min Bao - Hui Min Bao has been promoted nationwide for nearly six years, with "special drug liability" becoming a standard feature. In the previous year, it contributed approximately 1.8 billion yuan in innovative drug payments from a premium scale of less than 20 billion yuan, marking a ninefold increase from 2021 [3][4]. - The scheme faces challenges due to varying experiences among the 150 million insured individuals, with some receiving substantial claims while others struggle to meet deductibles or face reduced payouts due to pre-existing conditions [3][4]. Group 2: Regulatory Changes and Trends - The recent notification from the National Financial Regulatory Administration emphasizes the need for commercial health insurance, including Hui Min Bao, to align premium collection with coverage levels and avoid chaotic low-price competition [4][8]. - The 2026 version of Hui Min Bao is introducing a trend of "premium stratification," moving away from low premiums to better match coverage levels, with new inclusions for chronic diseases and overseas drugs [4][6]. Group 3: Expansion of Special Drug Coverage - As of 2024, 90% of Hui Min Bao projects include "special drug liability," with a total of 672 drugs covered, reflecting a 1.8 times increase since 2021. The focus remains on cancer and rare disease medications, with over 40% of the drugs being innovative cancer treatments [6][7]. - Some regions are expanding their special drug coverage to include high-value drugs for chronic diseases, with certain plans approaching the coverage levels of pure commercial health insurance [7][8]. Group 4: Pricing and Risk Management - The core of commercial health insurance is the dynamic balance between funding and benefits. The low premium model of Hui Min Bao has slowed funding growth, impacting benefit enhancements [10][12]. - The 2026 version of Hui Min Bao is adopting a risk stratification approach, allowing for differentiated pricing based on factors like age and health status, which aims to enhance fairness and adaptability in product offerings [10][11]. Group 5: Inclusion of New Citizens and Cross-Regional Medical Services - The new Hui Min Bao products are increasingly targeting healthy individuals and young people by lowering deductibles and enhancing coverage for outpatient services and common illnesses [16][18]. - Several regions are allowing the use of personal medical insurance accounts for family members and expanding coverage to include new citizens and those seeking medical services across regions [17][18].
惠民保“上新”:多地保费分层,汕头主动衔接创新药目录丨“病有所保”大调研
Di Yi Cai Jing· 2025-11-13 12:41
Core Insights - The "惠民保" (Huimin Insurance) has expanded its coverage to include chronic diseases, mental health medications, outpatient drugs, overseas drugs, and original research drugs, reflecting a shift in the insurance landscape [1][2] - The insurance scheme has seen a significant increase in claims, with approximately 18 billion yuan paid for innovative drugs in the previous year, a ninefold increase from 2021 [1] - However, the experience of claims varies widely among the 150 million insured individuals, with some facing high out-of-pocket costs due to thresholds and pre-existing conditions [1][6] Group 1: Policy Changes and Trends - The recent notification from the National Financial Regulatory Administration emphasizes the need for commercial health insurance to align premium collection with coverage levels and avoid low-price competition [2] - The 2026 version of "惠民保" has introduced a tiered premium structure, moving away from the previous low-cost model, and has expanded coverage to include more drug categories [2][3] - The number of drugs covered under "惠民保" is expected to reach 672 by 2024, with a significant focus on innovative treatments for cancer and rare diseases [3] Group 2: Coverage Expansion - The 2026 "北京普惠健康保" (Beijing Universal Health Insurance) will cover 87 disease categories and 159 drugs, including new treatments for Alzheimer's and CAR-T therapy [4] - The "齐鲁保2026版" (Qilu Insurance 2026) has expanded its coverage to include 3 high-value medical devices and additional innovative drugs for chronic conditions [4] - Many regions are now including outpatient drugs and original research drugs in their coverage, indicating a trend towards more comprehensive health insurance products [3][4] Group 3: Risk Management and Pricing Strategies - The insurance sector is adopting a risk-based pricing model, allowing for differentiated premiums based on age, health status, and pre-existing conditions [6][10] - The introduction of tiered coverage options aims to balance the need for affordable premiums with adequate benefits, particularly for high-risk groups [6][10] - Recent adjustments have led to increased reimbursement rates for patients with pre-existing conditions, reflecting a shift towards more equitable coverage [8][10] Group 4: Inclusion of New Demographics - The 2026 "惠民保" products are increasingly targeting new citizens and those seeking medical care outside their registered locations, broadening the scope of insured individuals [10][11] - Initiatives to allow family members to share health insurance accounts and to include flexible workers and retirees in coverage are being implemented in various regions [10][11] - The trend towards inclusivity aims to enhance the overall participation rate in the "惠民保" scheme, particularly among younger and healthier individuals [10]
这个重阳,用齐鲁保的守护,告白父母
Qi Lu Wan Bao· 2025-10-24 02:18
Core Viewpoint - The article emphasizes the importance of providing long-term health protection for aging parents, highlighting that love should be expressed through practical measures such as insurance, especially in the context of health risks faced by the elderly [1][2][3]. Group 1: Product Overview - "Qilu Bao 2026" is presented as a comprehensive insurance product aimed at providing peace of mind for parents, serving as a "filial piety gift" that offers substantial protection [4]. - The product is designed to be inclusive, allowing coverage without age restrictions, meaning even centenarians can apply for insurance [5]. - It accommodates individuals with pre-existing conditions, ensuring that families can secure coverage without the worry of past health issues [6]. - The insurance is available to all professions, whether retired or still working, making it accessible to a wide demographic [7]. Group 2: Coverage Features - The product focuses on major medical expenses, covering out-of-pocket costs that remain after insurance reimbursements, thus mitigating the risk of poverty due to illness [8]. - It includes coverage for high-cost medications not listed in the insurance directory, particularly for critical illnesses like cancer, alleviating concerns over expensive treatments [9]. - Anticipated upgrades may include online consultations and health management services, enhancing the overall user experience and making health management easier for parents [10]. Group 3: Affordability and Accessibility - The insurance is described as cost-effective, with premiums starting at a very low amount, providing high coverage limits, thus making it financially feasible for families [11]. - Enrollment is simplified through online processes, allowing individuals to use their personal health insurance account balances to pay for family members, streamlining the application [12]. Group 4: Call to Action - The article encourages individuals to take action this Double Ninth Festival by securing the "Qilu Bao 2026" insurance for their parents, framing it as a meaningful way to express care and ensure their well-being [14][15].
第一份保障,从济南医保+齐鲁保开始
Qi Lu Wan Bao· 2025-10-24 02:09
Core Insights - The article highlights the continuous development and improvement of the medical insurance system in Jinan, emphasizing its role in providing comprehensive protection against health risks for the public [1] Group 1: Product Launch and Features - The "Qilu Bao 2026 Edition" insurance plan was officially launched on October 12, 2023, designed to closely integrate with basic medical insurance while introducing various innovations [1] - The plan features a "zero-threshold" enrollment policy, allowing participation regardless of age, occupation, or health status [2] - Three coverage tiers are available: - Rural Revitalization Version starting at 19 yuan per year, offering four core protections - Inclusive Livelihood Version starting at 59 yuan per year, covering five basic responsibilities - Beautiful Life Version starting at 149 yuan per year, providing comprehensive coverage across nine major responsibilities [2] Group 2: Family Benefits and Discounts - Newborns can be enrolled for free in the 2026 edition if both parents are insured, ensuring medical coverage from birth [6] - Discounts are available for family enrollments, with reductions of 3 yuan per person for two new enrollees and 6 yuan for three or more [6] Group 3: Enhanced Coverage and Services - Deductibles have been lowered across various responsibilities, with significant reductions in the thresholds for different coverage tiers [7][8] - The drug coverage has expanded from 2,000 to 3,000 items, including 37 special drugs and 15 rare disease medications, along with the addition of over 50 original research drugs for online outpatient services [8] - New high-value medical equipment coverage has been introduced, including costs for robotic surgeries and artificial hearts, addressing gaps in basic insurance [8] - Health services have been upgraded to include over 20 management services, covering various aspects of health care [8] Group 4: Claims and Technology Integration - The 2026 edition offers streamlined claims services, enabling local medical treatment with "one-stop settlement" and automatic payment within 1-5 working days for out-of-area treatments [9] - Policyholders can submit claims online via the "Qilu Bao" WeChat account or through a dedicated service hotline, ensuring comprehensive support throughout the claims process [9]
九大责任全覆盖 “齐鲁保2026版”开启“美好生活”
Qi Lu Wan Bao· 2025-10-17 02:36
Core Insights - The "Qilu Bao 2026 Edition" insurance program has officially launched, designed as a supplementary commercial health insurance closely linked to basic medical insurance in Shandong Province [1] - Since its inception in 2020, "Qilu Bao" has enrolled over 4.1 million participants, demonstrating its popularity and effectiveness in providing health coverage [1] - The 2026 edition introduces three main products: Rural Revitalization Version, Inclusive Livelihood Version, and Beautiful Life Version, with continuous optimization in terms of deductibles, coverage responsibilities, and reimbursement ratios [1][3] Product Features - The Beautiful Life Version is highlighted as a significant offering this year, featuring enhancements through "Six Optimizations, Four Additions, and Four Expansions" [3] - The "Four Additions" include new coverage for specific medical expenses, overseas special drugs, internet outpatient responsibilities, and post-operative care [3] - The "Six Optimizations" focus on lowering deductibles for various categories of medical expenses, including high-cost drugs and proton therapy, while increasing coverage amounts for proton therapy [3] - The "Four Expansions" broaden the range of covered drug categories across different responsibilities, enhancing the overall protection offered [3] Accessibility and Inclusivity - The "Qilu Bao 2026 Edition" is designed to be inclusive, with no restrictions on age, occupation, or health status for policyholders [3] - Participants can utilize their employee medical insurance personal accounts to enroll themselves or their close relatives, promoting accessibility [3] - The program adheres to principles of being distinctive, beneficial to the public, and sustainable, addressing diverse community needs [3]
一文读懂“齐鲁保2026版”参保流程
Qi Lu Wan Bao· 2025-10-14 09:27
Group 1 - The "Qilu Bao 2026 version" insurance enrollment channel officially opened on October 12, allowing participants from Shandong Province and Jinan City to enroll in basic medical insurance [1] - Enrollment can be completed through the Jinan Medical Insurance platform, Qilu Bao service account, or local promoters [1] - The online enrollment process is accessible via a QR code [2]
齐鲁保上线首日,参保人数突破15万!
Qi Lu Wan Bao· 2025-10-13 12:28
Core Insights - The "Qilu Bao 2026 Edition" insurance program has officially launched, with over 150,000 participants on the first day, targeting employees and residents covered by basic medical insurance in Shandong Province and Jinan City [1] - This program is designed as a supplementary commercial health insurance that closely integrates with basic medical insurance, offering enhanced coverage and convenience [1] Product Features - The "Qilu Bao 2026 Edition" offers three main products: Beautiful Life Version, Inclusive Livelihood Version, and Rural Revitalization Version, each tailored to different demographic needs [1][3][5] - The Beautiful Life Version features lower deductibles, broader coverage, and higher coverage limits, including new benefits for high-value medical devices and advanced medical technologies [1] - The Inclusive Livelihood Version retains core responsibilities while increasing reimbursement rates and expanding the range of covered medications, catering to those seeking stable protection [3] - The Rural Revitalization Version focuses on basic coverage with high cost-effectiveness, offering a maximum coverage of 2.61 million yuan starting from a premium of 19 yuan [5] Optional Upgrades - The program includes three optional upgrade plans that can be combined with the Rural Revitalization and Inclusive Livelihood Versions, such as overseas special medication coverage and online consultation services [7] - The total annual coverage can reach up to 4.77 million yuan, providing an additional layer of security for insured individuals [7]
两块把子肉的钱,关键时刻能救命!
Qi Lu Wan Bao· 2025-10-13 12:28
Core Insights - The launch of "Qilu Bao 2026 Edition" offers affordable commercial health insurance starting at 19 yuan, aiming to provide essential health protection for families [1][4] - The product features tiered options catering to different needs, including basic coverage, stable protection, and comprehensive services for high-quality medical care [2] - The insurance emphasizes convenience in claims processing, with a "one-stop settlement" service that ensures seamless reimbursement and quick payouts [3] Group 1 - The "Qilu Bao 2026 Edition" is designed to be accessible with a minimum premium of 19 yuan, promoting a "zero threshold, high coverage" model [1][4] - The product offers three distinct plans: the "Rural Revitalization Version" at 19 yuan, the "Inclusive Livelihood Version" at 59 yuan, and the "Beautiful Life Version" at 149 yuan, each tailored to different consumer needs [2] - The comprehensive design allows for small investments to yield significant health protection, addressing various market segments effectively [2] Group 2 - The claims process is streamlined, allowing for immediate payouts upon discharge from local hospitals, and automatic transfers for out-of-area claims within 1-5 working days [3] - Trust in the product is evidenced by over 410 million users, with 51.39 million claims processed and a total payout of 220 million yuan from 2023 to September 2025 [4] - The insurance aims to prevent poverty caused by medical expenses, reinforcing its role as a stabilizing force for families [4]