"Although our whole family has high-end medical insurance, I still plan to buy 'Beijing Pratt & Whitney Health Insurance', because its annual premium is only 195 yuan, and the maximum coverage is 3 million yuan, which can be used as a 'basic' existence." On November 1, when the 2023 "Beijing Pratt & Whitney Health Insurance" was opened for insurance, a citizen living in Haidian District, Beijing told a reporter from Beijing Business Daily.

　　It is understood that the "Beijing Pratt & Whitney Health Insurance" in 2023 will have four major upgrades on the basis of unchanged premium prices, including the possibility of new citizens in Beijing participating in the insurance, reducing the deductible and optimizing the special medicines. Serve.

And online quick compensation is more convenient, and the health management service experience is better.

　　Ensuring the expansion of the population

　　"This year is the second year of 'Beijing Pratt & Whitney Health Insurance'. After a year of development, 'Beijing Pratt & Whitney Health Insurance' has further improved and upgraded its protection responsibilities, reduced deductibles, dynamically supplemented special drug coverage, and increased value-added services. By sharing medical insurance data, the claims settlement process has been simplified and the claim settlement time has been improved." Li Mingxiao, Secretary of the Party Committee and Director of the Beijing Banking and Insurance Regulatory Bureau, said at the 2023 "Beijing Inclusive Health Insurance" conference.

　　It is understood that the 2023 "Beijing Pratt & Whitney Health Insurance" will be underwritten by PICC and China Life Insurance, jointly underwritten by Taikang, Pacific Insurance, Ping An, and Beijing Life Insurance, and the main operating platform will be provided by Yidu Cloud.

In addition to paying attention to the official designated insurance platform "Beijing Pratt & Whitney Health Insurance" WeChat public account to apply for insurance online, citizens can also apply for insurance through the professional staff of the above-mentioned six insurance companies. , China Construction Bank, Bank of Communications, Postal Savings Bank of China, Bank of Beijing, Beijing Rural Commercial Bank offline outlets.

Enrollment ends on December 31, 2022, and the guarantee period is from January 1, 2023 to December 31, 2023.

　　"Beijing Pratt & Whitney Health Insurance" continues to be favored by citizens. It is understood that 100,000 people were insured within 10 minutes of the release of "Beijing Pratt & Whitney Health Insurance".

　　In 2023, "Beijing Pratt & Whitney Health Insurance" will upgrade the product plan on the basis of unchanged premiums to expand the coverage of the insured population.

The coverage of the "Beijing Inclusive Health Insurance" in 2023 covers the insured people who are closely connected with the city's basic medical insurance, and the insured people with the city's basic medical insurance (basic medical insurance for urban workers, basic medical insurance for urban and rural residents) .

　　Judging from the number of insured people expanded this year, specific groups of people managed by the Beijing Municipal Medical Security Bureau and other relevant government departments, new citizens of Beijing who have Beijing household registration or Beijing residence permits and have participated in the basic medical insurance in other places.

No age limit, no limit on occupation, no limit on health condition, the whole family can be guaranteed.

　　Deductibles drop

　　The annual premium of 195 yuan can enjoy a maximum coverage of 3 million yuan. What does the 3 million yuan coverage include?

　　First, the self-payment liability in the medical insurance (the medical expenses paid by the outpatient and inpatient in the basic medical insurance catalog) is 1 million yuan per year.

Second, the out-of-medical insurance coverage for out-of-pocket hospitalization liability is 1 million yuan per year.

Third, from the perspective of special drug liability, the domestic special drug insurance coverage is 500,000 yuan/year, and the foreign special drug coverage is 500,000 yuan/year, with a total coverage of 1 million yuan/year.

　　Compared with the original protection plan of "Beijing Inclusive Health Insurance" in 2022, the deductible amount of "Beijing Inclusive Health Insurance" in 2023 has decreased.

Among them, the self-pay liability deductible is reduced to 15,000 yuan for healthy people; 20,000 yuan for people with specific pre-existing conditions; the liability deductible for special medicines is reduced to 0 yuan, and the number of domestic special medicines has increased to 40, which is more in line with the public's medication need.

　　In addition, the "Beijing Pratt & Whitney Health Insurance" health management service experience has ushered in optimization.

The number of health management services has increased from 25 to 42, covering four categories of services, including medical escort, home care, home rehabilitation and home testing, to meet the health management needs of the elderly, women and children of all ages. The application aims to reach more healthy people.

Judging from the 42 value-added services provided by "Beijing Pratt & Whitney Health Insurance", even if the claim standard is not met, you can enjoy more than 5 free health care services.

　　From the point of view of the claims settlement that citizens are more concerned about, the insured does not need to provide claim materials (except for special circumstances), and only needs to fill in the insured’s payment account through the “Beijing Pratt & Whitney Health Insurance” WeChat public account to receive compensation, which means This will not only simplify the claims process, but also increase the speed of claims settlement.

　　"The claim settlement service is more convenient, quick claims are activated, direct claims are promoted, claim settlement procedures are simplified, and claim settlement efficiency is improved. These practical and practical protection upgrades fully demonstrate the inclusiveness, convenience and convenience of 'Beijing Pratt & Whitney Health Insurance' products. Standardized management is a good product that benefits the people and the people." Ma Jiye, Secretary of the Party Leadership Group and Director of the Beijing Municipal Medical Insurance Bureau, said at the launch conference of "Beijing Inclusive Health Insurance" in 2023 that the "Beijing Inclusive Health Insurance" in 2023 will adhere to universal Based on the principle of benefiting the people, comprehensive upgrades have been made in terms of population coverage, protection responsibilities, and claims settlement services, and strive to allow more Beijing citizens to enjoy the protection of commercial supplementary medical insurance.

The population covered is further expanded, and more people with household registration in the city who have not participated in the city's basic medical insurance are included in the coverage.

　　Medical insurance account can be paid

　　"Paying premiums from medical insurance personal accounts is simply 'yyds'!" A netizen who lives in Fengtai District told a reporter from Beijing Business Daily that for most people, they can use medical insurance personal accounts to pay premiums without causing great economic pressure on themselves. , which means making decisions is relatively easy.

In addition, the more insureds, the stronger the stability of the product. For the consideration of the elderly and children at home, he will also recommend that people around him apply for insurance.

　　It is understood that from November 1st, Beijing employee medical insurance participants can use the balance of the medical insurance account to insure themselves the city's supplementary medical insurance "Beijing Pratt & Whitney Health Insurance". , the balance of the available medical insurance account is the insurance payment for spouses, parents and children who can enjoy the basic medical insurance treatment in Beijing, and one person can pay for the insurance for the whole family.

　　According to Song Zhanjun, deputy secretary-general of the China Insurance Research Institute of Beijing Technology and Business University, the opening of “Beijing Inclusive Health Insurance” to pay medical insurance accounts plays an important role in revitalizing the existing funds in individual accounts, promoting the upgrading of family health insurance, and helping to further expand benefits Civil insurance participation rate.

　　"Beijing Inclusive Health Insurance" realizes "seamless connection" with medical insurance, and both internal and external medical insurance can be reported at their own expense.

"Beijing Pratt & Whitney Health Insurance" includes self-payment 1 and self-payment 2 in the medical insurance catalog, out-of-pocket expenses for hospitalization outside the medical insurance catalog, and 100 high-value domestic and foreign special drug expenses.

　　From the perspective of out-of-pocket hospitalization liability outside medical insurance, the insured amount is 1 million yuan per year, the deductible is 15,000 yuan (the deductible for specific pre-existing conditions is 20,000 yuan), and the payout ratio is 70% for healthy people and 35% for people with specific pre-existing conditions. .

The annual reimbursement limit for a single drug is 300,000 yuan.

　　"In terms of personal out-of-pocket expenses for basic medical insurance, there is currently a lot of pressure. Among the national medical expenses, personal out-of-pocket expenses account for 27%. After the reimbursement of basic medical insurance and serious illness insurance, personal out-of-pocket expenses are still very heavy. 'Benefiting the people' is to reduce the pressure on individuals to pay at their own expense." said Zheng Bingwen, director of the World Social Security Research Center of the Chinese Academy of Social Sciences.

　　How to choose the same price medical insurance

　　"The threshold for commercial insurance is a bit high now, such as age restrictions and pre-existing conditions. When I applied for insurance, I was rejected." The above-mentioned residents of Fengtai District told a reporter from Beijing Business Daily.

Some citizens also said that there are endless health insurance products on the market, and they are "dizzying" to choose, and they are entangled in the two choices of "Beijing Inclusive Health Insurance" and million-dollar medical insurance.

　　So, what are the advantages of "Beijing Inclusive Health Insurance" compared with the million-dollar medical insurance of the same price on the market?

How can citizens make better choices?

　　From the product comparison point of view, Million Medical is generally a pure commercial insurance sold nationwide.

The "Beijing Inclusive Health Insurance" is a customized product for urbanization, supervised and guided by the government, and closely linked to the local basic medical insurance.

　　"Compared with the million-dollar medical insurance in the market, Pratt & Whitney Health Insurance has obvious advantages." A senior sales director of an insurance brokerage company told the Beijing Business Daily reporter that the advantages include that "Beijing Pratt & Whitney Health Insurance" does not It can be insured regardless of age and health conditions, which is difficult for commercial insurance, so it can be used as a necessary supplement to commercial insurance.

For non-healthy groups and the elderly, the advantages of inclusive health insurance are also very obvious. For this group of people who can insure millions of medical treatments, having one more copy of "Beijing inclusive health insurance" is equivalent to more A guarantee.

　　Song Zhanjun also said that "Beijing Inclusive Health Insurance" has lower premiums for the elderly and young children, and allows people with illness to participate in the insurance, which is the advantage of Inclusive Health Insurance over Millions of Medical Insurance.

　　The report of the 20th National Congress of the Communist Party of China emphasized that it is necessary to improve a multi-level social security system that covers the whole people, integrates urban and rural areas, is fair, unified, safe and standardized, and is sustainable.

"Huimin Insurance products have very strong urban territorial characteristics, and have the characteristics of a combination of price-friendly and commercial insurance, and the price is uniform, which has a considerable 'small social security' factor." Zheng Bingwen said.

　　It is understood that in 2021, more than 3 million people will participate in the "Beijing Inclusive Health Insurance" in 2022.

As of April 19 this year, 855 free value-added services have been provided to insured persons.

In June, the official WeChat account of “Beijing Pratt & Whitney Health Insurance” released information showing that since the insurance took effect on January 1, 2022, the minimum payout age is 1 year old and the maximum payout age is 88 years old. , the per capita compensation amount of women is higher than that of men; in the total number of compensation cases and total compensation amount, malignant tumors occupy the first place, and nearly half of the compensation cases and compensation amounts are for the treatment of malignant tumors.

Among the compensation cases, the cases with higher compensation amount are mostly surgical treatment.

The maximum compensation amount for a single compensation case is 160,626.89 yuan.

　　Beijing Business Daily reporter Chen Tingting Hu Yongxin