Xinhua News Agency, Beijing, December 12th, title: "Huimin Bao" sales survey
Xinhua News Agency "Xinhua Viewpoint" reporter Tan Moxiao
Recently, many places across the country have successively launched the new year's urban customized commercial medical insurance.
This kind of insurance, known as "Huiminbao", is favored by consumers because of its low threshold for insurance, low premiums, and high coverage.
How can "Huiminbao" develop healthily and sustainably?
How to benefit the people more?
"Xinhua Viewpoint" reporter conducted an interview.
Low threshold, low premium, high insurance amount, 140 million person-times insured
In 2015, Shenzhen City launched a supplementary medical insurance for serious and serious diseases. By purchasing serious disease insurance from commercial insurance companies, it provides further protection for the medical expenses incurred by patients with serious diseases.
This type of insurance is regarded by the industry as the prototype of "Benefiting the People's Insurance", and it was welcomed by the public once it was launched.
In recent years, under the guidance of local governments and relevant departments, the commercial operation of insurance companies and the connection with basic medical insurance have grown rapidly.
According to data from the Insurance Association of China, as of the end of 2021, "Huimin Insurance" covers 28 provinces across the country, with a total of 140 million people participating in the insurance.
In 2022, the sales enthusiasm of "Huiminbao" will not decrease.
Since November, the 2023 "Huiminbao" has been launched in many places across the country. According to incomplete statistics, more than 20 products have been newly launched or upgraded.
After the 2023 "Beijing Puhui Health Insurance" and Guangzhou "Sui Suikang" opened for enrollment on November 1, the number of insured persons both exceeded 2 million.
Zheng Bingwen, director of the World Social Security Research Center of the Chinese Academy of Social Sciences, said that "Huiminbao" is an integral part of the medical security system and a supplementary inclusive mechanism of the basic medical insurance system, which can solve the insufficient coverage of traditional commercial insurance to a certain extent The problem.
"No age limit, no occupation limit, no medical examination required, the maximum insurance amount is 3 million yuan..." On the official website of an insurance company, the "Huiminbao" product underwritten by it has such an advertisement slogan.
The reporter combed through the "Huiminbao" products in various places and found that most of these products are not limited to age and occupation, do not require medical examinations, and have no waiting period.
The insured amount ranges from several million yuan, and the price ranges from tens to hundreds of yuan.
"It is really attractive to be able to obtain high medical insurance for the price of a meal." Ms. Wang, a citizen of Ningbo, recently bought a local "Tianyi Yongning Insurance" for 100 yuan.
She told the reporter: "I have pre-existing medical conditions, which cannot be purchased in many traditional commercial medical insurances. This product will include the sick body in the scope of coverage, which can provide additional protection."
In the eyes of industry insiders, the current consumer awareness of insurance is getting stronger and stronger, and they hope to have better risk protection.
"Huiminbao" has the characteristics of low threshold, low premium, and high insurance amount, which meets the actual needs of consumers to improve medical security and reduce medical expenses.
Open insurance to new citizens and continuously expand special drug responsibilities
With the rapid development of the business, "Huiminbao" has presented some new features in recent years, such as the expansion of the scope of insurance, the increase of protection responsibilities, and the improvement of the timeliness of claims.
At the beginning of November, the 2023 "Beijing Pratt & Whitney Health Insurance" officially opened for enrollment, and the coverage of the population was further expanded.
The reporter learned that, in addition to the insured persons of Beijing's basic medical insurance, groups with Beijing household registration or Beijing residence permit and who have participated in basic medical insurance in other places can participate in the insurance.
"I immediately insured my parents." Mr. Li, who works in a company in Beijing, said that his parents came to Beijing from other places to help take care of their children a few years ago. Very peace of mind.
"Beijing Puhui Health Insurance" includes people who are not covered by Beijing medical insurance, which solves a big problem.
Not only in Beijing, but in Changsha, Changzhou, Guangzhou and other places, more and more cities' "Huiminbao" products are open to new citizens to insure.
"Huiminbao" products protect the scope of the population continues to expand, the protection responsibility is also expanding.
Qingdao’s “Qindao eBao” increased the positive list of drugs outside the scope of medical insurance to 2,000; Shanghai’s “Huhuibao” included CAR-T and other new precision targeted "According to the needs of citizens for special medicines, the list of special medicines will be dynamically adjusted and perfected...
The relevant person in charge of Ping An Annuity said that the special medicines and treatment methods required for the treatment of some major diseases are often expensive and bring a greater burden to patients.
The "Huiminbao" product focuses on expanding the responsibility for special medicines, allowing high-end medical technologies and medicines to benefit more patients, achieving the effect of "treating serious diseases and reducing burdens".
The time limit for claim settlement has always affected the hearts of patients, and many places have launched measures to facilitate claim settlement.
According to Guan Yijun, head of the Ningbo Puhui Insurance Public Service Center, the 2023 "Tianyi Yongning Insurance" claims settlement will be more convenient, and self-paid medical expenses for hospitalization and special disease outpatient clinics in Zhejiang Province can be settled in medical institutions. One-stop" real-time settlement, that is, simultaneous settlement with basic medical insurance.
This move will effectively alleviate the burden of patients' large medical expenses advances and avoid the trouble of running errands for claims.
How to better benefit the people?
It is worth noting that although "Huiminbao" continues to be popular, its business model, guarantee responsibility, rate level, and value-added services are still being explored, and multiple parties need to work together to promote its healthy and sustainable development.
"In some areas, the security plan has insufficient data and lacks risk calculations. It does not combine basic elements such as local economic development, medical expense levels, basic medical insurance policies, and insurance coverage, and does not make full use of past medical insurance data for actuarial pricing." Relevant departments of the China Banking and Insurance Regulatory Commission The person in charge said that insurance companies should formulate protection plans in a scientific and reasonable manner in accordance with the principles of continuous operation and risk control.
Experts said that the medical insurance department can provide medical insurance big data support for the product design of "Huiminbao".
Insurance companies should reasonably estimate the number of insured people based on relevant data such as basic medical insurance and critical illness insurance, and do a good job in premium calculation and protection plan formulation.
At the same time, consider introducing a long-term rate adjustment mechanism. On the one hand, the insurance period can be appropriately extended from the current one year to three years or more. On the other hand, the rate level can be adjusted in a timely manner according to the compensation situation every year, so as to improve the operation of "Benefit Insurance" continuity and stability.
The reporter's investigation found that the deductibles for hospitalization and special outpatient services of the current "Huiminbao" products are generally between 5,000 yuan and 20,000 yuan, which is relatively high overall.
At the same time, the compensation rate of "Huiminbao" in some areas is not high.
All of these affect consumers' sense of acquisition to a certain extent.
People in the industry suggest that for "Huiminbao" products with a low compensation rate, the treatment level of policyholders can be optimized by reducing the deductible, expanding the scope of reimbursement, and increasing the reimbursement ratio.
In order to bring more benefits to the common people, "Huiminbao" should not be limited to traditional compensation for risk losses, but should also focus on health management and intervention on health risks.
Yu Ze, vice president of PICC Group, said that while insurance companies provide inclusive health protection, they can also provide health management services such as health consultation, early screening of major diseases, drug services, medical services, and rehabilitation care for the insured, and improve the health management services including The sense of acquisition and satisfaction of insurance participants, including healthy people, with insurance services, thus effectively improving the participation rate and renewal rate of "Huiminbao".