Industry News | "Beijing Pratt & Whitney Health Insurance" officially launched

On November 1, 2022, the 2023 "Beijing Universal Health Insurance" launch conference was held in Beijing, and relevant leaders of Beijing Municipal Medical Security Bureau, Beijing Municipal Financial Regulatory Bureau, Beijing Regulatory Bureau of China Banking and Insurance Regulatory Commission, and representatives of six member units of the co-insurance body witnessed the official release of "Beijing Universal Health Insurance".

From now on, the public can follow the official designated insurance platform "Beijing Universal Health Insurance" WeChat public account to apply for insurance online, can also search for "Beijing Universal Health Insurance" online insurance on Alipay, can also consult the professional staff of 6 insurance companies to apply for insurance, and can also purchase through the Industrial and Commercial Bank of China, Agricultural Bank of China, Bank of China, China Construction Bank, Bank of Communications, Postal Savings Bank of China, Bank of Beijing, Beijing Rural Commercial Bank offline outlets. The coverage expires on December 31, 2022 and is valid from January 1, 2023 to December 31, 2023.

The annual premium is 195 yuan, with a maximum coverage limit of 3 million yuan. In 2023, "Beijing Universal Health Insurance" is jointly guided by the Beijing Municipal Medical Security Bureau and the Beijing Municipal Financial Supervision Bureau, supervised by the Beijing Regulatory Bureau of the China Banking and Insurance Regulatory Commission, underwritten by Chinese Min Insurance and Chinese Life, jointly insured by Taikang, Pacific Insurance, Ping An of China and Beijing Life, and provided by Yidu Cloud as the main operating platform. The product protection scheme is closely linked to basic medical insurance, further improving the ability of Beijing citizens to cope with the burden of high medical expenses.

Government supervision is more secure and sustainable development is guaranteed

First, the government strengthens guidance and supervision. Establish a government supervision mechanism to ensure that products are fully compensated, fully protect the rights and interests of insureds, promote the healthy and sustainable development of products, and promote the construction of a multi-level medical security system.

Second, the medical insurance account can be paid. From now on, the insured person of the basic medical insurance for urban workers in this city can use the funds from the medical insurance personal account to purchase "Beijing Inclusive Health Insurance" for himself; After the platform or the medical insurance agency in each district is processed), the balance of the medical insurance account can be used to pay for the spouse, parents and children who can enjoy the basic medical insurance in Beijing, and one person can pay for the insurance for the whole family.

The premium of 195 yuan remains unchanged, and the protection is fully upgraded

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.

In 2023, "Beijing Pratt & Whitney Health Insurance" has made a major upgrade to the product plan on the basis of unchanged premiums:

The first is to expand the coverage of the insured population. In addition to the insured persons of the basic medical insurance in this city, all new citizens of Beijing who have Beijing household registration or a Beijing residence permit and have participated in the basic medical insurance in other places can participate in the insurance.

The second is to reduce the deductible and optimize the structure of special drugs. 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 uniformly reduced to 0 yuan, and the number of domestic special medicines has increased to 40, which is more in line with people's medication needs. (Note: The original protection plan of "Beijing Inclusive Health Insurance" in 2022 is used as a comparative example)

Third, online quick compensation is more convenient. 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 the claim, simplifying the claim settlement process and improving the speed of claim settlement!

Fourth, the health management service experience is excellent. 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. Apply to reach more healthy people and enhance the experience.

Closely connected to medical insurance, both internal and external medical insurance can be reported

The State Council calls for accelerating the development of commercial health insurance to help deepen the reform of the medical security system. It is proposed to support the development of more insurance products for serious illnesses, do a good job of connecting and supplementing with basic medical insurance, etc., and improve the ability of urban and rural residents to guarantee serious illness insurance. Based on the needs of policy development, the 2023 "Beijing Inclusive Health Insurance" will start with expanding the coverage of the population and the scope of reimbursement, so as to effectively reduce the burden of Beijing citizens' personal medical expenses.

The scope of the insured population of "Beijing Inclusive Health Insurance" in 2023: First, the insured population closely linked to the basic medical insurance of the city: the insured persons of the basic medical insurance of the city (basic medical insurance for urban workers, basic medical insurance for urban and rural residents) ); the second is the expansion of the insured population this year: specific groups 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 permit and have participated in the basic medical insurance in other places. No age limit, no occupation limit, no health condition limit, the whole family can be guaranteed.

In the first year, if you are insured as a healthy person, even if you suffer from specific pre-existing conditions during the insurance period, you can still get compensation according to the treatment standard for healthy people after the renewal in 2023; this year, the standard for specific pre-existing conditions has also been adjusted, and diabetics without complications are no longer considered specific. Pre-existing conditions can be paid in proportion to the healthy population. For healthy people/specific pre-existing conditions, you can learn more about the “Beijing Pratt & Whitney Health Insurance” WeChat public account. Here, I would like to remind the general public to apply for insurance as soon as possible.

According to reports, "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 special drugs at home and abroad. , providing supplementary protection to the basic medical insurance for the insured.

One is the self-payment liability in the medical insurance (outpatient and inpatient medical expenses in the basic medical insurance catalogue): ①The insured amount is 1 million yuan/year. ②The deductible is the same as the standard amount of basic medical serious illness insurance in Beijing in the current year of the coverage period. ③Individuals pay medical expenses above the threshold of basic medical insurance and serious illness insurance, and the payment ratio is 80% for healthy people and 40% for people with specific pre-existing conditions.

The second is the out-of-medical hospitalization liability: ①The insured amount is 1 million yuan/year. ②The deductible is 15,000 yuan (20,000 yuan for specific pre-existing conditions). ③ The benefit ratio is 70% for healthy people and 35% for people with specific pre-existing conditions. The annual reimbursement ceiling for a single drug is 300,000 yuan; for a single implant or consumable, the annual reimbursement ceiling is 100,000 yuan.

The third is the responsibility for special medicines: (special medicines for domestic special medicines purchased in outpatient clinics or pharmacies of designated medical institutions for medical insurance; special medicines for foreign special medicines that are prescribed and prescribed by designated medical institutions in Boao Lecheng, Hainan): ①The insured amount of domestic special medicines is 50 10,000 yuan/year, foreign special drug insurance coverage is 500,000 yuan/year, and the total insurance coverage is 1 million yuan/year. ②The deductible is 0 yuan. ③ The payment ratio is 60% for healthy people and 30% for people with specific pre-existing conditions.

Beijing Municipal Medical Security Bureau and other relevant government departments manage specific groups of people, who have Beijing household registration or Beijing residence permit and who have participated in basic medical insurance in other places. The medical insurance responsibility of "Beijing Inclusive Health Insurance" only covers hospitalization. Other benefits are the same.

If you have any other questions about the "Beijing Pratt & Whitney Health Insurance" product and insurance coverage, you can follow the "Beijing Pratt & Whitney Health Insurance" WeChat public account to contact online customer service or call the official customer service number 4000761788. The service hours during the insurance period are 8 :00-21:00.