Since the "Beijing Universal Health Insurance" officially came into effect on January 1, 2022, claims settlement services have been carried out in an orderly manner. Following the completion of the first domestic special drug claim payment on January 12, on the 21st, the first overseas special drug claimant of "Beijing Universal Health Insurance" was generated, and the compensation payment was received on the night of admission to the designated hospital in Hainan (Boao Evergrande International Hospital).
Pre-existing status insurance, without going abroad can afford to buy, use overseas new drugs and special drugs, which is of great breakthrough significance for overseas special drugs to gradually benefit the people of the whole country through the benefit of the people insurance products, to achieve cross-border medical medication and insurance claims efficient combination and development.
Patients with pre-existing conditions receive efficient reimbursement
Do not go abroad to use overseas special drugs
"Beijing Inclusive Health Insurance" was launched on July 26, 2021, jointly guided by the Beijing Municipal Medical Security Bureau and the Beijing Municipal Financial Supervision and Administration Bureau, supervised by the Beijing Supervision Bureau of the Banking and Insurance Regulatory Commission, and jointly designed and developed by five insurance companies: Chinese Minsheng Insurance, Chinese Life Insurance, Taikang Insurance, China Pacific Insurance and Ping An of China. Since the product was opened for insurance, the "Beijing Universal Health Insurance" has attracted more than 3 million Beijing citizens to participate in the insurance.
In the first overseas claim case, the client, Ms. Li (pseudonym), was insured as a pre-existing condition. In July 2015, Ms. Li was diagnosed with lung adenocarcinoma and underwent multi-course chemotherapy and ALK targeted therapy at Beijing Cancer Hospital; in December 2021, the doctor gave a perfect examination and chemotherapy plan, and recommended the use of overseas special drug - lung cancer targeted drug Lobrena (loratinib); on January 7, 2022, Ms. Li applied for a claim online, and the Yuanxin Huibao claims service team contacted the family for the first time and then sent a professional doctor to provide 1-on-1 guidance. On the same day, according to the complete information, the rationality of overseas drug use was reviewed, and the admission schedule of the designated hospital (Boao Evergrande International Hospital) was communicated at the same time.
The claims adjuster learned that Lorbrena, the disease drug suffered by Ms. Li, was a drug in the "Beijing Universal Health Insurance" "List of Specific Drugs" according to the terms. On January 10, the service team of Yuanxin Huibao's compensation case communicated the progress of Ms. Li's overseas drug approval and got the customs clearance form on January 18; on January 19, the drug Lorbrena arrived at Boao Evergrande International Hospital to notify Ms. Li that she could go to the hospital for medication treatment; on the evening of January 20, Ms. Li arrived in Hainan; on January 21, she successfully handled the admission and completed the use of overseas drugs on the same day; on the night of the 21st, the yuanxin Huibao compensation service team completed the payment of the drug compensation within 30 minutes after receiving the patient's collection information.
Since the "Beijing Universal Health Insurance" officially came into effect on January 1, 2022, claims settlement services have been carried out in an orderly manner. Following the completion of the first domestic special drug claim payment on January 12, on the 21st, the first overseas special drug claimant of "Beijing Universal Health Insurance" was generated, and the compensation payment was received on the night of admission to the designated hospital in Hainan (Boao Evergrande International Hospital).
Pre-existing status insurance, without going abroad can afford to buy, use overseas new drugs and special drugs, which is of great breakthrough significance for overseas special drugs to gradually benefit the people of the whole country through the benefit of the people insurance products, to achieve cross-border medical medication and insurance claims efficient combination and development.
Patients with pre-existing conditions receive efficient reimbursement
Do not go abroad to use overseas special drugs
"Beijing Inclusive Health Insurance" was launched on July 26, 2021, jointly guided by the Beijing Municipal Medical Security Bureau and the Beijing Municipal Financial Supervision and Administration Bureau, supervised by the Beijing Supervision Bureau of the Banking and Insurance Regulatory Commission, and jointly designed and developed by five insurance companies: Chinese Minsheng Insurance, Chinese Life Insurance, Taikang Insurance, China Pacific Insurance and Ping An of China. Since the product was opened for insurance, the "Beijing Universal Health Insurance" has attracted more than 3 million Beijing citizens to participate in the insurance.
In the first overseas claim case, the client, Ms. Li (pseudonym), was insured as a pre-existing condition. In July 2015, Ms. Li was diagnosed with lung adenocarcinoma and underwent multi-course chemotherapy and ALK targeted therapy at Beijing Cancer Hospital; in December 2021, the doctor gave a perfect examination and chemotherapy plan, and recommended the use of overseas special drug - lung cancer targeted drug Lobrena (loratinib); on January 7, 2022, Ms. Li applied for a claim online, and the Yuanxin Huibao claims service team contacted the family for the first time and then sent a professional doctor to provide 1-on-1 guidance. On the same day, according to the complete information, the rationality of overseas drug use was reviewed, and the admission schedule of the designated hospital (Boao Evergrande International Hospital) was communicated at the same time.
The claims adjuster learned that Lorbrena, the disease drug suffered by Ms. Li, was a drug in the "Beijing Universal Health Insurance" "List of Specific Drugs" according to the terms. On January 10, the service team of Yuanxin Huibao's compensation case communicated the progress of Ms. Li's overseas drug approval and got the customs clearance form on January 18; on January 19, the drug Lorbrena arrived at Boao Evergrande International Hospital to notify Ms. Li that she could go to the hospital for medication treatment; on the evening of January 20, Ms. Li arrived in Hainan; on January 21, she successfully handled the admission and completed the use of overseas drugs on the same day; on the night of the 21st, the yuanxin Huibao compensation service team completed the payment of the drug compensation within 30 minutes after receiving the patient's collection information.
"Beijing Universal Health Insurance" mainly covers the triple guarantee inside and outside the medical insurance directory: one is the hospitalization + outpatient personal out-of-pocket expenses in the medical insurance directory, with a maximum insurance amount of 1 million yuan; the second is the out-of-pocket expenses of hospitalization outside the medical insurance directory, with a maximum insurance amount of 1 million yuan; the third is 100 kinds of high special drug costs at home and abroad, of which 25 kinds of domestic special drugs are insured for 500,000 yuan, and 75 kinds of foreign special drugs are insured for 500,000 yuan. This time, Ms. Li mainly enjoyed the guarantee of the cost of 75 foreign special drugs.
In the name of health protection
Professional services benefit more Chinese people
As a specific drug service enterprise of "Beijing Universal Health Insurance", Yuanxin Huibao exclusively undertakes 75 kinds of overseas special drug protection services, providing medication guidance, medication claims and other services for insured persons who meet the claim conditions, so that patients can use global innovative drugs without going abroad and going to Hainan Boao Lecheng.
Lecheng overseas special drugs were included in the "Beijing Universal Health Insurance", which is the first time that 75 unlisted special drugs of Lecheng have gone out of Hainan, and the first time that the insurance types of local multi-level medical insurance system reform in the capital have been included in the Lecheng special drug guarantee, and it is also the first case of the policy spillover cooperation and inter-provincial cooperation system innovation of Hainan Free Trade Port.
In 2020, Yuanxin Huibao and Hainan Boao Lecheng International Medical Tourism Pilot Zone Administration jointly established an insurance comprehensive service platform to inject new ideas into lecheng's health insurance industry with the help of Lecheng's first-mover policy advantages. Adhere to the basic principle of patient-centeredness, realize information sharing and refined operation management among various collaborative institutions.
As a specific pharmaceutical service enterprise with products such as "Beijing Universal Health Insurance", "Lecheng Global Special Drug Insurance 2021 Edition", "Jinhuibao 2021 Edition", "Jihuibao 2021 Edition", Lanzhou "Jincheng Huibao 2022" and other products, Yuanxin Huibao has carried out in-depth cooperation with many Chinese and foreign insurance companies, reinsurance companies, pharmaceutical companies and a number of health management companies while undertaking overseas special drug protection services, and is committed to solving the problem of out-of-hospital sales of drugs, and has reached a variety of models of cooperation such as special drug insurance and huimin insurance. It provides reliable medical and medical protection for people with major diseases, chronic diseases and other diseases and healthy people.
As overseas special drugs enter more and more provinces and cities across the country, so that international advanced medical resources and domestic health needs are effectively linked, so that patients can enjoy the most effective innovative drugs for the first time, this is the original mission of Lecheng Pioneer District to practice the people's health services, and it is also the responsibility of Yuanxin Huibao to benefit more Chinese people in the name of health protection.
It is reported that in order to ensure that the insured people make claims in a timely and efficient manner and enjoy the rights and interests of insurance, the yuanxin huibao compensation service team has established an efficient claim service channel to standardize the claim service process, no matter what channel the insured user purchases from, they can apply for claims online through the "Beijing Puhui Health Insurance" WeChat public account, or call the official customer service telephone 400-076-1788 for consultation. In the next step, Yuanxin Huibao will continue to upgrade the "online quick claims" service channel to further improve the speed of claims settlement and empower insurance companies to provide convenient, efficient, high-quality and accurate claims settlement services for the people.