According to the Municipal Medical Insurance Bureau, the 2024 Shanghai Urban Customized Commercial Supplementary Medical Insurance "Shanghai Huibao" insurance window was officially opened today (April 23)! The premium remains unchanged at 129 yuan / year, and from now until 24 o'clock on June 30, Shanghai basic medical insurance (including employee medical insurance, resident medical insurance) participants can apply for insurance. The coverage period is from July 1, 2024 to June 30, 2025. See ↓ for details
The 2024 version of "Shanghai Huibao" is guided by the Shanghai Municipal Medical Security Bureau, supervised by the Shanghai Regulatory Bureau of the State Financial Supervision and Administration Administration, provided technical support by the Shanghai Big Data Center, coordinated by the Shanghai Insurance Association, and underwritten by the chief underwriter of China Taibao Life Insurance, and jointly underwritten by 8 insurance companies including Chinese Life, Xinhua Life, PICC Health, Ping An Health, Taiping Property Insurance, CCB Life, BOCOM Life Insurance, and ICBC AXA.
As a new city card of Shanghai, "Shanghai Huibao" has been guarding the citizens of Shanghai for three years, continuing to adhere to the principle of "government guidance, commercial operation, benefiting the people and benefiting the people", co-insurance insurance companies cohesion, adhere to product innovation, model innovation, service innovation, the cumulative number of insured people in three years exceeded 20 million, is the largest Huimin Insurance project in the country, has become an important practice of inclusive finance in Shanghai.
As of the end of March 2024, the cumulative number of cases closed in three years has exceeded 650,000, with a cumulative compensation amount of more than 1.6 billion yuan, benefiting hundreds of thousands of families, with the oldest beneficiary being 104 years old and the youngest beneficiary only 3 months, with a cumulative maximum compensation amount of 2.436 million yuan for a single person in three years, effectively reducing the burden of medical expenses on the insured. At the same time, the application rate of electronic diagnosis and treatment data for claims has reached 75%, and the average time limit for closing cases is only 2.3 days, which improves the customer service experience, provides timely and effective help for all kinds of patients, and alleviates the burden of patients' family medical expenses.
In 2024, the premium of "Shanghai Huibao" will remain unchanged at 129 yuan/year, but the protection responsibility will be upgraded again, that is, on the basis of maintaining "low premium, high protection and wide coverage", compared with 2023, the five major protection responsibilities will achieve "one expansion, one excellence, and one increase":
An expansion
Expand the cost of out-of-pocket treatment for hospitalization, and include treatment expenses in the scope of insurance on the basis of protecting self-financed drugs, consumables, and examinations, so as to further reduce the burden on patients;
One excellent
The deductible is optimized, the basic deductible is reduced from 16,000 yuan/year in 2023 to 12,000 yuan/year, customers who have been insured for two consecutive years and have no claims can enjoy a deductible of 11,000 yuan/year, and customers who have been insured for three consecutive years and have no claims can enjoy a deductible of 10,000 yuan/year, lowering the threshold for claims;
One increase
The types of domestic and foreign special drugs have been increased, the number of domestic specific high-value drugs has been expanded from 36 last year to 41, the number of overseas special drugs has increased from 15 to 28 last year, and the number of CAR-T treatment drugs has increased from 2 to 3 last year, covering the high-incidence diseases of Shanghai citizens and expanding the beneficiary group.
In 2024, the service experience will be further optimized, and the service model will be empowered by scientific and technological innovation, which will further improve the convenience of claims settlement and enhance the sense of gain of the insured.
First, in order to alleviate the financial pressure of patients facing serious illness treatment and create a fast claim service experience, the 2024 version of "Shanghai Huibao" will open a direct compensation service for proton and heavy ion hospitals to solve the pressure on patients to advance funds, up to 300,000 yuan/year/person.
Second, with the collaborative support of the Shanghai Big Data Center and the Shanghai Medical Insurance Center, the blockchain technology is applied to upgrade the active claim service, so that the insured can "enjoy without application" after authorizing the service, and after being discharged from the hospital, those who meet the claim conditions of "specific hospitalization self-paid medical expenses insurance" can be automatically compensated without applying, creating the first chain of public services.
The third is to add two exclusive health rights, the insured can enjoy a 9% discount on self-paid drug purchases at offline designated pharmacies in Shanghai (covering 16 administrative districts of the city, over 2000+ pharmacies) and online designated malls, and at the same time enjoy online graphic consultation service discounts for specialists in tertiary hospitals, which are open 24 hours a day, 7 ×, to meet the daily medical needs of customers for mild symptoms and night services.
The 2024 version of "Shanghai Huibao" continues to be inclusive in terms of wide coverage and low threshold, and there is still no restriction on household registration, as long as it is a basic medical insurance participant in Shanghai, it can be enrolled. At the same time, it supports the purchase of medical insurance personal account balance, and the insured person can use the personal account balance of the past year to enroll up to 6 immediate family members (parents, spouses, children).
In addition, in order to further respond to the advocacy of the financial regulatory authorities on actively serving new citizens, in 2024, we will further promote the expansion of the coverage of new citizens to participate in the insurance, and under the guidance of the government, we will continue to expand the form of group orders in the past, steadily expand the number of insured enterprises, and continue to promote the health protection level of new citizens.
From now until 24:00 on June 30, participants of Shanghai basic medical insurance (including employee medical insurance and resident medical insurance) can apply for insurance through multiple channels such as the "Shanghai Huibao" official account, Sui Shenban, Alipay, Tencent Micro Insurance, and insurance code. At the same time, you can also apply for insurance by scanning the QR code of the relevant financial institution. Some groups such as the elderly who are inconvenient to apply for insurance online can give feedback on their insurance needs by dialing 4008955550 telephone, and there will be a service specialist to follow up on the follow-up insurance work. The coverage period is from July 1, 2024 to June 30, 2025. Shanghai citizens can quickly enroll in insurance online to add an extra layer of protection for themselves and their families.
Editor: Zhou Mengzhen
Source: Shanghai
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