Alipay Launches Commercial Insurance Code for Integrated Medicare and Commercial Insurance Settlement

To enhance the reimbursement experience for medical services, Alipay announced on December 13 the launch of the “Commercial Insurance Code,” enabling integrated payment for both basic medical insurance and commercial health insurance. After settling hospitalization fees using their basic medical insurance, patients can use the Commercial Insurance Code to apply for advance payment of remaining costs if needed, and subsequently file reimbursement claims with their insurance providers. Currently, users can activate this service by searching for “Commercial Insurance Code” on Alipay and applying for a medical expense quota as guided. Reportedly, the initial phase of the Commercial Insurance Code covers mainstream million-yuan medical insurance products offered by Taikang Online and ZhongAn Online, serving over 10 million users, with plans to expand coverage to more insurance institutions and policy types in the future.

Alipay Commercial Insurance Code

The "Blue Book on the Development of Commercial Medical Insurance in China," released this May, shows that 30.7% of respondents consider the reimbursement process cumbersome. For most million-yuan medical insurance plans, policyholders must pay medical expenses out-of-pocket first and seek reimbursement later, imposing a significant burden on hospitalized patients. Staff from an insurance company participating in the Commercial Insurance Code initiative provided an example to reporters: A patient holding a commercial health insurance product with a deductible of RMB 5,000 was hospitalized due to illness. After using their social medical insurance code, the patient still needed to pay RMB 15,000. At this point, the patient could apply for a credit limit as prompted and pay RMB 10,000 directly via the Commercial Insurance Code, without needing to cover this amount out-of-pocket. Within one week after payment, the patient can upload claim application materials online instead of visiting offline service centers, and any difference between the advanced payment and the insurer’s actual approved claim amount will be refunded or supplemented accordingly.

Furthermore, through the Commercial Insurance Code interface, users can query insurance policies held with partner insurers under their name, enabling one-stop management of personal insurance assets. Zhang Yu, General Manager of the Digital Medical Insurance Business Department within Alipay’s Healthcare Division, stated, “Alipay will continue to deepen collaboration with partners such as insurance companies to optimize product and service experiences. Payments via the Commercial Insurance Code will gradually expand to cover more insurers and insurance products.” It is reported that Commercial Insurance Code payments currently cover mainstream million-yuan medical insurance products offered by Taikang Online and ZhongAn Online, supporting patients at over 10,000 public medical institutions at secondary level or above across China during hospitalization.

In recent years, China has made concerted efforts to improve its basic medical security system, which features a three-tiered burden-reduction mechanism comprising basic medical insurance, critical illness insurance, and medical assistance. The National Healthcare Security Administration (NHSA) has repeatedly sent “positive signals” regarding data interoperability between basic medical insurance and commercial health insurance. In its recently issued document, *New Growth Drivers Enabled by Medical Insurance*, the NHSA stated that it is actively planning and exploring initiatives to leverage medical insurance data to empower commercial insurers, implement synchronized settlement between medical insurance funds and commercial insurance, and introduce other supporting policies. Industry experts believe that, with policy support from the NHSA and active exploration by relevant platforms, it may become possible to truly realize the vision of “letting data do the running so that the public does not have to,” significantly optimizing the service experience of commercial health insurance, further promoting effective integration between commercial health insurance and basic medical insurance, and increasing the proportion of commercial insurance payments in total national healthcare expenditures.

Public data shows that the number of national medical insurance code users has exceeded 1.12 billion, among which more than 600 million users have activated and used it through Alipay, making it the largest third-party activation and medical insurance payment channel officially recognized by the National Healthcare Security Administration. Since 2019, the Alipay platform has pioneered multiple medical insurance services such as family accounts for medical insurance, shared benefits within families, and mobile payments for medical insurance, actively responding to and exploring innovative applications of medical security in various scenarios.