Huizhou Launches City-Exclusive "Hui Min Bao" to Strengthen Multi-Tiered Medical Security System

Following the launch of Guangzhou’s inclusive commercial supplementary medical insurance product, “Guangzhou Huiminbao,” last December, Huiminbao has expanded further in Guangdong Province. The customized Huiminbao plan exclusive to Huizhou City was launched on March 1.

It is understood that Huiminbao, tailored to the local medical and healthcare security conditions in Huizhou and drawing on the mature experiences of cities such as Shanghai, Guangzhou, and Shenzhen, is jointly launched by Pacific Insurance and Medbanks Health. Leveraging Pacific Insurance’s professional expertise and robust underwriting capacity, along with Medbanks Health’s years of accumulated medical data advantages and healthcare service experience, the product provides Huizhou policyholders with convenient “one-stop insurance coverage + healthcare services.”

According to the project leader at Pacific Insurance, “Huiminbao” is designed to complement basic medical insurance and break through conventional commercial insurance rules. It offers a uniform premium for all age groups, with no age restrictions, allowing individuals aged 0 to 100 to enroll. There is no waiting period; coverage takes effect immediately upon purchase and lasts for one full year. The scope of covered medical services has been expanded to include hospitals designated by basic medical insurance, aligning with the coverage scope of Huizhou’s social security and medical insurance programs. To facilitate patient access to the 15 specific high-cost drugs covered under the plan, the policy provides convenience for out-of-hospital drug purchases, allowing patients to buy these medications at designated pharmacies. This product aims to help residents alleviate the substantial out-of-pocket medical expenses associated with critical illnesses and the high cost of self-paid drugs for specific conditions, while also providing insured individuals with professional, high-quality health management services.

As the premium scale of health insurance rapidly climbed from RMB 67.7 billion in 2010 to over RMB 700 billion in 2019, its contribution to medical expenditures remained minimal, accounting for only 2.6% in 2018.

The Outline of the Healthy China 2030 Plan, previously issued by the Central Committee of the Communist Party of China and the State Council, states: “By 2030, the proportion of commercial health insurance claim payouts in total health expenditure will increase significantly.”

Building on the foundational layer composed of medical assistance and similar programs, and the main layer formed by basic social medical insurance, commercial health insurance is regarded as a crucial supplementary layer, in which the industry has placed high expectations.

Local governments across China are actively exploring models to integrate commercial health insurance with basic medical insurance. In 2019, Guangdong Province took the lead in Guangzhou by launching “Guangzhou Huiminbao,” under the joint guidance of the Guangzhou Municipal Healthcare Security Administration and the Administrative Committee of Guangzhou Development District. This March, Huiminbao was introduced in Huizhou, making it another city in Guangdong to offer an exclusive “Huiminbao” product. Additionally, with initiatives such as Shenzhen’s Government Critical Illness Insurance, Foshan’s “Fo Yi Bao,” and Zhuhai’s “Da Ai Wu Jiang,” Guangdong is at the forefront of improving a multi-tiered healthcare security system.

“Hui Min Bao, as a new form of commercial health insurance, has overcome many limitations of traditional commercial health insurance products through collaboration with government departments. It not only helps raise funds for social security and broadens the ‘moat’ of social medical insurance fund protection, but also better meets residents’ healthcare needs, representing a new exploration adapted to the development needs of China’s current medical security system.” Professor Fan Yangdong, Deputy Dean of the School of Health Management at Guangzhou Medical University, stated this, expressing hope that such truly effective supplementary medical insurance products will be continuously improved.

“Huiminbao” supplements Huizhou’s basic medical insurance. As of the end of March this year, all participants in Huizhou’s social medical insurance programs (including employee medical insurance, resident medical insurance, and the New Rural Cooperative Medical Scheme) are eligible to enroll individually, regardless of their household registration status. Meanwhile, local enterprises and organizations in Huizhou may also arrange group enrollment for their employees by April 15 this year.

The coverage scope of “Huiminbao” aligns with that of Huizhou’s social security medical insurance, encompassing all designated medical institutions. This ensures better coordination with medical insurance in claims processing. Notably, medical expenses incurred after January 1, 2020, are eligible for reimbursement as long as they fall within the coverage scope of Huiminbao.

Since the launch of Huiminbao, it has been compared with million-yuan medical insurance products on the market. In fact, both serve as important supplements to social security and can complement each other. For example, Huiminbao covers hospitalization and specific high-cost medications, some of which can be administered in outpatient settings.

Guided by local government authorities, Huiminbao demonstrates greater inclusiveness in product pricing, coverage scope, and pre-underwriting processes, thereby further expanding protection across multiple dimensions.

No age restrictions; individuals aged 0 to 100 are eligible for enrollment, provided they are covered by Huizhou’s Social Medical Insurance (including employee basic medical insurance, resident basic medical insurance, and the New Rural Cooperative Medical Scheme).

No waiting period; coverage period is one year.

According to the project lead at Pacific Insurance, “Huiminbao” broke through conventional commercial insurance rules in its design philosophy by offering a uniform premium for all age groups.

The maximum payout is RMB 1 million, with a deductible of RMB 20,000 and a reimbursement rate of 80% of the out-of-pocket expenses; the deductible is higher than the RMB 10,000 threshold common to most million-yuan medical insurance plans.

No medical examination is required, and individuals with a prior medical history are eligible for coverage; however, the 12 specified critical illnesses and conditions related to the 15 designated high-cost specialty drugs that were pre-existing before enrollment are excluded from coverage.

Following the conclusion of the individual enrollment period, Pacific Property & Casualty Insurance will assume unified underwriting starting April 1, with coverage taking effect immediately. However, for individuals who have already enrolled, the coverage period will still be calculated retroactively from January 1. Expenses incurred between January 1 and the date of enrollment that fall within the scope of insurance liability will also be eligible for reimbursement.

According to the "Huiminbao Catalog of Specific High-Cost Drugs," 15 high-cost out-of-pocket medications not included in the National Reimbursement Drug List have been selected. In response, Dr. Cai Xiuyu, Associate Chief Physician at the Sun Yat-sen University Cancer Center, stated in an interview with reporters that while the majority of current hospitalization expenses fall within the scope of medical insurance reimbursement, coverage for novel targeted therapies and immunotherapies remains inadequate.

According to the introduction, the "Huiminbao Specific High-Cost Drug List" covers the latest and relatively expensive drugs used in the treatment of certain high-incidence tumors, such as lung cancer, liver cancer, breast cancer, prostate cancer, and lymphoma. For example, dacomitinib is a targeted therapy for lung cancer; palbociclib is indicated for breast cancer; and lenvatinib mesylate capsules are used for liver cancer. These are all out-of-pocket medications not included in the National Reimbursement Drug List, with monthly costs amounting to tens of thousands of yuan. More importantly, patients often require combination therapies rather than single-agent treatment during their course of care, which would result in prohibitively high expenses if borne entirely out-of-pocket. “Including these drugs within the coverage scope of ‘Huiminbao’ represents the most significant and crucial advancement in protection for the vast majority of insured individuals,” Cai Xiuyu told reporters.

Various regions in Guangdong Province are vigorously exploring models for integrating commercial health insurance with basic medical insurance, leading to rising user expectations for health management services. In the product design of “Hui Min Bao” (inclusive supplemental health insurance), nine personal oncology medical services—including precise triage, medication delivery, clinical trials for new drugs, and charitable assistance—have been incorporated into the coverage framework.

The project lead at Medbanks Health stated that, leveraging years of accumulated medical data and healthcare service experience, Medbanks has partnered with Pacific Insurance to design Huiminbao (inclusive commercial health insurance) products. Medbanks provides technical support encompassing product design, medical services, system development, promotional operations, and specialty drug management. By implementing precise policies and targeted interventions, the company aims to help build a nationwide healthcare system covering all citizens.

Professor Fan Yangdong of Guangzhou Medical University believes that the integration of health management services into Huizhou’s “Huimin Bao” supplementary insurance facilitates a shift from a treatment-centric to a prevention-centric model, enhances citizens’ awareness of disease prevention and health management, and contributes to overall healthcare cost savings. As the pooling areas of basic medical insurance are upgraded, the development of city-level health security systems will become more tailored to local conditions. It is therefore necessary to accelerate the industrial integration of various sectors within the broader health industry chain to better meet citizens’ increasingly diverse health needs.