IVF will enter the medical insurance to assist the reproductive market?Insurance is only embryo transplantation. Can't buy over 40 years of age ... Will it improve?

After the two -child policy liberalized, Li Li (pseudonym), 43, wanted to have a daughter again and made a "good" word. Because she was too old to be too old and naturally conceived, Li Li went to Thailand to try IVF. But it took more than 700,000 yuan before and after, but it was still unsuccessful.

Recently, the auxiliary reproductive technology such as IVF has been incorporated into medical insurance, and IVF insurance under the air outlet has also received attention.

However, there are also some couples lamenting: insurance only compensate for transplantation failure, but there are risks in each link of test tubes; there are so few models to pick and choose, and there are too few choices; Sixty -thousand insurance is not enough; if you are 40 years old, you can't buy it, it is a pity ...

From the current situation, the success rate and expensive cost are still the pain that IVF cannot be avoided. However, IVF insurance on the market is generally only for women under 40 years of age. The service targets are conservative, the scope of protection is narrow, and the compensation is also limited. Recently, the National Health and Health Commission has made it clear that the auxiliary reproductive technology will be included in the medical insurance in accordance with the procedures. As an important supplement to basic social security, how far is commercial insurance from taking off?

Every 8 couples have one pair of difficulties

Auxiliary fertility is expected to usher in the 100 billion market

According to the data released by the National Health and Health Commission and the China Population Association, the infertility rate of couples in the childbearing age climbed from 2.5%-3%20 years ago to about 12%-15%in recent years, and about 5,000 infertility. Thousands of people. It is reported that every eight couples in my country have one pair of fertility problems, but IVF costs tens of thousands of yuan, 100,000 yuan, and the success rate of 40%-50%, which has repelled many families.

Feng Na (pseudonym), who lives in Jiangxi, has experienced two shifts, but ended in failure. "It has spent more than 100,000 test tubes, and the toll and rent also cost nearly 20,000. Only my husband makes money to support his family. He and he are too tired." Feng Na admits that this is not only mental pressure, but also economic pressure, but also economic pressure Essence After discussing with her husband again and again, the two decided to give up and never seek medical treatment again.

Under the trend of aging the trend, assisting reproductive technology has become one of the means to alleviate the pressure of some population. Recently, the National Health and Health Commission has clearly released the signal that the auxiliary reproductive technology is incorporated into medical insurance in accordance with the procedures. According to the "Guiding Opinions on Further Importing and Implementing Active Fertility Support Measures" issued by the 17 departments, it will gradually incorporate the appropriate childbirth analgesic and auxiliary reproductive technology projects in the scope of the medical insurance fund payment in accordance with procedures.

The gradual incorporation of auxiliary reproductive technology projects will also promote the release of the auxiliary reproductive demand. According to the calculation of the Institute of Open Source Securities, the size of the auxiliary reproductive market by 2023 is expected to increase to 40 billion yuan, which is expected to exceed 100 billion in the long run.

As the auxiliary reproduction was pushed to the spotlight again and again, IVF insurance has also become a hot topic. Beijing Commercial Daily reporters learned that before the medical insurance was covered, some insurance companies with a keen sense of smell have begun to explore special insurance for assisting reproductive, mainly due to IVF insurance for embryonic transplantation failure. Ru Tai Kang online released "Wish Pregnancy IVF Insurance" in 2016. In addition, insurance companies such as Chinese Civil Insurance, Bohai Property & Casualty Insurance, and Ping An Insurance have also launched IVF insurance.

The premium of 3700 yuan starts at 3700 yuan

What can be guaranteed?

What are the test tubes that can be bought now? The Beijing Commercial Daily reporter found that the test tube insurance currently on sale is mostly customized products, which are sold in specific scenarios.

There are two ways to buy IVF insurance: the first is to buy separate insurance directly. Before buying, customers need to choose a hospital to ensure that their choice hospitals are within the scope of insurance coverage. If you buy a separate insurance directly, the price ranges from 3700 yuan to tens of thousands of yuan. The lowest guarantee amount is 50,000 yuan, up to 200,000 yuan.

A IVF insurance that can be directly insured

The second method of buying does not need to choose a hospital in advance. Instead, it is directly purchased for IVF packages. The package contains the medical expenses of IVF, as well as services such as insurance and appointment. The difference between the first purchase method is that the second purchase method not only needs to consider insurance compensation, but also the number of hospitals and the number of excretion. , Choose Hospital, etc.

Taking the "IVF Pack" package launched in Beijing in Beijing as an example, one shift is promoted, and the package price is 68,000 yuan. 818,000 yuan. After purchasing, you can choose to receive test tubes in Haidian Maternal and Child, 306 Hospital, Naval General Hospital and other hospitals.

The test tube baby package introduced to Beijing Commercial Daily reporter for peanut medical consultants

It is reported that the IVF insurance on the market generally cooperates with hospitals and reproductive health consulting companies. After purchasing insurance, not only can it be guaranteed, but also a reproductive consultant or online customer service, offline companionship and other services.

However, it is worth noting that IVF insurance has no imagination in actual landing. Beijing Commercial Daily reporters sorted out and found that only a few insurance companies have launched several sporadic products at present, and there is a small choice space. In addition, many IVF insurance binds the entire auxiliary reproductive services, rather than selling it alone as the main product.

In this regard, Yang Zeyun, a teacher at the Department of Finance, School of Management of Beijing United University, said that the difficulty of developing baby insurance insurance is that there are fewer historical data. According to the data of the Health Commission, in recent years, there are 300,000 -assisted reproductive babies in my country in recent years. Among them, there are fewer IVF babies, and less related data controlled by insurance companies. In addition, IVF is 40%-50%. According to the simplicity of the test tube failure, this means that nearly 10%of the insured will have claims. In this way, the insurance company's operating risk is high. And because of the high loss rate and high cost, it may face the dilemma of limited market demand. Not only does the product type have few types of products, the scope of the protection of IVF insurance needs to be expanded. A reporter from Beijing Commercial Daily found that the commercial insurance launched by various insurance companies currently is mainly aimed at the steps of embryonic transplantation. For ovulation promotion, egg retrieval, fertilization, and fetal protection "zone.

There is a threshold for buying

If you do not meet the standard, you will be "out of the door"

In addition to the problem of product types and scope of guarantee, reporters from Beijing Commercial Daily inquired about it that whether it is directly buying insurance or choosing a IVF package, there will be a certain threshold, such as women's age, whether men are dead, the number of previous IVF failures, and the number of previous infants failed, and AMH indicator, etc.

In terms of age, the scope of insurance is mostly 20-35 or 20-40 years old. Women who are not at this age cannot be purchased. It is also necessary to meet the women's less than 1 in half a year (there are also product requirements that AMH is not less than 1.2), follicle stimulus FSH is less than 10, and the history of previous transplantation/insemination failure is less than or equal to 3 times.

"Can these conditions be insured if they are met? Will it be reviewed before the insurance?" Faced with the consultation of a reporter from the Beijing Commercial Daily, the consultant of peanut medical treatment sent a list of underwriting information to reporters.

Caption: List of underwriting information

The underwriting list shows that before the insurance is insured, the normal hysteroscopy, the male semen non -dead essence and non -100%abnormality, and the normal chromosomes of the male and female chromosomes.

A obstetric medical worker of a three -level hospital told reporters that most of the IVF insurance excludes elderly women over 40 years of age to participate in the insured.

Because the "three -child" policy is open, more and more older women want to give birth through IVF, and they are the main force of the three -generation test tube demand for the three -generation test tube.

In addition, IVF insurance also has some exemptions in the process of claims. The Beijing Commercial Daily reporter inquired about the product clauses that if surrogacy such as surrogacy violated human IVF technology, medical accidents or medical faults occurred, and the insurance company did not assume insurance liability for insurance companies.

Li Wenzhong, deputy director of the Insurance Department of the University of Economic and Trade University, also reminded that such insurance products generally agreed that the number of auxiliary fertility during the insurance period. Only all failures trigger insurance compensation. You need to bear responsibility, and you can only go to the medical institution designated or recognized by the insurance company for IVF embryo transplantation and examination, otherwise the insurance company will not bear the insurance liability.

Facing potential markets

What will the insurance company do?

In the current state, Li Wenzhong analyzed that because the successful embryo transplantation of test tube and the quality of the embryo and the physical condition of women, often those consumers who have suffered many failures are more willing to insure, and the reverse choice is more serious. Insurance companies operate this type of insurance products are more difficult in risk control and pricing.

In fact, the service object of IVF insurance is divided into conservatives and small guarantees, which is the consideration of insurance companies for profit. Because IVF insurance is a typical low -frequency and high -priced medical projects, if the risk control occurs in the early stage, it is very easy to have underwriting losses.

In June 2021, a head property insurance company revealed that the company's IVF insurance was temporarily losing money. It is necessary to wait for the fertility policy to be further liberalized and the insurance pool is further expanded. Nowadays, the "three -child" policy has been liberalized, and a reporter from the Beijing Commercial Daily consulting some insurance companies on the IVF Insurance Insurance Insurance Consultation has not yet received a positive response.

So how will it affect the commercial insurance market after the policy "blessing" and the auxiliary reproduction is included in medical insurance? The relevant person in charge of Taikang Online said that at present, the commercial insurance company has strong willingness to assist the reproductive field. It needs to be connected to the reimbursement of fertility expenses with social security to further alleviate the pressure of patients' self -funded payment.

If the insurance company designs a more attractive type of insurance with larger coverage, wider range of protection, and higher compensation rates, not only can alleviate the pressure of patients' self -funded payment, promote the expansion of the auxiliary reproductive market, but also in turn drives the relevant insurance market develop.

Li Wenzhong also stated that in the context of encouraging fertility and support for fertility and support, insurance companies should carefully study and analyze the risk guarantee needs in the process, actively develop design and design related insurance products, accumulate relevant data for market competition Opportunity. It also said that insurance companies can appropriately relax the age range of the insured, which is conducive to the sales and promotion of such insurance products.

In addition, the entire IVF process is a long -term medical treatment process. Insurance is an important means for transferring payment. So is it expected to insured the medical expenses of the entire IVF in the future?In this regard, Yang Zeyun said that the current test tube baby insurance mainly underwritten the cost of the failure of IVF, and the successful medical expenses of IVF's success are not low.However, from the requirements of insurance (the uncertainty of the insurance company for the uncertainty of whether or not to pay) and high moral risk consideration, a reasonable insurance time point and the guarantee period need to be set.Reporter 丨 Chen Tingting Li Xiumei

Edit 丨 Wang Naixin

Image 丨 Peanut Medical Consultant provided, IVF promotion maps, one picture network, visual China

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