By Fineline Cube China’s National Healthcare Security Administration (NHSA) and Ministry of Finance (MoF) jointly issued the “Notice on Implementing Cross‑Provincial Pooling for Personal Accounts of Employee Basic Medical Insurance (BMI)”, breaking geographical restrictions to enable nationwide family pooling of personal medical insurance accounts. The policy expands fund utilization from provincial to national levels, strengthening family mutual assistance and improving liquidity for 450 million insured employees and their 1.2 billion eligible relatives.
Regulatory Overview
| Item | Detail |
|---|---|
| Issuing Authorities | NHSA (National Healthcare Security Administration) & Ministry of Finance |
| Policy Name | Notice on Implementing Cross‑Provincial Pooling for Personal Accounts of Employee BMI |
| Publication Date | 09 Jan 2026 |
| Scope | Nationwide expansion (previously provincial‑only) |
| Eligible Participants | Close relatives of Employee BMI enrollees |
| Fund Utilization | Out‑of‑pocket medical/pharmacy expenses, Resident BMI contributions, Long‑term Care Insurance premiums |
| Settlement | Monthly full settlement via national allocation + provincial/municipal settlement |
Core Policy Details
Pooling Relationship Mechanics
- Voluntary Establishment: Both parties must voluntarily agree to create or dissolve pooling relationship
- Multiple Relationships: One contributor can establish pooling with multiple family members
- Automatic Termination: Relationship ends if contributor’s insurance status changes
- Fund Access: Within pooling limit, contributor cannot use pooled funds; unused portion returns upon dissolution
Eligible Recipients
Close relatives include:
- Spouse, children, parents
- Grandparents/grandchildren (if primary caregiver)
Fund Usage Scope
Pooled funds may cover:
- Out‑of‑pocket medical expenses for pooled members
- Pharmacy expenses at designated retailers
- Personal contributions to Resident BMI premiums
- Long‑term Care Insurance premiums
Operational & Financial Mechanics
Settlement Process:
- Frequency: Monthly full settlement
- Mechanism: National‑level unified allocation + provincial/municipal‑level settlement
- Prepaid Funds: Ensures timeliness; amounts adjusted dynamically based on utilization
- Information Systems: Full integration of operations, funds, and data flow required across all jurisdictional levels
Financial Impact on Funds:
- Increased Liquidity: ¥450 billion in employee personal accounts becomes nationally accessible, up from ¥180 billion under provincial pooling
- Utilization Rate: Expected to increase from 45% to 65% as family members access previously idle funds
- Pharmaceutical Market Uplift: ¥90‑120 billion additional annual spending capacity for out‑of‑pocket drugs and pharmacy products
Market Implications
Healthcare Sector Beneficiaries:
| Sector | Impact | Companies |
|---|---|---|
| Retail Pharmacies | +15‑20% prescription volume from cross‑provincial utilization | Sinopharm (1099.HK), Jointown (600998.SH) |
| Insurance IT Systems | ¥5‑8 billion investment in platform upgrades | Yidu Tech (2158.HK), WeDoctor |
| Chronic Disease Drugs | +12% demand for diabetes, hypertension meds | Hansoh (3692.HK), CSPC (1093.HK) |
| Long‑Term Care | +25% premium payment capacity | Ping An (2318.HK), CPIC (2601.HK) |
Implementation Timeline:
- Effective Date: 01 Mar 2026 (provisional)
- System Readiness: Provincial IT upgrades must be completed by 31 Dec 2026
- Full Compliance: Healthcare and finance departments must establish oversight frameworks by Q2 2026
Forward‑Looking Statements
This brief contains forward‑looking statements regarding the financial impact of nationwide pooling, pharmaceutical market growth, and IT system investment requirements. Actual results may differ materially due to implementation delays, regional compliance variations, and utilization rate uncertainties.-Fineline Info & Tech