Photo: VCG

China aims to basically achieve nationwide zero out-of-pocket payments for childbirth expenses for those who are covered by policy, Zhang Ke, Party Secretary and Director of the National Healthcare Security Administration (NHSA), said on Saturday at a national medical insurance work conference held in Beijing, according to The Paper.

Zhang said that in 2026 China will actively adapt its medical insurance system to the country's population development strategy and promote the development of maternity insurance and long-term care insurance. Efforts will be made to expand maternity insurance coverage to flexible workers, migrant workers, and people in new forms of employment, per the report. 

The level of coverage for prenatal medical examinations will be reasonably increased, with the goal of basically achieving zero out-of-pocket payments for policy-covered childbirth expenses nationwide. Eligible labor analgesia services will also be included in medical insurance fund payments in accordance with procedures, said Zhang.

Zhang noted that in recent years China has comprehensively enhanced coverage for inpatient childbirth expenses and actively promoted full reimbursement of policy-covered maternity medical costs. Seven provinces, including Jilin, Jiangsu and Shandong, have already taken the lead in achieving near-zero personal expenses for childbirth. 

"The goal is that from the moment a pregnant woman enters the hospital until she leaves holding her baby, insured individuals will basically not have to pay out of pocket for expenses incurred during inpatient delivery that fall within the medical insurance catalogue," he said, according to The Paper.

The NHSA said it will fully implement the direct payment of maternity allowances to insured individuals in accordance with procedures and comprehensively advance the long-term care insurance system, while optimizing the supply of long-term care services. Commercial insurers will be encouraged to develop commercial long-term care insurance products.

Zhang also said that in 2026 China will optimize medical insurance payment and settlement mechanisms to promote the healthy development of the healthcare sector. Authorities will release a version 3.0 diagnosis-related group (DRG) payment classification plan, fully implement quarterly or monthly special case reviews, and support the clinical use of new drugs, medical consumables and technologies, as well as the treatment of complex and severe diseases, per the report. 

Efforts will also be made to support the development of primary-level medical institutions and promote tiered diagnosis and treatment, The Paper reported. The prepayment of medical insurance funds will be increased, real-time settlement of medical insurance funds will be fully advanced, quarterly settlement will be explored, and the compilation of 40 batches of pricing guidelines will be completed to achieve basic nationwide uniformity in medical service pricing items, The Paper reported.

Global Times