On 10 13, financial industry news: The "7th Health and Pension Insurance Protection Index (2025) Launch Event," jointly organized by Xiaoyusan Insurance Brokerage, Shouhui Insurance Agency, and the School of Finance at Nankai University, was held in Tianjin. The event unveiled the "Health and Pension Insurance Protection Index (2025)" (hereinafter referred to as the "Report"). According to the report, the health insurance protection index for 2025 was 0.6428, an increase of 0.0187 compared to 2024. Residents' health protection levels continue to improve, with the protection structure steadily optimizing.
The report shows that the health security structure score rose from 0.7244 to 0.7944 in 2025, reflecting a marked increase in residents' awareness of multi-layered coverage. Synergy between basic medical insurance and commercial health insurance, as well as between critical illness and medical insurance, continues to improve. By tier distribution, 3% of the population now meets the basic level of health security—an increase of 8.18 percentage points since 2024. These results demonstrate significant progress in expanding coverage and strengthening foundations, with health security rapidly evolving from "broad reach" to "high quality."
Young people are emerging as a new force in health protection. By age group, those aged 26–30 scored highest at 0.6676, up 0.0463 from 2024, leading all other groups. The peak scoring age range has shifted from 36–40 to 26–30, reflecting growing awareness of health protection among younger generations, accelerated adoption of commercial health insurance, and increasing acceptance of the concept of lifelong health coverage.
Budgets are highly concentrated; structural innovation trumps responsibility stacking.
The report reveals a demand-side trend characterized by "high willingness, tight budgets": consumers expect increasingly comprehensive coverage—from multiple payouts for critical illnesses and disease care benefits to cancer allowances, specialty drugs, and chronic disease outpatient services. Yet, annual premium payment willingness is heavily concentrated in the mid-to-low range, with nearly 80% of respondents falling within the same budget bracket. This gap between coverage expectations and affordability represents a key opportunity for product innovation—neither requiring forced upsells of added coverage at higher premiums nor compromising through price cuts and reduced benefits.
A more effective approach is to modularize the product: segment liability, tier coverage amounts, extend payment terms, and enable dynamic top-ups. This allows customers to secure a basic plan within their budget first, then gradually upgrade as income and family responsibilities evolve. Fundamentally, this shifts the focus from selling a single product to managing an ongoing relationship.
Meanwhile, stratification remains structural: coverage levels show a clear gradient tied to education, job stability, and household income. Improvements for older adults have been modest, and senior-focused offerings still need expansion. Importantly, our survey sample skews toward insurance prospects, whose coverage is likely higher than the general population's. Thus, the gaps shown represent an optimistic scenario. For the full population—especially low-income, lower-education, gig workers, and those with multiple chronic conditions—the room for improvement is even larger, calling for more targeted products and services tailored to their needs.
Outlook and Recommendations: From "Guaranteed" to "Adequate Coverage, Premium Service"
In light of these findings, the Report recommends that insurers strengthen demand assessments based on family life cycles by integrating household income, expenditures, liabilities, medical risks, and existing coverage into a comprehensive analysis. This will guide residents in determining appropriate premium contributions and coverage levels. To address declining alignment, insurers should develop products with clearer responsibilities, more flexible payment options, and dynamically adjustable coverage, while implementing regular coverage reviews and dynamic top-up mechanisms to adapt to evolving family risk profiles. Additionally, deepening the integration of "insurance + health management" and "insurance + elderly care" models will enable insurers to evolve from single-purpose payout tools into long-term risk management and service support platforms. Furthermore, sustained public education will help consumers transition from experience-based purchasing to evidence-driven coverage planning.
Drive product innovation by expanding modular optional coverage and tiered benefit levels to lower barriers to entry for the general public. Develop tailored products for older adults, individuals with chronic conditions, and flexible workers. For commercial long-term care insurance, focus on light-to-moderate disability, dementia care, and post-surgical rehabilitation scenarios not yet fully covered by social security, addressing gaps in current coverage and shifting from cash payouts to in-kind nursing services.
At the public education level, governments, industry associations, and insurers should strengthen public protection education. They should deliver differentiated, easy-to-understand outreach tailored to different age groups, income levels, occupations, and family types. This will guide residents to adopt a mindset of early planning, adequate coverage, long-term holding, and dynamic adjustment—and translate it into consistent protective behavior.
