China to Roll Out Long-Term Care Insurance Nationwide by End of 2028

On September 9, 2026, the National Healthcare Security Administration held a briefing on the 15th Five-Year Plan for Nationwide Medical Security, covering the multi-tiered medical insurance system, payment method reform, and centralized procurement of drugs and medical consumables. Liu Juan, deputy director of the administration's Benefits Guarantee Department, said 22 provincial-level regions have issued provincial implementation plans, and long-term care insurance now covers more than 320 million people. Thirty-six items of daily care and medical nursing services, including dietary care and cleaning care, have been included in the fund's scope. More than 4.6 million disabled people have received benefits, with cumulative fund spending exceeding RMB 114.2 billion. The country has 13,000 designated long-term care insurance service institutions, about 400,000 nursing service personnel at designated institutions, and more than 70,000 long-term care workers. Long-term care insurance is estimated to have drawn nearly RMB 70 billion in social capital investment.

During the 15th Five-Year Plan period, long-term care insurance will shift from localized pilots and accelerated establishment to nationwide implementation with improved quality and efficiency. The healthcare security authorities plan to expand coverage to 247 pooling regions by the end of 2026 and achieve near-universal coverage nationwide by the end of 2028. Following the principles of coordinating urban and rural areas and covering all citizens, coverage will be extended from employees to urban and rural residents. A dynamic financing adjustment mechanism will be established and improved, policies for receiving benefits outside one's home region will be refined, an incentive and constraint mechanism for participation will be explored, and a unified national standard for assessing disability levels will be created. In addition, policy coordination between long-term care insurance and related care subsidy systems will be strengthened, eligible elderly care institutions and primary healthcare institutions will be encouraged to provide long-term care insurance services, and the policy system supporting the training of long-term care workers will be improved.

The plan upgrades smart medical insurance to digital-intelligent medical insurance and, for the first time, adds scientific medical insurance, incorporating comprehensive value assessment of real-world medical insurance into this system. Xie Zhangshu, deputy director of the administration's Price and Procurement Center, said the traditional clinical evaluation model of randomized controlled trials has long been dominated by European and American institutions. After the National Healthcare Security Administration launched real-world medical insurance evaluation, China can rely on real-world research, with more intuitive results, larger-scale data, and more timely evidence, to independently determine what constitutes a good drug and how to evaluate new drugs, and to independently define the value and prices of drugs, medical consumables, medical service items, and even devices. Real-world medical insurance evaluation is oriented toward clinical value, and its results can directly and rapidly achieve medical insurance access through evaluation.