Table 1.
Summary of China’s three health insurance programs
| Contents | UEBMI | URBMI | NRCMS |
|---|---|---|---|
| Target population | Urban employees | Urban residents, eg, children, students, elderly people without previous employment | Rural residents |
| Unit of enrollmente | Individuals | Individuals | Households |
| Type of enrollmente | Compulsory | Voluntary | Voluntary |
| Source of premium | Employer and individual | Government and individual | Government and individual |
| Benefits package | Inpatient and outpatient care | Inpatient and outpatient care and critical illness insurance | Inpatient and outpatient care and critical illness insurance |
| Management level of pooling funde | Prefecture/municipality | Prefecture/municipality | County |
| Number of pools of risk fund (approx)e | 330 | 330 | 2600 |
| Overseeing government | MOHRSS | MOHRSS | NHFP |
| Year of pilote | 1994a | 2007 | 2003 |
| Year of formal launche | 1998 | 2009 | 2006 |
| Facts in 2014 | |||
| Enrollment rate, % | >95 | >95 | 98.9 |
| Number of enrollees, million | 283 | 315 | 736 |
| Proportion of population,b % | 21 | 23 | 54 |
| Premium per capita (Yuan) | 1962c | 410 | 411 |
| Benefit coverage | |||
| Reimbursement rate for inpatient care, % | 80 | 70 | 75 |
| Reimbursement rate for outpatient care, % | 50, 70, 80d | 50 | 50 |
| Number of reimbursable serious illnesses | – | 22 | 22 |
Notes:
Before 1994, employees were insured through the government insurance system and the labor insurance system. In 1994, both of them were converted into the UEBMI.
The total population in 2014 was 1.367 billion.
The premium, which is obtained from Yu,2 is for year 2011 since we did not get the information for year 2014.
The reimbursement rates differ for different insured populations in different provinces. The numbers are reimbursement rates for current employees, retired employees under 70 years of age, and retired employees of 70 years of age and older in Beijing after payment for certain nonrefundable amounts.69
Adapted from Liang, Lilin; Langenbrunner, John C. The Long March to Universal Coverage : Lessons from China. UNICO Study Series; No. 9. World Bank, Washington DC. 2013. © World Bank. https://openknowledge.worldbank.org/handle/10986/13303 License: CC BY 3.0 IGO. Creative Commons license and disclaimer available from: http://creativecommons.org/licenses/by/4.0/legalcode.10
Abbreviations: MOHRSS, Ministry of Human Resource and Social Security; NHFP, National Health and Family Planning Commission; NRCMS, New Rural Cooperative Medical Scheme; UEBMI, Urban Employee Basic Medical Insurance; URBMI, Urban Residence Basic Medical Insurance.