China insurance covers 95% as fraud probes hit 1,626 institutions

Authorities inspected 124700 providers using tracking codes to enforce compliance.

China’s basic medical insurance last year covered more than 1.33 billion individuals, a 95% coverage rate.

Enrollment rose by 4.06 million year-on-year, data from China's National Healthcare Security Administration (NHSA) showed.

In 2025, the basic medical insurance fund, including maternity insurance, recorded nearly $520b in revenue and $440b.

In 2025, 7.215 billion outpatient visits were covered by the schemes, up 25.51% year-on-year (YoY). Inpatient treatments totalled 278 million, down 3.40% from a year earlier

China's medical insurance system continued to help reduce childbirth costs in 2025, said the NHSA, noting that about 260 million people were covered by maternity insurance in 2025, an increase of 6.66 million YoY.

From the beginning of 2025, China began covering certain assisted reproductive treatments, such as egg retrieval and artificial insemination, under medical insurance, and 30 provincial-level regions included pain relief during labour under medical insurance coverage.

In 2025, medical insurance covered over 3 million assisted reproductive treatments, helping more than 1.6 million people across the country, according to NHSA data.

In rural areas, over 99% of the low-income population and those lifted out of poverty are now covered by medical insurance in China, said the NHSA.

The updated 2025 national medical insurance drug list added 114 drugs, bringing the total to 3,253.

In 2025, $5.01b (CNY34.2b) was recovered, and 1,626 institutions involved in fraud were identified through enhanced oversight of the medical insurance fund.

Authorities used drug-tracking codes to inspect 124,700 medical and pharmaceutical institutions and to punish 39,100 that violated regulations.

($1.00 = CNY6.82)