China Expands Medical Insurance Sharing Across Provinces

China has launched a landmark policy allowing employees’ medical insurance personal account funds to be shared across provincial boundaries with close family members, marking a significant expansion of healthcare financing flexibility for the nation’s 1.5 billion insured population.

The National Healthcare Security Administration (NHSA) and the Ministry of Finance jointly issued the “Procedural Regulations for Cross-Province Sharing of Employee Basic Medical Insurance Personal Accounts (Trial)” on June 5, 2026, as reported by The Paper citing CCTV News. The regulations establish detailed operational rules for a policy framework first announced in January 2026.

What the Policy Does

Under the new system, employees enrolled in China’s basic medical insurance can share funds from their personal accounts with close relatives — including spouses, parents, children, siblings, grandparents, grandchildren, and great-grandchildren — regardless of where those relatives are registered. The mechanism operates through a “Personal Medical Insurance Wallet” on the national unified healthcare information platform, using virtual quota management rather than physical fund transfers.

According to China News Service, the shared funds can be used for medical expenses at designated institutions, purchasing approved medicines and devices at designated pharmacies, paying for Urban and Rural Resident Basic Medical Insurance premiums, and covering long-term care insurance contributions.

Solving the “Dormant Funds” Problem

The policy addresses a long-standing structural inefficiency in China’s healthcare financing system. By 2023, employee medical insurance personal accounts held approximately 1.4 trillion yuan in accumulated balances — funds that were largely idle due to geographical restrictions. This created a paradox where healthy individuals in one province had unused balances while their family members in other provinces faced out-of-pocket medical expenses.

The problem is particularly acute given China’s 150 million cross-province migrant workers, many of whom contribute to medical insurance in their workplace province while their parents and children remain registered elsewhere. As the NHSA noted in its January policy interpretation, cross-province sharing transforms “dormant” personal account funds into “family health gold.”

How It Works

Users can establish or dissolve sharing relationships through the National Healthcare Security Service Platform App, provincial medical insurance platforms, or local agency offices. The sharing person must sign a commitment letter attesting to the accuracy of the information provided.

Key operational features include:

• Multiple relationships: One person can share with multiple close relatives, and one recipient can receive from multiple relatives.
• Quota management: The sharing person sets a quota for each recipient and cannot use that portion of their personal account funds. Recipients cannot re-share the quota to a third party.
• Quota recovery: When a sharing relationship is dissolved, any unused quota automatically returns to the sharing person’s account.
• Interest attribution: Interest on unused quota belongs to the sharing person.

As the People’s Daily emphasized in its policy Q&A with NHSA officials, a critical distinction is that “money can be shared, cards cannot” — the policy involves fund sharing only, not the transfer of insurance eligibility or benefits.

Broader Reform Context

This policy represents the third stage of a gradual reform process. After initial intra-provincial sharing was introduced, the eligible relative scope was expanded in 2021 and again in 2024. The cross-province dimension — breaking geographical barriers entirely — was piloted in Suzhou in December 2024 and expanded to 30 provinces and 337 regions by mid-2025.

The technical infrastructure underpinning the system is substantial. The National Unified Medical Insurance Information Platform handles 28 million transactions daily, and 1.25 billion people had activated medical insurance QR codes by 2026.

Implications and Outlook

The policy has significant implications for China’s healthcare system. By mobilizing approximately 1.4 trillion yuan in personal account balances, it improves fund utilization efficiency and provides direct financial relief to families separated by provincial boundaries. It is part of a broader reform agenda that includes long-term care insurance expansion, facial recognition payment systems, and commercial insurance integration.

Implementation challenges remain, including technical coordination across 300-plus administrative regions, fraud prevention for virtual quota management, and public awareness campaigns to ensure eligible families understand how to use the new system. Provincial disparities in implementation pace may also create uneven access in the early stages.

Nevertheless, the policy represents a fundamental shift in China’s healthcare financing model — from individual accounts to family-based risk pooling across provincial boundaries — and is expected to benefit tens of millions of families nationwide.