The Chinese authorities want to cover the country's long-term care insurance strategy by the end of 2028. The programme is intended to finance basic assistance to those who have lost their ability to function independently. However, this is not a general provision of money for all seniors, but a strategy of payment of certain services after prior assessment of the degree of independence.
The improvement corresponds to the scale of demographic change. At the end of 2025, there were 223.65 million people at least 65 years of age surviving in China, with a full population of 323.38 million people over the age of 60. At the same time, the Chinese People's Political Consultative Conference estimates that about 36 million seniors are independent, and about 17 million experience cognitive disorders (a variety of types and degrees of dementia). These groups overlap in part, so they should not be added up, but both show the size of long-term care needs.
From pilots to national systems
Long-term care insurance in Chinese changhu xian, is simply a separate kind of social security. It is intended to cover the costs of basic support for regular life and basic care. In March, the KC KPCh General Office and the General Office of the State Council published a paper setting about a three-year deadline to build a strategy adapted to the conditions of the country. The mark was set at the end of 2028.
Before the program is to become nationwide, it was tested in 2 pilot rounds for a decade, launched in 2016 and 2020. By the end of 2025, they included 92 areas and 308 million participants. According to the National wellness Safety Administration (NHSA), more than 3.3 million people with independency benefited from the aid, and the fund's expenditure exceeded 100 billion yuan.
That's a fraction of the scale of future needs. The SCMP material describes the destiny of 86-year-old Wu Boyao, suffering from Parkinson’s disease. erstwhile he lived in Shanghai, he received an hour's aid all day from the caretaker, for whom he paid 6 yuan (the remainder was covered by local insurance). After moving to the administrative area owned by Suzhou, he lost access to this service, although both cities operated their own pilots. The case shows how powerfully the scope of the aid has depended on local financing rules and the organisation of services.
The fresh model is to gradually reduce specified differences. The authorities foresee implementation by provinces and cities at different rates, without imposing a single deadline on all towns. The insurance can initially cover people employed and subsequently residents of cities and villages; local authorities can besides cover both groups simultaneously. The pilot programmes to date are intended to adapt their rules to the national strategy while maintaining continuity of aid to current beneficiaries.
Who will benefit and what will pay for the fund
In the first stage, people with severe independency are to be protected: long-standing, incapable to live independently and requiring aid from others. The award of services is to be decided by a uniform assessment. The strategy distinguishes 3 levels of independency — light, moderate, and dense — but at the beginning of the ministry they focus on the last of these groups. Any extension to people with average needs will depend on the improvement of the programme and financial opportunities.
Fund funds are not to be paid straight to the user in principle. They are to pay the services ordered from approved entities. 36 types of benefits are included in the national catalogue. 20 concerns regular help, specified as support for meals, baths and oral hygiene. The another sixteen include basic care and medical activities, specified as suction or catheterisation.
The financing model involves participation of workers, employers and the public sector. The People’s regular study indicates an indicative rate of around 0.3% of the assessment base, with an equal share of the worker and employer. For pensioners, 0.15% related to pensions were given, and for those not working in cities and agrarian areas, a gradual transition from about 0.15 to 0.3% with public subsidies was foreseen. The insurance does not have a minimum cost threshold and the yearly backing limit is to be linked to the income of the inhabitants of the area.
Equal rules do not mean equal access
The task includes a common directory of services, uniform evaluation standards and a nationwide IT system. The NHSA informs that digital tools are to support the submission of applications, the assessment of independence, the management of services and the accounting of expenditure. Pilots besides included recording home visits and their duration. The aim is to increase transparency and facilitate the transfer of rights between residences.
However, standardisation of procedures will not solve the problem of shortage of people and facilities alone. According to the NHSA, around 12 000 approved long-term care institutions and about 370 000 people in the sector operate in the country. The government is developing a long-term guardian profession; by the end of 2025 the number of people holding the applicable certificate exceeded 10 thousand.
The biggest test for families remains the availability of services where they are needed. In interviews cited by SCMP, experts point out that care centres and caregivers are more many in the rich cities of the east coast than in agrarian areas and in the western part of the country. On the outskirts of the metropolis can besides be a problem: the hourly tour of the carer on an hr visit reduces the attractiveness of orders and limits the real supply of aid at home.
In this sense, the strategy develops previously described plan to cover the country with long-term care insurance, but now more is already known about the financing model, evaluation rules and the benefit catalogue. Long-wave LTCI is besides to be part of wider redevelopment of the Chinese social safety system.
Care as a fresh part of social services
The fresh insurance is of importance beyond payments for single visits. For non-responsibles it may mean access to professional assistance. For their loved ones, a limited share of the cost and time that frequently needs to be spent on care at the expense of work. The authorities are besides counting on the improvement of care services, vocational training and the marketplace for stand-alone equipment. Since the beginning of the pilots, according to the NHSA, more than 60 billion yuan of social capital have been allocated to long-term care sectors.
The success of the improvement will so not be determined solely by the scope of formal insurance. unchangeable funding, trained staff and available home and environmental services will besides be needed. Only a combination of these elements will show whether the strategy will translate into regular assistance for families across the country, not primarily in the major cities.
Source:
- National Healthcare safety Administration: conference on speeding up the creation of long-term care insurance, March 26, 2026
- People’s Daily: 长期护理保险制度向全国推行, March 27, 2026
- CPPCC: study on the care strategy for dependent and cognitive impairment of seniors, July 17, 2026
- National Bureau of Statistics: data on Chinese population for 2025, January 19, 2026
- South China Morning Post: Will a fresh insurance strategy get China’s age population the long-term care it needs?, September 1, 2026
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