National Healthcare Security Bulletin: Basic Medical Insurance Covers 1.33 Billion People, 142 Types of High-value Medical Consumables Included in VBP

Source: National Healthcare Security Administration

DentalGoodNews｜On July 16, 2026, the National Healthcare Security Administration (NHSA) released the "2025 National Healthcare Security Development Statistical Bulletin." The report shows that as of the end of 2025, the number of participants in the national basic medical insurance (hereinafter referred to as basic medical insurance) reached 1,330.6939 million, with the participation rate stabilized at 95%. In 2025, the total revenue of the national basic medical insurance fund (including maternity insurance) was 3,592.132 billion yuan, with total expenditures of 3,005.519 billion yuan, and a current-period surplus of 525.772 billion yuan in the pooling fund.

In terms of employee basic medical insurance, the number of participants at the end of 2025 was 388.5612 million, an increase of 2.4% year-on-year. In 2025, the revenue of the employee medical insurance fund (including maternity insurance) was 2,468.360 billion yuan, with expenditures of 1,937.655 billion yuan. Regarding benefit utilization, employee medical insurance visits reached 54.86 billion, including 27.90 billion general outpatient and emergency visits. In 2025, the fund payment ratio for inpatient expenses within the catalog for employee medical insurance reached 84.1%.

Source: National Healthcare Security Administration

The number of participants in the Urban and Rural Residents Basic Medical Insurance (hereinafter referred to as resident medical insurance) was 942.1327 million. In 2025, the revenue of the resident medical insurance fund was 1,123.772 billion yuan, with expenditures of 1,067.863 billion yuan. Benefit utilization reached 32.68 billion visits, with the fund payment ratio for inpatient expenses within the catalog at 66.0%, and payment ratios for tertiary, secondary, and primary and below medical institutions at 61.7%, 71.8%, and 79.4%, respectively.

Source: National Healthcare Security Administration

In terms of coordinated development of "three medical fields" (medical services, medical insurance, and pharmaceuticals), the medical insurance drug catalog has included a total of 3,253 types of Western and Chinese patent medicines. The reform of payment methods continues to deepen, with the proportion of discharges settled under case-based payment reaching 91.8%. Significant results have been achieved in centralized procurement of drugs and consumables. As of the end of 2025, 11 batches of national centralized drug procurement have been conducted, covering 490 drugs; and 6 batches of national centralized procurement of high-value medical consumables have been carried out, covering 142 types of consumables across 9 categories, involving clinical fields such as cardiology, orthopedics, ophthalmology, vascular surgery, otorhinolaryngology, and urology.

According to previous reports by DENTALGOODNEWS (Leading Dental Industry Media, DGN), the NHSA had previously proposed including 11 categories of services, such as dental implantation, into the national unified medical insurance catalog, and plans to achieve full coverage of on-site inspections at designated medical and pharmaceutical institutions by 2030. Additionally, regions such as Beijing have already taken the lead in clarifying the medical insurance categories for dental service pricing items.