Long-term care insurance is being rolled out nationwide. How much will different groups need to pay?

How can the nationwide promotion of long-term care insurance help address the aging society?

China’s social security system is gradually entering the “six insurances and one fund” era.

On March 25, the Central Committee of the Communist Party of China and the State Council issued the “Opinions on Accelerating the Establishment of a Long-term Care Insurance System” (hereinafter referred to as “Opinions”), proposing that by the end of 2028, the long-term care insurance system will be basically fully covered nationwide. On the 26th, the National Healthcare Security Administration, the Ministry of Civil Affairs, the Ministry of Finance, and other eight departments jointly issued supporting implementation plans (hereinafter referred to as “Implementation Plans”).

The insured population of long-term care insurance covers all citizens. The “Opinions” propose that localities establish long-term care insurance systems starting with insured units, employees, retirees, and flexible employment personnel, gradually including unemployed urban and rural residents in the coverage.

Regarding the public’s concerns about payment issues, different pilot programs adopted varying methods in different regions. Some cities implement a rate system, such as Qingdao and Chengdu; while others use a fixed quota system, like Ningbo and Hangzhou.

This time, the “Opinions” clarify that the long-term care insurance fee will adopt a “rate system,” with the rate uniformly controlled at around 0.3%. The original 92 pilot areas must adjust and improve their policies according to the “Opinions” and achieve a stable transition by 2028.

In specific implementation, the insured population is mainly divided into four categories: unit employees, retirees, unemployed urban and rural residents, and flexible employment personnel, as well as vulnerable groups and those under 18 years old, with different specific payment standards for each group.

Unit Employees: Monthly income of 10,000 yuan, each pays 15 yuan

Unit employees participating in long-term care insurance are jointly funded by the employer and the employee, alongside the employee’s basic medical insurance contributions. The overall rate is controlled at around 0.3%, shared by the employer and the employee at about 0.15% each. Assuming the monthly income of a unit employee is 10,000 yuan, the individual pays 15 yuan per month, and the unit pays 15 yuan, totaling 30 yuan.

The “Implementation Plans” also clarify that the individual accounts of employees’ basic medical insurance can be used for personal contributions to long-term care insurance for themselves and their close relatives (including spouses, parents, children, siblings, grandparents, grandchildren, and other relatives).

Retirees: Pension of 5,000 yuan, pay 7.5 yuan, no employer contribution

For retirees, participation in long-term care insurance is funded by the individual, with the original employer not contributing. The rate is the same as for unit employees, around 0.15%, based on the individual’s basic pension. Assuming the retiree’s monthly pension is 5,000 yuan, calculated at a rate of 0.15%, the monthly payment would be 7.5 yuan, borne by the retiree.

The “Implementation Plans” clarify that, with the individual’s consent, the payment can be deducted and paid on behalf of them from their individual account of basic medical insurance, with localities exploring specific deduction methods based on local conditions.

Farmers and Unemployed Urban Residents: Annual contributions, individual and government pay in a ratio of 1:1

For unemployed urban residents, including farmers and unemployed urban residents, their long-term care insurance funds are collected annually, jointly paid with the basic medical insurance for urban and rural residents. The funding consists of individual contributions and government subsidies, with a ratio of about 1:1. The government subsidy part is jointly borne by the central and local finances.

Regarding the rate, the “Implementation Plans” clarify that the plan for establishing the long-term care insurance system in various regions can reduce the applicable rate for unemployed urban and rural residents by half, starting from around 0.15%, transitioning to around 0.3% over approximately five years. In qualified areas, the rate can also start directly from around 0.3%. The contribution base is the per capita disposable income of urban and rural residents in the previous year in the planning area.

Assuming that the previous year’s per capita disposable income in a certain area was 40,000 yuan, the rate for the year of implementation calculated at 0.15% would mean an annual payment of 60 yuan, with individual contributions and government subsidies each bearing 30 yuan. Assuming the per capita disposable income of residents nationwide in 2025 is 43,377 yuan as the contribution base, a certain area can directly fund at a rate of around 0.3%, resulting in an annual individual contribution of approximately 64 yuan.

Considering the significant differences among regions, the “Implementation Plans” propose that localities can determine the contribution base in rural areas based on the previous year’s per capita disposable income of rural residents, ensuring that the funds are balanced after adequate actuarial assessments. For such planning areas, the “Implementation Opinions” emphasize clarifying the scope of rural areas, strengthening information sharing between relevant departments, and ensuring that insured individuals pay according to the standards set by the system to avoid selective insurance participation.

Flexible Employment Personnel: Encouraged to participate at the unit employee standard, individual payment

For flexible employment personnel, it is encouraged that they participate at the unit employee rate standard, which is around 0.3%, with individuals paying according to regulations. The contribution base can be determined at a certain percentage of the social average salary in the planning area from the previous year (not less than 60%).

Assuming the local average social salary from the previous year is 6,000 yuan, flexible employment personnel would contribute at no less than 60%, which is 3,600 yuan, at a rate of 0.3%, resulting in a monthly payment of 10.8 yuan, borne by the flexible employment personnel individually.

Flexible employment personnel may also choose to participate in the insurance policy for unemployed urban and rural residents.

Support for Vulnerable Groups, and all under 18 should participate

For vulnerable groups, the “Implementation Plans” clarify that the government will provide categorized subsidies for their individual contributions: full subsidies for extremely difficult individuals, and fixed subsidies for those under minimum living standards and qualifying individuals at risk of falling back into poverty, with the fixed subsidy standards determined by provincial governments based on actual conditions.

In addition, unemployed individuals under 18 are to participate alongside their parents or other legal guardians and are not required to fund independently. Those meeting the eligibility criteria will receive benefits according to the standards for unemployed urban and rural residents. Orphans and children without guardians who cannot follow are treated as insured. Localities can refine policy provisions based on actual conditions to ensure that eligible individuals under 18 participate fully.

Reporter: Jiang Huizi

Editor: Zhang Lei Proofreader: Li Lijun