Abstract: Based on the 2015 CHARLS microdata，under the condition of controlling sample selection bias，this paper analyzes the impact of medical insurance on the absolute medical burden and relative medical burden of middle-aged and elderly households. It is concluded that medical insurance has a mitigating effect on the absolute medical burden of the households，but it has almost no effect on the relative medical burden. According to the type of insurance，medical insurance can reduce the absolute medical burden of households with Medical Insurance for Urban and Rural Residents（MIURR）and the relative medical burden of households with the Urban Employee Basic Medical Insurance（UEBMI）；the results of robustness tests are very similar. Based on this，the paper proposes to adopt the measures of classified management to reduce the medical burden of middle-aged and elderly households，and to reduce the treatment gap between the UEBMI and the MIURR through financial subsidies，with the final target of integrating the two systems in the future.

Key words: health insurance, family medical, astogeny, medical burden, medical risk, medical compensation