Chongqing - Chongqing is expanding long-term care insurance to residents of all ages, including children, to meet growing demand for support among people who lose the ability to live independently because of aging, illness or injury.
An elderly resident (right) at Longkang Medical and Elderly Care Center in Wulong District, Chongqing. (Photo/Peng Yu)
Enrollment for residents will begin in the fourth quarter of 2026 and will be coordinated with the annual enrollment period for the basic medical insurance program for urban and rural residents, Deng Li, Director of Chongqing Municipal Administration of Healthcare Security, said at a government briefing on August 14. Those enrolled will be eligible for benefits from 2027.
The expansion highlights the evolving role of long-term care insurance in China as the country responds to the growing pressures of an aging population.
China now has 323 million people aged 60 or above, accounting for 23% of its population, according to the briefing. About 10% have some degree of disability affecting their ability to live independently.
The demographic challenge is particularly pronounced in Chongqing, where 8.35 million permanent residents are aged 60 or older, representing 26.2% of the municipality's population.
Long-term care insurance, or LTCI, is a relatively new branch of China's social insurance system. It is designed to help people who lose the ability to perform everyday activities because of aging, disease, disability, or accidents.
Unlike a cash welfare payment, the program primarily finances care services. These can include assistance with daily activities such as eating, bathing and personal grooming, as well as necessary medical care, including dressing changes and other nursing procedures.
"In the traditional model dominated by family care, the quality of care for disabled people varies, while family caregivers face physical, mental and financial pressure," Deng said.
China launched long-term care insurance pilots in 2016, with Chongqing among the first 15 cities selected. By 2025, the program covered 308.5 million people nationwide, with 1.88 million receiving benefits. This March, central authorities called for a basic nationwide system covering urban and rural residents to be largely established within about three years.
Several pilot cities have already broadened access. Qingdao covers all participants in its urban and rural medical insurance programs, while Nantong has increased its designated care providers from two to 361. Binzhou extended coverage to minors citywide in 2025.
During Chongqing's pilot phase, coverage focused on people enrolled in the employee medical insurance system. The new policy will also bring participants in the resident medical insurance program into long-term care insurance.
That distinction is important in Chongqing's social insurance system: employee medical insurance generally covers employees and retirees, while resident medical insurance covers many people not enrolled through formal employment, including minors. As a result, Chongqing says the expanded long-term care insurance program will have no age restriction.
From 2027, the number of covered care services will also increase from 28 to 36, adding services such as sputum suction, routine wound dressing and swallowing-function training.
Funding will come from employers, individuals and government contributions, depending on the type of participant. The insurance fund will be accounted for and managed separately as part of Chongqing's social security funds, said Tang Jia, deputy director of the Chongqing Municipal Bureau of Finance, with dedicated supervision to prevent fraud and misuse.