Starting January 1, 2026: China’s Social Insurance Expands from Five to Six—What It Means for Your Take-Home Pay

In September this year, the National Healthcare Security Administration issued the Interim Measures for the Designated Management of Long-Term Care Insurance (LTCI) Nursing Service Institutions, further clarifying the detailed requirements for managing designated LTC service providers.

With that, the “sixth social insurance”—Long-Term Care Insurance (LTCI)—has once again moved into the public spotlight.

Even so, many people still don’t have a clear understanding of LTCI. Some don’t even realize they may already be contributing to it.

So today, we’ll walk you through LTCI in a structured, easy-to-follow way. This article covers:

Which regions have begun implementing LTCI, what the contribution standards look like, what LTCI actually is, and how to qualify for benefits.

Feel free to scroll directly to the section you care about most.

01 From January 1, 2026, Another Region Officially Launches LTCI

1) Hainan

On November 18, the General Office of the Hainan Provincial People’s Government released the Implementation Plan for Establishing Hainan’s Long-Term Care Insurance System (the “Notice”). The policy will take effect starting January 1, 2026.

Below is a practical summary of the key points:

1. Who needs to contribute to LTCI?
Coverage is designed to be broad and unified, including: employees and retirees of employers (enterprises, public institutions, government agencies, social organizations), flexible workers participating in employee basic medical insurance, flexible workers and non-employed urban/rural residents participating in resident basic medical insurance, and other eligible groups.

2. How much does LTCI cost?

• Employees:
• • Employer contribution rate: 0.3%, shared equally by employer and individual (0.15% each).
  • The contribution base matches the basic medical insurance base.
  • To avoid increasing employer burden, the policy lowers the employer basic medical insurance rate by 0.15%, shifting that portion to LTCI instead.
• Retirees:
• • Contribution rate: 0.15%.
  • Contribution base: the individual’s basic pension.
• Residents (initial 1–2 years):
• • Contribution rate: 0.15%.
  • Contribution base: last year’s provincial per-capita disposable income for urban/rural residents.
  • Generally shared about 1:1 by government finance and individuals.
  • Over roughly five years, the system gradually transitions toward the national unified rate of 0.3%.
  • For qualified low-income groups, the government provides tiered subsidies for the individual share, aligned with local medical insurance subsidy rules.
• Flexible workers (under employee basic medical insurance):
• • Contribution rate: 0.3%.
  • Base: 60% of last year’s average wage for full-caliber urban unit employees.
  • The policy also shifts 0.15% from the current employee medical insurance rate to reduce the individual burden.

3. Who can receive LTCI benefits?
Insured individuals who have contributed as required and remain in a long-term disabled condition for six months or more, and who pass the application and assessment process as severely disabled, may receive benefits. Coverage is expected to expand gradually in line with national guidance.

4. Benefit scope
There is no deductible threshold. For eligible nursing service costs:

• Fund payment ratio is about 70% for employees and 50% for residents.
• The annual personal maximum payout is capped at no more than 50% of the province’s previous year per-capita disposable income for urban/rural residents.

5. How benefits are delivered
Multiple care models are supported: home-based care, community care, and institutional care. Monthly maximum payouts per person include:

• Home care: employees 1,449 RMB, residents 1,190 RMB
• Community care: employees 1,209 RMB, residents 893 RMB
• Institutional care: employees 1,302 RMB, residents 977 RMB

2) Qinghai

On October 15, Qinghai’s Department of Civil Affairs released a revised version of the Regulations on the Protection of the Rights and Interests of Older Persons in Qinghai Province. Article 22 states that Qinghai will establish an LTCI system, gradually advancing long-term care protection work to safeguard elderly care needs.

The regulation will take effect on December 1, 2025.

02 Several Provinces and Cities Are Preparing to Implement LTCI

1) Yunnan

On October 26, the Yunnan Provincial Healthcare Security Administration published a notice seeking public feedback on the Implementation Plan for Establishing Long-Term Care Insurance (Draft for Comments).

Key points include:

Who is covered
Employers and their employees, retirees, flexible workers, and non-employed urban/rural residents participate under local administration principles—typically enrolling in LTCI alongside basic medical insurance.

Contribution rate
A province-wide unified rate of 0.3%. For employees, the employer and individual share the cost equally (0.15% each). Contribution bases remain consistent with basic medical insurance. Retirees contribute 0.15% based on their previous year’s basic pension, paid personally.

2) Jiangxi

On October 21, the Jiangxi Provincial Healthcare Security Administration issued an updated draft for comments: Implementation Plan for Establishing Jiangxi’s Long-Term Care Insurance System (Revised Draft for Comments).

Highlights include:

Who is covered
Employers and their employees, retirees, flexible workers, and non-employed urban/rural residents participate under local administration principles.

Funding and sharing mechanism

• Employees: total rate 0.3%, split equally (0.15% employer + 0.15% individual)
• Retirees: paid by individuals only, rate 0.15%, base is basic pension; with consent, contributions may be deducted via the employee medical insurance personal account
• Flexible workers: may participate as employees or as non-employed residents; if participating under employee rules, 0.15% is shifted from the medical insurance rate and deducted via the personal account; paid annually, base not lower than 60% of the province’s previous year social average wage
• Non-employed urban/rural residents: total rate 0.3%, shared 1:1 by individuals and government. Some areas may start at 0.15% in year one and increase gradually to 0.3% over years 2–5, or adopt 0.3% immediately.

3) Jilin

On October 24, the Jilin Provincial Healthcare Security Administration released a public consultation draft: Implementation Plan on Improving the Long-Term Care Insurance System in Jilin Province (Draft for Comments).

By the end of 2024, nearly 188 million people had participated in LTCI across 49 pilot cities, with 1.4625 million people receiving benefits.

Many people have likely noticed that their social insurance has quietly shifted from “five insurances + one housing fund” to “six insurances + one housing fund.” So which regions are already collecting LTCI contributions—and how much are they paying?

03 Where Has LTCI Already Been Implemented?

Below are a few common examples of contribution standards:

1) Chongqing: Pilot Citywide Since January 1, 2022

Starting January 1, 2022, Chongqing began piloting LTCI citywide. Anyone enrolled in Chongqing’s employee basic medical insurance participates in LTCI simultaneously.

In 2024, the Bishan District Healthcare Security Bureau released the Pilot Policy for Expanding Coverage and Improving Quality of Chongqing’s LTCI.

Policy text reference: https://www.bishan.gov.cn/bmjz/bm_97237/qylbzj_97261/dt/202405/t20240530_13249072.html

(Contribution and benefit details follow the policy document.)

2) Ningbo, Zhejiang: Full Coverage Since January 1, 2023

As one of China’s earliest national LTCI pilot cities—and the only one in Zhejiang—Ningbo began pilot programs in December 2017 across five districts. In August 2022, Ningbo released guidance to deepen reforms and confirmed that starting January 1, 2023, LTCI coverage would extend citywide.

Contribution standard (early deepening stage)
A fixed financing standard of 90 RMB per person per year.

• Active employees: 45 RMB paid by the individual and 45 RMB by the employer
• Retirees: 45 RMB paid by the individual and 45 RMB by the medical insurance pooling fund
• • The individual share is deducted from the employee medical insurance personal account
  • The employer share is transferred from employee medical insurance contributions, without increasing employer burden
• Flexible workers under employee medical insurance: follow the same approach as active employees
• Urban/rural resident medical insurance participants: individuals pay 30 RMB, the remaining 60 RMB is covered by fiscal funds
• Government-subsidized resident participants: the individual share is fully subsidized (40% municipal finance, 60% district/county finance)

3) Chengdu, Sichuan: Full Coverage Since July 1, 2022

On June 5, 2022, the Chengdu Municipal Government issued the Implementation Opinions on Launching a New Round of LTCI Reform, bringing both employee and resident basic medical insurance participants into the LTCI coverage framework.

Contribution standards

(1) Urban employee group

• Individual contribution (via personal account transfer):
• • Under 40 years old (not retired): 0.1% per month of the employee medical insurance contribution base
  • Age 40+ (not retired): 0.2% per month of the same base
  • Retirees: 0.3% per month of the personal account transfer-in base
• Employer contribution:
• • 0.2% per month of the employee medical insurance contribution base, transferred from the pooling fund
• Fiscal subsidy:
• • Based on the number of insured retirees, calculated on the retirees’ personal account transfer-in base, at 0.01% per month, provided annually

(2) Urban/rural resident group

• Adults: 25 RMB per person per year (paid together with resident medical insurance), plus 30 RMB fiscal subsidy
• Students and children (including university students): 10 RMB per person per year (transferred from resident medical insurance individual payment), plus 10 RMB fiscal subsidy