This paper，focusing on the development of health care and medicare system of rural Shandong in 2018，analyzes the health status of the rural residents，the supply and demand on medical care and the development of medicare system. Meanwhile，some concerns will be also put forward，such as the disparity of medical resources between the town and the countryside，the economic overburden of disease，the insufficient supplement of elderly service and the situation of poverty due to illness. In order to speed up the program of “Rural Vitalization” and “Healthy Villages and Towns”，some proposals are going to submitted on enhancing the top-level design of health service，developing a multi-level medicare system，training the rural medical and health talents and facilitating the health-related industries.