Since the launch of the new health care reform，the reform of medical insurance system has been actively promoted in our country，and has achieved positive results，playing an important role in alleviating the medical burden of the urban and rural residents and safeguarding people’s health，mainly reflects in：achieve universal health insurance in general，compensation levels increase significantly，fund scale and compensation payment number increase gradually，the medical burden of the urban and rural residents decrease. However，at present，our country’s medical insurance system still exist many problems：serious fragmentation，part of the medical insurance system reform lag，many deficiencies in design，imperfect management and service system，poor regulation，and imperfect relevant coordinated reform. The future medical insurance system reform needs to effectively deal with the relationship between fairness and efficiency，and the relationship between government and market. The reform should be promoted from the following several specific aspects：reform the medical insurance system of the civil servants and college students，accelerate the integration of urban and rural residents medical insurance system，constantly optimize the design of the medical insurance system，promote the reform of medical insurance management system，promote the medical insurance system as a whole，strengthen the construction of medical insurance handling ability，establish and perfect the multi-level medical insurance system，strengthen the supervision of medical insurance system，and deepen the medical insurance related reform.