Objective/Meaning Exploring the action mechanism and practical challenges of the integration of medical insurance for urban and rural residents to prevent returning to poverty due to illness in China can provide a policy optimization path for the integration of residents’medical insurance to prevent returning to poverty due to illness.

Methods/Procedures Through the methods of policy review and literature analysis, the theoretical analysis on the mechanism of the integration of urban and rural residents’ medical insurance in preventing the returning to poverty due to illness was carried out, and the main achievements of the integration of urban and rural residents’ medical insurance to prevent the returning to poverty due to illness in China were summarized. Based on the practical challenges of the integration of urban and rural residents’ medical insurance in the treatment of returning to poverty due to illness, the corresponding optimization path was put forward.

Results/Conclusions There were still some practical challenges in the integration of urban and rural residents’ medical insurance to prevent returning to poverty due to illness in China, such as the difficulty of improving the level of overall planning, the impaired fairness of rights and interests, the reverse subsidy between urban and rural areas and the difficulty of sustainability, which should be solved by accelerating the overall planning of medical insurance at the provincial level, transiting to the“one system and one file” to enhance the fairness of medical insurance rights and interests, optimizing the allocation of medical resources in urban and rural areas, and strengthening the supervision of medical insurance funds to ensure the sustainable balance of payments, so as to better play the role of the integration of urban and rural residents’ medical insurance in preventing returning to poverty due to illness.