Changes in the structure of insured personnel: With the intensification of population aging, the age structure of the population covered by medical insurance has undergone significant changes, and the proportion of retirees to insured personnel is constantly increasing, leading to an increasingly obvious aging of the insured personnel structure. This change has increased the pressure on the payment of basic medical insurance funds.The impact of medical insurance fund income and expenditure: The aging population leads to an increase in medical expenses. At the same time, due to the accelerated aging process, the proportion of in-service employees and retirees increases, and the proportion of in-service employees decreases, resulting in a decrease in the income of the medical insurance fund. On the premise that there is no other channel of funding to solve the debt of elderly medical insurance, relying solely on the contributions of in-service employees and units to bear the medical expenses of in-service employees and retired personnel increases the pressure on the medical insurance fund, and the risk of the medical insurance fund continues to increase.The increase in demand and costs for medical services: The aging population has significantly increased the demand for health security, especially with the extension of the elderly population, the number of elderly people who have lost their ability to live due to illness, disability, and aging will significantly increase. In the future, the medical expenses for elderly people in China will increase rapidly, and the economic burden of diseases on the elderly will also significantly increase, bringing enormous pressure to the medical and health service system.The sustainability challenge of the medical insurance system: The aging population poses a challenge to the sustainability of the medical insurance system. With the deepening of aging, the medical expenses for the elderly will increase significantly, posing a huge challenge to the sustained and stable operation of the medical insurance system. At the same time, innovation in fundraising and payment for medical insurance will be the main line of sustainable development in the future, and it will also drive the reform of the entire medical service market.