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The primary social health insurance schemes in China, UEMIS and URRMS, mainly cover non-inpatient expenditures, neglecting costs associated with outpatient care and medications. A study found that over 60% of participants used non-inpatient services recently, with many purchasing medications from pharmacies but facing limited insurance reimbursement. A notable subgroup incurred significant out-of-pocket expenses exceeding 1,000 RMB monthly, highlighting financial risks, particularly for URRMS enrollees. Additionally, chronic diseases, older age, and limited financial resources were identified as factors contributing to financial hardships. The study advocates for reforming the health insurance benefit package to include non-inpatient costs to better protect vulnerable populations.