Objective:To effectively improve the health insurance security level of urban-rural residents and of-fer corresponding policy recommendations, the paper makes an empirical analysis of the security level of China’s ur-ban and rural residents health insurance system( U&RRHIS) . Methods: Frequency distribution and dummy variable regression tests were conducted with Tianjin’s urban-rural residents health insurance database. Results There is a large gap between real rate of reimbursement and policy rate in U&RRHIS;many factors have significant impacts on the real rate of reimbursement, including deductible tables, nominal rates of reimbursement, the age of the insured, insurance payment levels, medical expenses, medical institution classifications, etc. Conclusion:In order to improve the real rate of reimbursement for the insured, more attention should be paid to the real rate of reimbursement which is an important index of health security levels for health insurance policy adjustments; meanwhile, efforts should be made in terms of implementation, for instance, criteria should be established for an evaluation of the gap between the real rate of reimbursement and the policy rate of reimbursement, while medical insurance policies should be refined and a scientific and laddered policy rate of reimbursement should be established; moreover, the government’s finan-cial input in healthcare should be increased and the medical insurance system should be improved.