Objective:To investigate the insured and uninsured status of medical insurance among residents in Hunan province and the influential factors for uninsured status.Methods:A stratified,muti-stage,cluster sampling was used to select 7 rural counties and 7 urban districts from 122 counties/districts.In each selected county/district,5 towns were chosen at random.2 villages (or communities) were further selected in each given town randomly.At last,households were selected from sample villages (or communities) using systematic sampling and all members of selected households were surveyed through face-to-face interview.Complex sampling weights were considered to estimate the coverage rate of medical insurance and 95％ confidence interval.We used logistic regression to identify significant factors for not purchase insurance.Results:The overall coverage rate of medical insurance was 95.76％(95％ CI 93.04％ to 98.49％) in Hunan residents,and 4.24％ (95％ CI 1.51％ to 6.96％) of surveyed residents did not participate in any medical insurance program.Particularly,the proportion of residents not participating in any medical insurance program approached 10.17％ among urban residents under 18 years.Age,household income per capita,without chronic disease,were found being associated with uninsured status of medical insurance.Conclusion:To achieve the goal of universal health coverage by 2020,social medical insurance department should take measures to raise the coverage rate of medical insurance among residents.