There has been a major spread of health insurance in both urban and especially rural areas of China in the past 7 years.In the CHARLS pilot data some 90％ of our sample report having some type of insurance,with the New Cooperative Medical Scheme insurance being the most prevalent.Reported premiums actually paid are low in rural areas,averaging 20 Yuan per year per person,though higher in urban areas.As of 2008,in Zhejiang and Gansu,these schemes covered mainly inpatient care,and the reimbursement rates topped out at 64％ for respondents in Zhejiang having an urban hukou.For those with rural hukou,reimbursement rates are lower,ranging from 23％ to 35％ in Zhejiang and Gansu.There is much variation across county-units.Reimbursement rates tended to be higher for higher total health care costs,but do not rise enough to be said to offer very complete coverage for catastrophic illnesses.Outpatient service is just beginning to be covered by insurance in Zhejiang province,especially in urban areas and among those holding urban hukou,but not much yet in Gansu province.Simple descriptive regressions show that respondents with lower incomes as measured byper capita expenditure have a lower chance of being insured,as do migrants,older women and widows.There is a lot of variation across communities in coverage,and reimbursement rates,as reported in earlier studies.For inpatient use,having higherpce matters positively for both men and women,and it is also positively correlated with utilization for outpatient services for women.Unobserved community effects also are strongly correlated with utilization.Finally,although we cannot definitively call it a causal relationship,having health insurance is positively correlated with inpatient use for men.Overall,though the importance of income means that insurance is not fully covering the older populations in Zhejiang and Gansu.