Abstract: With the establishment of the national basic medical security system in China， protection of medical rights rare diseases vulnerable groups has become a major issue， and the medical insurance is the main form of medical security system. This paper mainly analyzes the current problems and causes of medical insurance for rare diseases in China， and probes into the medical insurance mode of rare diseases in other countries and regions. This paper argues that the lack of the definition of rare diseases， the lack of industrial incentive policies and the selection of medical insurance standards are the main reasons for the difficult access to medical insurance for rare diseases. To solve this problem， need to start from the aspects of rate disedses defined standards， health insurance directory， supply and price of orphan drugs， combined with the basic medical insurance， commercial insurance and social assistance for the formation of multi payment mechanism， so as to solve the drug problem in China for patients with rare diseases.