Objective: Under the premise of the policy of "Everybody has health insurance", It is explore d the plan of the integration of the basic medical insurance system for urban and rural residents in Tibet about the problems and the countermeasures. Methods : Descriptive and contrastive methods were used to analyze the status of urban and rural medical system operation in Tibet. Results: The problem of unbalanced development of urban and rural medical and health services in Tibet and the management of post - merger were put forward. Conclusion: It is necessary to put forward policy recommendations from the aspects of horizontal co-ordination, multi-sectoral collaborative management, unified medical insurance information management system, hierarchical diagnosis and treatment mechanism, perfect Tibetan medicine reimbursement catalog, "one system and multiple files" and vertical co-ordination, and gradually realize the urban and rural medical insurance in Tibet System integration