It is of great significance to introduce commercial insurance mechanism into the management of medical security in order to improve our multi-level medical security system and realize the strategic goal of the governance ability and modernization of the management system in the medical security field. With the characteristics of "wide threshold，low premium and high insurance amount"，city-customized insurance has developed rapidly in recent years，and has outstanding advantages in serving the medical security management in China. It analyzes the current situation of insurance participation in medical security governance from the aspects of government policy support and governance mode，then analyzes the effectiveness and existing problems of insurance participation in medical security governance，and finally puts forward corresponding countermeasures and suggestions.