Objective Evaluation of urban resident medical insurance for catastrophic disease and insurance companies in Shanghai so as to provide decision references for policy designers. Methods Literature review, policy review and quantity data searching method were used to collect data of specific policy design for catastrophic diseases insurance and operation status of insurance companies from 2014 to 2016. Results The number and the per capita amount of compensation of catastrophic disease insurance benefits and needs to be improved. ?Two companies comprised 5%?of?the?total volume. Conclusion The diseases should be expanded moderately and improve the entrusted management mode to give full play?to?insurance companies effectively. Also the medical insurance for catastrophic diseases should be third-party assessed regularly to improve the precision