To evaluate the policy effect of basic medical insurance, we employs the fixed effect model and Heckman two-stage model to conduct an empirical analysis of the impact of the basic medical insurance system on the life quality of the rural middle-aged and elderly residents, based on the CHARLS from 2011 to 2018, taking rural middle-aged and elderly residents as the study object.The results show that, the basic medical insurance system could significantly improve the life quality for the participants, but there are the heterogeneity differences. More precisely, the basic medical insurance system plays a more positive role in life quality for high-income people and frail people. Finally, by comparing the NRCMS with the integration of urban and rural social medical schemes, this paper finds that the latter plays a more important role in improving the life quality. Based on the empirical analysis, this paper puts forward relevant policy suggestions for the basic medical insurance system.