Based on the Meter-Hom model, the implementation dilemma of outpatient medication guarantee policy for chronic diseases in Nantong was analyzed through qualitative interview, and provide reference for improving the effective implementation of outpatient medication guarantee policy. Results showed that the policy implementation standards and objectives were not clear and concrete, implementation resources were insufficient, implementation method was single, the executive personnel and the patients did not understand policy, the hardware environment support of primary medical institutions was insufficient, and so on. Because of the above dilemmas, there were bias in policy making and implementation, the policy registration rate of hypertension and diabetes were only 7% and 14% , and the patients could not fully enjoy the treatment of policy. Thus, the health insurance department should improve the top-level design, refine the policy implementation objectives, enrich the implementation of methods, establish an effective feedback mechanism, contact multiple departments, strengthen communication and propaganda, strengthen skill training, enhance the quality of primary health care workers, optimize the policy implementation environment, enhance the health quality of the target population, and to make sure the policy is implemented properly and throughout the long term.