Objective：We aimed to measure the disease economic risk of Chinese families with the elderly suffered from chronic non-infectious diseases based on the China Health and Retirement Longitudinal Study (CHARLS). Methods：We used logistic multivariate regression analysis and multiple linear regression analysis to specify the differences of the effects of the three medical insurance systems on the economic risk. Results：The results showed that the incidence and intensity of catastrophic health expenditure were higher in Chinese elderly households with chronic diseases. The protection effect of new rural cooperative insurance (NCMS) in reducing catastrophic health expenditure was significantly lower than that of medical insurance for urban employees and urban residents. Conclusion：We suggest that the government should also attach importance to the fairness of the medical security level while focusing on the coverage of insurance，and should pay attention to the elderly with chronic diseases especially the vulnerable groups in rural areas. The funding levels need to be improved in rural areas，and the reimbursement of outpatient and inpatient medical expenses for patients with chronic diseases should be improved at the same time.