By evaluating the implementation effect of the full coverage policy of essential medicines for rural elderly patients in primary health care institutions in Qidong， this paper puts forward some suggestions for policy optimization. Based on the medical data of elderly patients over 70 years old who participated in basic medical insurance in Qidong， this paper quantitatively analyzed the changes of diagnosis and treatment indicators before and after the implementation of the full coverage policy of essential medicines， and conducted qualitative interviews with key insiders. The results showed that， after the implementation of the policy， the average monthly discharge of the beneficiary population increased by 478（P=0.001）， the average NCMS medical insurance compensation increased by 472.52 yuan（P<0.001）， the average out?of?pocket expenses decreased by 430.35 yuan（P<0.001）， the proportion of patients per time out?of?pocket decreased by 14.8%（P<0.001）， and the average hospitalization expenses increased by 31.18 yuan（P<0.001）. The interview results also showed that the policy had reduced the burden of seeking medical treatment for elderly patients and improved the utilization of inpatient health services for elderly patients. In order to ensure a better implementation effect of the policy， it is suggested that the implementation of the full coverage policy of essential medicines for rural elderly patients in primary health care institutions should be promoted step by step， the implementation of supporting measures should be strengthened， waste should be avoided， and a separate fund?raising channel needs to beset up.