Short videos of tourists wearing exoskeleton robots for "pain-free mountain climbing" once swept across social media platforms. Now, these intelligent exoskeleton devices have been formally written into the blueprint of national-level medical security. On August 20, it was learned that the National Healthcare Security Administration recently issued the "15th Five-Year Plan for Universal Medical Security" (hereinafter referred to as the "Plan"), which, in promoting long-term care insurance (hereinafter referred to as "LTCI"), calls for advancing the application of intelligent devices such as smart exoskeletons in the long-term care sector. In the context of LTCI, how can one device carry the hope of breaking through the dilemma of "one person incapacitated, the whole family off balance"? And how far is it from truly entering the homes of every elderly person with disabilities?

Encouraging smart devices into disabled households

LTCI is known as the "sixth social insurance." Since China launched the LTCI pilot program in 2016, after a decade of exploration, the current coverage has reached 320 million participants. In terms of its operational mechanism, LTCI pools funds through universal participation, providing basic daily care and medical nursing for insured individuals who have lost normal mobility, and reimbursing the nursing expenses incurred. The Plan proposes that during the "15th Five-Year Plan" period, the LTCI system will cover all coordinated regions. In promoting LTCI, the Plan also calls for rational distribution of long-term care service resources, fostering innovation in related fields, and advancing the application of intelligent devices such as smart exoskeletons in the long-term care sector.

What exactly is a smart exoskeleton? It is understood that an exoskeleton is an external supporting structure used to enhance the motor abilities of a biological body or provide protection. Taking the common lower-limb exoskeleton robot as an example, as a wearable bionic intelligent device, it can provide assistance, protection, and precise support for lower-limb movement through human-machine collaboration, and is widely used in fields such as medical rehabilitation. For exoskeleton robots, they have gained some fame as "climbing gadgets," with multiple scenic spots having launched exoskeleton-assisted mountain climbing services, helping outdoor enthusiasts enhance physical stamina and reduce injury risks.

In fact, policy signals have been intensifying regarding the push to connect such devices with LTCI. In May this year, the Ministry of Civil Affairs, at the ninth plenary meeting of the Inter-Ministerial Joint Conference on Accelerating the Development of the Rehabilitation Aids Industry, released a major signal: promoting the inclusion of eligible rehabilitation aids into the payment scope of medical insurance, work injury insurance, and LTCI at the appropriate time. In July this year, the "Three-Year Action Plan for Expanding Capacity and Upgrading Quality of the Rehabilitation Aids Industry (2026-2028)" jointly issued by 14 departments including the Ministry of Civil Affairs and the National Healthcare Security Administration clarified that at the national level, based on changes in the demographic situation and institutional development, research would be conducted on exploring the inclusion of intelligent services and supportive assistive devices related to long-term care into the LTCI payment scope.

Regarding how such devices can address challenges in the long-term care sector, Long Ge, co-founder and general manager of Zhongtuobang, stated that exoskeletons reduce complications such as pressure sores, thrombosis, and muscle atrophy by assisting with standing and walking, transforming the situation from "the whole family serving a bedridden patient" to "device plus caregiver collaborative rehabilitation," thereby reducing the physical and time investment of family members and delaying the time when the elderly need to enter institutions. "Such devices and services are a rigid need for the disabled elderly population in an aging society" - this is precisely the deeper reason behind the dense policy rollout.

Multiple hurdles remain for implementation

The policy signals have lit up, but what is the actual status of smart exoskeleton implementation in the LTCI field? At present, medical exoskeleton devices transitioning from rehabilitation departments to the LTCI sector are still in a "breaking-the-ice" phase. Long Ge stated that from an exploratory perspective, more than ten provinces including Beijing, Shanghai, and Jiangsu only reimburse 50%-70% of medical exoskeleton rehabilitation training service fees (not the device itself) under Class B medical insurance or LTCI pilots, and consumer-grade walking-assist devices have not yet entered the catalog.

Regarding the pace of implementation of smart devices like exoskeletons in the LTCI field in the next step, Long Ge predicts that against the backdrop of relevant policy releases, from 2026 to 2028, there will be a three-step acceleration of "hospital rehabilitation projects - community rental service packages - home assistive device rental," with medical-grade products advancing faster than consumer-grade ones. Undoubtedly, against the background of an aging population and rapid technological development, intelligent assistive devices are experiencing robust growth and playing an important role in the care of disabled individuals. In terms of market size, IDC data shows that in 2025, the market size of medical rehabilitation exoskeleton robots in China is approximately 1.42 billion yuan, with shipments of around 3,200 units. Currently, hospital rehabilitation departments, rehabilitation specialty hospitals, and rehabilitation centers remain the primary application scenarios.

However, it is important to note that lower-limb exoskeleton robots have formed technological prototypes and application cases in various fields, but large-scale promotion still faces bottlenecks such as persistently high costs, insufficient battery life, and limited user adaptability. Long Ge summarized the difficulties as "four-fold constraints": a single unit costing over 100,000 yuan is unaffordable for families, there is no dedicated LTCI coding and efficacy-based pricing, consumer-grade products lack elderly fall-prevention safety standards, and there is a lack of home maintenance and data feedback systems. In response, regarding the exploration of better models, Long Ge suggests adopting a model of "LTCI pays for rental plus training service packages (with continued payment based on standing/steps efficacy) plus community assistive device pool circulation plus medical/home graded products," rather than encouraging direct purchase of devices into homes.

Overall, the policy has paved the way, but before devices enter homes, multiple hurdles such as cost, standards, and service models remain to be crossed. In the view of industry insiders, when an exoskeleton robot truly becomes an "affordable and easy-to-use" daily device for families with disabled elderly, the dilemma of "one person incapacitated, the whole family off balance" will see further breakthroughs. For insurance companies playing roles such as administrators, there is also room to make efforts in the field of smart devices plus LTCI. Long Ge stated that the direction could be for insurers to set service standards and data interfaces, for manufacturers to create "LTCI-customized versions" (removing scenic-spot functions, adding fall-locking and gait reports), and to package "device plus rehabilitation therapist follow-up visits" as commercial insurance add-on packages or enter into risk-sharing agreements based on reduced rehospitalization rates, rather than insurers getting into robot manufacturing themselves.