Objective To investigate satisfactory degree on basic medical insurance system for the aged and to provide more data for improving insurance policies. Methods A face-to-face questionnaire survey was carried out with 367 elderly residents in Zhoupu communities in Shanghai using cluster random sampling method. The survey included social demographic characteristics, medical insurance, chronic disease, health cost, etc. The data were analyzed using descriptive statistical analysis, Chi-square test and multivariate logistic regression analysis by SPSS software. Results Totally 357 effective questionnaires were collected, with the effective rate being 97.3%. The overall satisfaction rate of the retired employees was high according to our survey, but the satisfaction rates of urban non-employed residents and land-requisitioned peasants were relatively low (P<0.001). Single factor analysis and multiple factor analysis both revealed that income, number of chronic diseases and self-rating health had significant association with satisfaction rate of the participants (P<0.05). Conclusion The basic medical insurance for urban non-employed residents and landless peasants needs to be further improved.