Objective: To summarize the guarantee mode of inclusive health insurance for rare diseases, and evaluate the impact of including rare diseases into the guarantee scope on the operation of inclusive health insurance, as to provide empirical evidence for further exploring the sustainable development path of inclusive health insurance for rare diseases. Methods: The guarantee mode of inclusive health insurance for rare diseases is summarized by selecting 62 products that does not limit the pre-existing conditions of rare diseases. Based on actuarial pricing technology, 5 high-value drugs for rare diseases with special clinical efficacy and urgent drug demand of patients and their corresponding universal benefit products with prominent insurance coverage are selected to conduct insurance cost analysis. Results: At present, the guarantee modes of inclusive health insurance for rare diseases mainly include insurance coverage in the medical insurance catalog, special drug coverage, hospitalization insurance coverage outside the medical insurance catalog and other coverage. Inclusive health insurance has sustainability in protecting rare diseases. Conclusion: Inclusive health insurance can make up for the protection gap of patients with rare diseases to a certain extent, but there is still a large room for improvement in the protection level of most products for rare diseases, and emphasis should be placed on optimizing the product protection responsibility of inclusive health insurance in the future. On the premise of fully considering local medical insurance policies and drug prices for rare diseases, inclusive health insurance can effectively balance operational risks by ensuring certain coverage rate and setting reasonable compensation standards, so as to achieve sustainability.