Objective: The paper attempts to understand the implementation mode and problems of unified planning for basic medical insurance at the provincial level in 16 provinces of China and provide valuable suggestions for promoting provincial unified planning. Methods: Content analysis was used to analyze policy tools of unified planning for basic medical insurance at the provincial level in terms of policy improvement, pooling mode, incentives constraints, empowerment and assessment, and support and guarantee. Results: In the process of implementing unified planning for basic medical insurance at the provincial level, medical insurance financing and benefit guarantee policies have been unified or gradually unified, and medical insurance unified planning mode that were compatible with regional realities have been promoted. Some provinces have established the incentive and constraint mechanism for balance retention and gap sharing, clarified the relationship of power and responsibilities between the provincial level and municipal level, and established the performance appraisal mechanism. Conclusion: Efficient provincial unified planning requires the improvement of policies, risk balancing, empowerment, evaluation and assessment, and other supporting tools, to make incentive compatibility of interests among participating entities. It is suggested to promote the provincial unified planning model that is tailored to local conditions and in line with regional realities, however, the scientificity and effectiveness of the policy tool design needs to be further improved.