In this paper, the GM (1,1) model was used to predict the income and expenditure of national employees’ medical insurance fund and residents’ medical insurance fund from 2024 to 2030. Under the realistic background of considering the inclusion of assisted reproductive technology in the reimbursement of medical insurance, an actuarial model was constructed to measure its impact on the operation of employees’ medical insurance fund and residents’ medical insurance fund, respectively. The study found that, first, during the calculation period, the employees' medical insurance fund was in good overall performance, with a cumulative balance of 12024.528 billion yuan by 2030. However, the residents' medical insurance fund began to face the risk of imbalance in 2030, with a deficit of 80.326 billion yuan. Second, even though the penetration rate of the employees’ medical insurance group is high, the inclusion of assisted reproductive technology in the medical insurance reimbursement will release the demand of the residents’ medical insurance group more obviously, that is, the increment of assisted reproductive treatment for the couples of childbearing age who participate in the residents’ medical insurance is higher. Third, when the penetration rate of assisted reproductive technology remained unchanged, the total number of newborns caused by assisted reproductive technology during the calculation period would be 2.9952 million. Increasing the penetration rate will significantly increase the number of newborns. Under the low, medium and high penetration rate growth plan, the total number of newborns will increase by 0.6324 million, 1.1017 million and 1.5710 million during the calculation period, respectively. It is clear that the inclusion of assisted reproductive technology in medical insurance reimbursement is conducive to alleviating the situation of fertility rate decline in China. Fourth, under the same penetration rate growth plan, the expenditure of the residents’ medical insurance fund on assisted reproductive technology is higher than that of the employees’ medical insurance fund, and the expenditure pressure brought by assisted reproductive technology to the residents’ medical insurance fund is much higher than that of the employees’ medical insurance fund. For example, under the plan of high penetration rate growth, the expenditure of employees’ medical insurance fund due to assisted reproductive technology would only account for 0.24% of the fund expenditure in 2030, but the proportion of residents’ medical insurance fund would reach 0.72%, which was about three times the expenditure pressure of employees’ medical insurance fund. Fifth, if there is no policy intervention in the residents’ medical insurance system to maintain the actuarial balance of the fund, the expenditure brought by the inclusion of assisted reproductive technology in the reimbursement of medical insurance will eventually be transferred to the financial burden of the residents’ medical insurance fund. Taking the high penetration rate growth plan as an example, the financial burden of making up the deficit of the residents’ medical insurance fund will rise from 80.326 billion yuan to 150.268 billion yuan in 2030. In view of the above conclusions, this paper puts forward relevant suggestions from the perspectives of how to reduce the number of infertile patients, improve the penetration rate and success rate of assisted reproductive technology, promote the sustainability of residents' medical insurance fund, and prevent the possible moral risks caused by the inclusion of assisted reproductive technology in medical insurance reimbursement, so as to provide references for improving the relevant measures of the inclusion of assisted reproductive technology in medical insurance reimbursement, which is helpful to balance the social benefits and the sustainable development of medical insurance fund.