Objective: The paper studies the application problems and countermeasures of medical insurance code in digital economy era. Methods: Taking the urban insured population of Nanchang city as the survey object, a questionnaire about the medical insurance code was designed and distributed, and the specific application of medical insurance code was deeply explored through descriptive analysis, cross-analysis and multiple response analysis. Results: Middle-aged and elderly people knew a little about the medical insurance code and the function of medical insurance code is relatively simple. Compared with employees, residents have a more negative attitude towards the use of medical insurance codes. Technology of the institution limits the use of medical insurance codes. Conclusion: It is suggested to accurately target the middle-aged and elderly groups, improve the medical insurance code to be the elderly-friendly, optimize the institutional medical insurance code system, and promote the development of smart healthcare security.