Health insurance in China for foreign expats

The quality of healthcare in China tends to be better in Urban areas than in the countryside. The healthcare system in China, is organised into three-tiers. The lowest tier being community walk-in clinics, followed by large hospitals and then specialist hospitals. However, many locals go straight to larger hospitals for minor illnesses, causing long waiting times. This is due to the poor quality of the community centres and their relatively recent national availabilty; natives are used to hospitals being the primary source of healthcare, hence why its part of the norm to seek medical attention from them first. 

Chinese citizens, permanent residents and (dependant on region) expats can access public healthcare through China’s government insurance plans. Most expats use private insurance as the public health institutions are slower and many treatments (including emergency transportation) are not covered by government plans. 

The premiums of Chinese state insurance are often high, and coverage is limited. Hence why accessing the Chinese health-care system can help with high costs.

For example: If you are relocating to China for work, your employer will often provide you with the necessary health insurance; similarly if you are working for an international company based in China, you are usually offered their own insurance plan or if you are self-employed, you can also benefit from the national plans but you’ll have to make these contributions privately.

Many companies provide broad coverage of a wide range of healthcare services, through comprehensive coverage. Therefore, you’ll have the chance to negotiate a private healthcare package, even if your employer is based in China. 

Otherwise, if you aren’t self-employed or don’t have an employer that could cover you, then you will need to purchase private coverage until you are given residency status.

The state medical insurance plans cover primary, specialty, hospital, and mental health care, as well as prescription drugs and traditional Chinese medicine. However, there are differences in China’s public insurance plans that you may not be used to, such as, most of the imported western prescription medicines are not covered by them. Or although you have public health insurance, your non-working family members may not be covered. So, if you are thinking of relocating, you should thoroughly research what your public health insurance covers and whether you need extra private coverage. 

Not all hospitals recognise all private insurers, including some Chinese insurers. So, you’ll have to pay a deposit or fees for medical services upfront - often in cash. Your insurance will reimburse you later. 

Emergency care

Medical emergencies are usually well managed in urban than in rural areas, this is because waiting times can be longer as the emergency services are more limited. The emergency teams are trained to a high standard but may not speak English, so it would be useful for you to learn some basic phrases in the local dialect, as well as specific words for chronic illnesses or allergies. In case of emergency, dial 120 or 999. Expats, also often keep the details of their embassy to hand too. Information on emergency visits is not routinely sent to your GP (General Practitioner), so don’t forget to ask for a medical summary when you’re discharged. 

Unfortunately, due to a shortage of state-regulated ambulances across China, private or ‘black’ ambulances have been used to meet demand. Many of these vehicles are unauthorised and staffed by unqualified professionals, so all expats are advised to avoid them.

Getting a doctor’s appointment in China

There are two types of hospitals in China: TCM (Traditional Chinese Medicine) and Western medicine. The former is often clearly marked by ‘TCM’ in the name of the hospital. Many physicians practice both types of medicine and may prescribe herbal medicine for non-life-threatening illnesses. Be aware that not all applications have English interfaces, and some pages will only be available in Chinese. 

Booking an appointment with your doctor is not common in China, as locals tend to go straight to the hospital for any medical problem. To get an appointment with a physician at a hospital, you would need to use an online service. Locally, there are apps where you can see available doctors at hospitals in your area and book a consultation. Your doctor will assess you and then either run tests, prescribe you medicine or ask you to stay in if needed, for example, a surgery or observation.

Chinese Prescriptions and Pharmacies

In China, there is no shortage of pharmacies you’ll usually find at least one 24-hour pharmacy in most cities. They stock both traditional Chinese medicine and Western medicine. Your local pharmacist may not speak English but will still be of good help. Labels and instructions are often in Mandarin, don’t worry, a colleague, friend or an app can help you translate. Some Western medicines are restricted by the Chinese government, so if you need specific medication, you’ll need to check with your doctor and the Embassy for China to see if you can bring your own supply. 

As part of the government’s measures to control the spread of Covid-19, it is not possible to buy antipyretics (such as ibuprofen and other medicines used to reduce a fever) from a pharmacy without a prescription.

Pregnancy and Giving Birth

You generally have the choice between a public, private or an international hospital. Check out our complete guide to pregnancy and giving birth in China to find out more. As the use of long-term oral contraceptive pills is not widely accepted in Chinese culture there is limited choice of medications for expats. 

VIP Wards and International Hospitals

Bridging the gap between public and private healthcare, VIP wards (sometimes referred to as international wards) are found in some public hospitals. They are more expensive than public wards, but cheaper than private hospitals, and tend to have a higher standard of care along with English-speaking medical staff. Many of these wards don’t accept international insurance, so you’ll  pay in cash and then claim the money back from your insurance provider.

International hospitals are a type of private hospital that meets certain international standards. In both cases, these hospitals offer a better standard of care and contain English-speaking staff, so they are preferred by expats.

Although public insurance covers many of your medical needs, there are significant limits to each policy and your medical care will be subject to deductibles and reimbursement ceilings. There is also no cap on out-of-pocket spending annually. Due to these gaps in coverage, delays and lack of English-speaking staff, private medical insurance is often favoured by expats.