Healthcare & Medical Insurance in China

The quality of healthcare in China (in urban areas) is generally comparable with Western standards. In the countryside, this may not be the case. China’s three-tier system starts with community walk-in clinics which are then escalated to larger hospitals, and then on to 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 implementation; natives are used to hospitals being the primary source of healthcare, so it is considered normal 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. 

If you are relocating to China for work, your employer is likely to provide you with the necessary health insurance. The premiums of Chinese state insurance are often high and coverage is limited. If you are self-employed, you can also benefit from the national plans, but all contributions must be made privately.

If you are working for an international company based in China, you are usually offered the enterprise’s own insurance plan. With many companies offering comprehensive coverage, you could try negotiating a private healthcare package, even if your employer is based in China. 

Otherwise, 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 gaps in China’s public insurance plans and the majority of imported western prescription medicines are not covered by them. For example, 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 will 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 areas. In rural areas, waiting times can be longer as the emergency services are more limited. The emergency personnel are trained to a high standard but often do 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 a medical emergency, dial 120 or 999. As a precaution, expats often keep the details of their embassy in case of emergency. Information on emergency visits is not routinely sent to your GP (General Practitioner), so do not forget to ask for a medical summary when you are 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

Taking an appointment with your family physician or doctor is not common in China, as locals tend to go straight to the hospital for any medical problem. In order 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 then assess you and either run tests, prescribe you medicine or ask you to stay in if needed (for a surgery or observation). Be aware that not all applications have English interfaces, and some pages will only be available in Chinese. 

It is also important to note that 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 try to prescribe herbal medicine for non-life-threatening illnesses. 

Chinese Prescriptions and Pharmacies

In China, there is no shortage of pharmacies and you can usually find at least one 24-hour pharmacy in most cities. However, be aware that they stock both traditional Chinese medicine and Western medicine. Your local pharmacist may not speak English and will offer you traditional Chinese medical alternatives instead of Western medication. Labels and instructions are often in Mandarin, so find a colleague or friend who can help you translate. Some Western medicines are restricted by the Chinese government, so if you need specific medication, you should check with your doctor and the Embassy for China to check 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. It is important to note that the use of long-term oral contraceptive pills is not widely accepted in Chinese culture. As a result, there is a very limited choice of medications for expats. 

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 with English-speaking medical staff. Many of these wards don’t accept international insurance, so you will have to 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.