Health Insurance and Healthcare in China Explained

Living abroad can make it difficult to understand a foreign healthcare system, especially if there are language barriers or cultural differences.

China has a national healthcare system that covers over 90% of its population. However, coverage is subject to regional interpretations of national laws. Expats have the option of choosing between private insurance, VIP wards and the public system.

This overview of Healthcare in China for expats. It includes insurance options, finding a doctor and even giving birth in China, which can be an extraordinary experience for those who have the right insurance.

In the first few weeks of your move, be aware that many local hospitals and VIP wards don't accept international health insurance. You'll need cash to pay for any treatment and then you can claim reimbursement from your insurance company.

What is the Chinese Healthcare System?

China has free healthcare that is covered by the social insurance program. The basic healthcare system covers the majority of the population, as well as expats. It will vary depending on where you live. Some areas do not require foreign residents to pay the required taxes in order to be eligible for public healthcare.

What does China's Health Insurance look like?

There are three types of medical insurance: basic coverage for employees of urban enterprises, basic coverage for other urban residents and rural cooperative health insurance for the farm population.

China's basic medical insurance for urban employees is mandatory. Both the employer and the employee pay the healthcare costs. The employer pays 6% and the employee 2% respectively. Although they may have different contributions, the average contribution is 6%. This insurance is also available to the self-employed, but they must contribute all.

Non-enterprise residents have their own health insurance and the state pays for it. The state subsidizes insurance for the unemployed and those who receive social assistance.

Are Healthcare Services Free in China?

You will need to pay upfront for healthcare services in China regardless of where you live or how much coverage you have. You may get reimbursement for some or all of the costs depending on which insurance plan you have.

It is important to note that the public healthcare system has some gaps. It doesn't typically cover emergency transport costs, nor does it grant you access to private healthcare facilities. Your non-working relatives may not be covered even if they have public health insurance.

Consider the pros and cons to the health system before you decide on private insurance.

A Review of Private Health Insurance

Private health insurance is a bit of a mystery because the Chinese government is primarily concerned with public healthcare. Private healthcare services can be confusing and costly because of a lack of understanding and cooperation between insurers and hospitals. People with average incomes are not able to afford Chinese health insurance at an average cost. The public is not well informed about the options available to them and those who are able to afford it rarely choose private healthcare.

Private Healthcare Plans in China

Life insurance policies are the most popular type of healthcare plan. These policies pay a lump sum for any serious illness that a person has been diagnosed with. This type of insurance has limited coverage but is very affordable. Private individuals often find reimbursement-type policies too costly, so it is something that most companies are able to afford. Consider asking your employer if they can include you and your family members in your company's group plan.

The current landscape of the market for health insurance is very narrow. The services of local companies are provided in Mandarin, and expats will not find English-speaking customer service. Local companies are available if you speak the language and have someone who can assist you in navigating the process of getting health insurance. You will have more options for choosing your hospital or doctor when you get one from a local company.

China's Health Insurance Companies

Expats often require international healthcare providers. Although they should be able provide all the information in English, their options may be limited. They might not be able cover expenses at certain hospitals. Make sure that you understand your plan's coverage.

You should be aware, however, that international health insurance may not be accepted or recognized in China if you have it. While your global provider may pay for the bills at public clinics, you will need to first pay in cash. The costs of major surgery, such as after an accident, can be quite high.

How to find a doctor or dentist

There are many options available to you when searching for a Chinese dentist or doctor. The Chinese Medical Doctor Association (CMPA) claims that it is the home to four million Chinese medical professionals. Sub-associations were created to bring together such a large group of doctors. They were based on their area (26 regions) or their specialties (18 sub-associations that include dermatologists, neurologists and general practitioners).

How to find a family doctor and specialist

The Chinese online market has a few options for you when searching for a doctor in your local area. Online tools, ChunyuYisheng and Ping An Good Doc, allow you to search for doctors in your local area. You can often check the background of the doctor, find out what hospital they work in, and see their schedule. You can also register for an appointment. The pages, along with many other resources, are only available in Chinese.

Ask your insurance provider for some suggestions if you don't speak the language. Many insurance companies also list the contact information for their affiliated doctors on their websites.

Another option is to ask your friends and family for recommendations. Ask your colleagues and expats for recommendations and visit expat forums online. The Care Voice is a useful website that allows you to read other people's reviews and make recommendations.

How to find a dentist in China

As with all other Chinese hospitals, there are many options for dental care. There are three options: a private hospital, a public hospital, or an expat-oriented one. Prices will increase accordingly. Because standard health insurance does not cover dental procedures, budget for dental visits and any possible treatments.

Finding a Chinese dentist is easy. Simply contact or visit the clinic you prefer and choose from one of their specialists. You can also use the above-mentioned websites to find a local dentist.

Ask around for recommendations if you're looking for a particular doctor. You might find a trusted specialist through your family doctor, while colleagues may have some helpful tips.

China: Giving birth

It should not be difficult to give birth in China as a foreigner. The government should cover most of your maternity costs if you have public healthcare insurance. Make sure you have maternity care included in your private insurance plan.

China has a wide range of prices for giving birth. Fees will vary depending on what type of care you choose, how you deliver (natural or C section), and where you live. China's average cost to give birth in a public hospital is between 2,000 and 10,000 CNY. Private clinics will cost you much more. Expect to pay approximately 50,000 CNY per birth, but don’t be surprised if your bill is higher than 100,000 CNY.

Our guide to working in China will provide more information about the rules surrounding maternity leave.

Prenatal Care in China: How it Works

Many expat women choose to have their baby at a Chinese hospital. This is especially true for those who don't have private insurance. After you have had your pregnancy confirmed by your doctor, you will be given a prenatal care booklet. Keep it safe as your doctor will use it to keep track of important information such as blood pressure, weight, and vital signs.

Prenatal health checks will be performed at regular intervals. They will take place every month, bi-weekly and then weekly for the last month. You will have an ultrasound exam at week 20. This will allow you to view your baby's heartbeat and enable you to get a picture of the inside.

Always make sure you ask the doctor what they are looking for during these tests. You may need to request additional lab work in order to have your urine or blood tested. In some cases, an additional fee will be required.

What to Expect From Public Maternity Hospitals

You should be prepared for whatever awaits you when you give birth in China, the closer you are to your due date. You might face additional challenges if you're giving birth in China.

Language barriers are just one obstacle to overcome. You may also find cultural differences in your home country's attitudes regarding pain management, birthing techniques, the doctor-patient relationship, and spouse roles.

Caesarean sections, for example, are becoming more popular among Chinese women who give birth. Natural births are not very common. Your partner may not be allowed into the room, as you might be required to share the birthing area with other patients.

The standards of medical care for neonatal emergencies vary greatly from one Chinese clinic to the next. However, the majority of children arrive in China more or less quickly, regardless of where they are born.

What is the Hospital Experience in China like?

You will usually spend a week in hospital after giving birth to a healthy baby. You will need to bring your own pajamas, baby clothes, as well as your bed linens, towels, and hospital gowns. You should also bring hygiene products like sanitary napkins and diapers, baby pads, and diapers.

Many public clinics do not provide food for patients. Your family members are expected to visit you after giving birth and provide regular meals.

You should also ensure that you have enough cash to pay for the services. Most people will have to pay cash. For every hospital bill, you should insist on a tax receipt . The provider may reimburse you for costs associated with giving birth in China, depending on what your insurance policy covers.

What happens if you choose a private maternity clinic?

China's private hospitals for maternity are an option if you want to give birth in China but don't have the funds. These Chinese clinics not only have English-speaking staff but can sometimes feel more like a hotel or wellness center than a hospital. All these advantages of having your baby there come with a high price.

China: Citizenship and giving birth

You must take care of administrative matters after giving birth. You must sign up for the official immunization schedule if your baby was born in a public hospital.

Also, make sure you check with the hospital as soon as possible to see if they have issued the Chinese birth certificate. Ask the staff where and how to obtain the official certificate if it isn't. Next, contact your embassy for information on how to register your child's birth there.

Giving birth and citizenship

Parents must wish to give their child Chinese citizenship. Either one must be Chinese, or both must have lived in China. Your newborn Chinese citizenship will not be granted if you are a permanent resident of China.

You will need to fill out additional paperwork if your child wants to be given a nationality other than Chinese. To leave China, you will need a non Chinese birth certificate and a passport. The passport will be issued by your embassy or consulate so that you can apply for the visa at the local immigration authorities.

Note: A Chinese citizen parent may cause additional complications. China does not recognize dual citizenship. However, every child born to a Chinese parent in China is automatically a Chinese citizen. This is why it might be necessary to first reject your child's Chinese citizenship. You can then apply for their foreign passport. If you are in such a situation, please contact the non-Chinese parent's embassy in advance to get legal advice.