Health insurance in China

The Chinese healthcare system is perpetually evolving as the government tries to find solutions to provide services for nearly one and a half billion citizens. Their Healthy China 2020 initiative, committed to provide an efficient, affordable, and accessible healthcare system for all by 2020, but its implementation had to be extended to 2030. While improvements have certainly been made, many Chinese citizens complain that they still must pay a large share of their medical bills out of their own pockets. This can be costly, and so taking out individual health insurance can buffer these expenses considerably.

Health insurance for expats in China

How does the healthcare system work in China?

China has almost universal coverage through publicly funded basic medical insurance. Employed residents, be they citizens or foreigners, must enroll in an employment-based program, which is funded primarily through the employers. The self-employed can voluntarily enroll in this Basic Medical Insurance. 

This system works on the basis of:

• Personal accounts, into which each employee pays social security contributions, which allow them to finance their outpatient care and medication (until the account is exhausted). Expenses below 10% of the employee's annual salary are fully covered.

• A common hospitalisation fund, which covers 50% to 80% of the expenses incurred (when they fall within a minimum threshold of 10% of the local annual average wage and a maximum cap of 6 times the local annual average wage).

This basic scheme, therefore, very often requires insured residents to pay out of pocket to supplement their medical expenses. Thus, private health insurance helps to cover cost-sharing and coverage gaps.

How to choose health insurance in China: local or international?

Residents in China get a considerably low level of reimbursement for healthcare expenses from their basic cover. This is even more so when they use the private sector (which is often more modern and better equipped than public facilities), whose fees are often very high.

Taking out supplementary health insurance is therefore highly recommended. Some Chinese employers provide it to their employees, but beware as the coverage of local insurers' health insurance policies can vary considerably. Some drugs or tests may not be included, and some medical treatments might not be covered. In addition, many policies have high deductibles, coverage limits and waiting periods.

Given the overall scenario, you might want to consider taking out international health insurance. They are flexible and can be tailored to your particular needs, offering a higher level of coverage and possibly extending to several countries.