2024 Guide to Health Insurance & Healthcare in China

China's booming economy and growing international businesses have created numerous job opportunities for expats in various sectors. Despite the rapid development, the cost of living in many parts of China can be relatively lower compared to Western countries, offering expats a higher standard of living with their income.

If you plan to move to China, familiarising yourself with the healthcare system and securing proper health insurance is crucial. This article will help you make informed decisions about your health and well-being in the country.

Public vs. private healthcare in China

China had approximately 36,570 hospitals in 2021, with private institutions making up about two-thirds. Public hospitals remain a predominant option, commonly offering modern medical technology and staffed with highly trained doctors.

Public facilities: While public hospitals in China generally offer medical expertise that compares favourably to Western standards, expats often face several challenges when accessing these facilities.

Public hospitals are known for being overcrowded, leading to extended wait times and long queues to see a doctor. The overcrowding also means that appointments with specialist doctors need to be made two or three weeks in advance. However, some public hospitals have VIP departments that provide access to top-tier physicians, shorter queues, and enhanced services, albeit at higher charges.

Communication can also be a significant challenge, as many medical staff in public hospitals do not speak English fluently. This makes it difficult for expats who don't speak Mandarin or other local dialects. To address this issue, some public hospitals have established international departments where medical staff can communicate in English, and they charge services often at a lower cost compared to private facilities.

Additionally, some of the most prestigious public hospitals affiliated with top universities offer world-class care on par with international standards.

Private facilities: In contrast, China's private healthcare sector has expanded rapidly over the past couple of decades, concentrated primarily in major metropolitan centres like Beijing, Shanghai, Guangzhou, and Shenzhen. Private hospitals and clinics are meeting the rising demand for higher-quality care from China's growing middle and affluent classes.

These private medical providers differentiate themselves by offering shorter wait times, cutting-edge facilities and medical technologies, internationally-trained medical staff who often speak English, and hotel-like amenities and customer service.

However, patients can expect to pay far higher out-of-pocket fees at private hospitals compared to public facilities.

Quality of care in rural vs. urban areas

Large urban hospitals and medical centres are typically equipped with modern technology, state-of-the-art diagnostic equipment, and specialised treatment facilities that are not widely available in rural areas.

Urban areas often have a greater number of specialised hospitals and clinics dedicated to specific medical fields, such as cardiology, oncology, and neurology, providing access to advanced and comprehensive care.

In contrast, rural healthcare facilities often lack advanced medical equipment, specialised treatment facilities, and modern diagnostic tools, limiting the range of services and treatments available.

Rural areas also face a shortage of qualified medical professionals, as many doctors and specialists prefer to work in urban centres with better career opportunities and resources. Remote rural areas have limited access to healthcare facilities, with patients needing to travel long distances to seek medical attention, potentially delaying critical care.

The costs of healthcare in China

While basic healthcare services are relatively affordable in China, hospitalisations and specialist care can be quite expensive. According to China Access Health, these are the typical costs of healthcare in the country:

If you’re going to see a doctor, major cities like Beijing and Shanghai typically have higher medical bills for similar treatments compared to smaller Tier 2 or 3 cities. For instance, a well-known private clinic chain like Parkway Health might charge around USD 225 for a general consultation with a family doctor in Shanghai. In Suzhou, a nearby Tier 2 city, the same consultation at a Parkway Health clinic could cost 10-30% less, ranging from roughly USD 158 to 199.

The cost of emergency room service at a private hospital in Beijing like Beijing United Family Hospital is expected to be between USD 276 to 591, while critical care would cost between USD 693 to 1,055. Inpatient surgery costs can vary significantly, ranging from USD 765 to 22,500. This vast range depends heavily on the complexity of the medical condition being treated.

Giving birth at a public hospital in China is a significantly cheaper option compared to private facilities. Expect costs to range between USD 450 and 1,200 for a natural delivery in a standard room. If you opt for a VIP section with more amenities and privacy, the price jumps from USD 1,500 to 5,250.

Important things to remember:

• Location: Bigger cities tend to have higher healthcare costs.

• Tier 1 hospitals are generally community hospitals or clinics that focus on preventive care and provide basic medical services. Think of them as your first point of contact for routine checkups or minor illnesses or injuries. Most public Tier 1 hospitals receive government funding, making treatment generally less expensive.

• Tier 2 hospitals can handle more complex cases and acts as referral centres for tier 1 hospitals when a case is beyond their expertise.

• Tier 3 hospitals are top tier and the largest, most well-equipped hospitals. They offer comprehensive medical care, cutting-edge technology, and specialist doctors.

Traditional Chinese Medicine integration

Traditional Chinese Medicine (TCM) is deeply integrated into China's healthcare landscape. This system incorporates practices like acupuncture, herbal remedies, and massage therapy, offering a holistic approach to treatment.  Many hospitals and clinics even integrate TCM alongside conventional Western medicine.

While the majority of TCM facilities in China primarily serve local patients due to the language barrier, several clinics have adapted to accommodate foreigners seeking TCM treatments. For instance, Body and Soul Medical Clinics in Shanghai offer premium TCM services delivered by English-speaking practitioners.

Under outpatient benefits, APRIL International covers TCM expenses up to the plan limit.

Emergency services

China has a dedicated emergency hotline number 120 for accessing emergency medical services across the country. In major urban centres and cities, emergency medical services are generally well-equipped and efficient. These urban areas have modern ambulances, trained personnel, and access to well-resourced hospitals and medical facilities.

However, some rural areas face challenges, such as a shortage of ambulances, longer response times, and limited access to advanced medical facilities. Expats must be aware of “black” ambulances, which refer to unauthorised or unlicensed ambulance services operating in rural areas. These services may claim to provide emergency medical transportation but they are not part of the official emergency services system.

In the event of a severe medical emergency where appropriate treatment is not available locally, APRIL International provides assistance for emergency medical evacuation and repatriation. This service arranges for transportation to a medical facility with the necessary expertise and equipment.

Is healthcare free for expats in China?

China has a national health insurance program called the Urban Employee Basic Medical Insurance (UEBMI) scheme, which is mandatory for all employed Chinese citizens and legal foreign residents working in China. The UEBMI covers a portion of medical expenses incurred at public hospitals and clinics.

For expats, participation in the UEBMI scheme is generally tied to their employment status. If you're employed by a Chinese company, you and your employer will contribute a fixed percentage of your monthly salary to the UEBMI fund. This entitles you to basic coverage at public healthcare facilities, although the extent of coverage and reimbursement rates can vary across regions.

It's important to note that the UEBMI scheme has limitations. It typically doesn't cover outpatient services, dental care, or some advanced medical treatments.

Health insurance for expatriates in China

Many expats prioritise securing an international health insurance when moving to China. MyHEALTH China offers the perfect solution: a local insurance company's direct billing network and easy access to the extensive benefits of an international medical insurance plan.

This ensures you and your family have access to a wider range of reputable hospitals and clinics to receive the best possible medical care throughout your stay in China or when travelling back home.

You can create your own plan that works for your specific needs, whether you only need coverage for yourself or you also need to cover your family. You can add outpatient, maternity, dental, and optical benefits modules to our inpatient plan, which covers major treatments like kidney dialysis, cancer treatments, and even organ transplants, and you can select one of three levels of coverage for each module.