China – Doctors

How does the healthcare system in China work, and does it cover expats?

China’s healthcare structure combines publicly financed social insurance with an extensive and expanding private sector. The majority of medical care is delivered through state-owned hospitals, while insurance administration is largely handled at the local government level. Rather than a fully centralised model like the UK’s NHS — where the state funds care directly from general taxation — China’s approach resembles a social insurance framework in which both employers and workers contribute to a shared national fund.

The basic health insurance systems fall under the oversight of the National Healthcare Security Administration (NHSA), which was established in 2018. China’s national medical security structure operates across multiple tiers, with Basic Medical Insurance (BMI) forming the primary layer of coverage, supplemented by medical aid, commercial health insurance, and mutual aid arrangements.

BMI in China is divided into two broad categories. The first, the Employee Basic Medical Insurance Programme (EBMI), covers enrolled workers and is funded primarily through payroll contributions from both the employee and employer. Participation in this programme is compulsory for employees in urban areas.

Throughout the 2021–2025 period, China’s basic medical insurance maintained an enrolment rate of approximately 95%, with over 1.32 billion individuals covered in 2024 according to the NHSA. This makes China’s healthcare security network one of the largest anywhere in the world, though both the quality of care and ease of access vary considerably from one region to another.

The Urban Employee Basic Medical Insurance (UEBMI) scheme is mandatory for all employed Chinese nationals and legally resident foreign workers in China. For expats, participation in UEBMI is generally linked to their employment status. Those hired by a Chinese company will find that both they and their employer contribute a set proportion of monthly salary to the UEBMI fund. This entitles the contributor to basic coverage at public healthcare facilities, though the level of coverage and reimbursement rates differ from city to city.

Because local governments bear responsibility for healthcare provision, some rural areas may not extend services to foreign residents. Permanent foreign residents in China are generally entitled to the same healthcare entitlements as Chinese citizens, whereas tourists and undocumented immigrants are excluded. Expats should always verify current eligibility rules with the National Healthcare Security Administration (NHSA) or their local government’s social security bureau, given that policies can differ between municipalities.

China’s healthcare system is structured in three tiers: community walk-in clinics at the base level, then larger general hospitals, and finally specialist hospitals at the top. In practice, many residents bypass lower-tier facilities and go directly to larger hospitals even for minor complaints, leading to considerable waiting times. China also operates two parallel medical traditions — one rooted in modern or Western medicine, and another built around Traditional Chinese Medicine (TCM).

How do you find and register with a doctor in China?

The idea of registering with a single named GP — as is standard practice in countries like Australia or the Netherlands — does not apply to China in the same way. The country has a notable shortage of general practitioners in the conventional sense, and even straightforward consultations are frequently conducted within a hospital setting. Hospitals serve as the primary venue for both routine and complex medical matters.

Primary care is provided through rural clinics staffed by village doctors and community health workers, by general practitioners or family doctors in township or community hospitals, and by doctors and nurses in secondary and tertiary referral centres. General practitioners do not act as gatekeepers to specialist services. This means that, unlike in countries such as France or Germany, patients can typically walk into a specialist department at a public hospital without first obtaining a referral.

Accessing a public hospital involves registering directly at the facility — a process known as guahao (挂号). Patients are usually required to select a department when making their booking. If the wrong department is chosen, they may be redirected after waiting, or may need to repeat the booking process. According to China’s National Healthcare Big Data Report (2024), more than 85% of hospitals in urban areas now support mobile registration services.

A valid passport is typically required when registering at a hospital in China, serving as proof of identity for medical administration purposes. Expats enrolled in the public social insurance system will also need to present their medical insurance card. Usually, the employer registers the foreign worker in the medical insurance system through the local social security centre. From the 15th day of the enrolment month onwards, employees can present the passport used for registration at the nearest community affairs service centre to obtain a medical insurance card, which is issued immediately on the spot.

For those who prefer private care, appointments can be arranged by calling the clinic or hospital directly, or through its website. Once booked, you simply attend at your scheduled time. Applications such as Ping An Good Doctor and Chunyu Yisheng also let users search for doctors according to location and medical requirements. For the most current guidance on registration procedures in your city, contact your local municipal health authority or visit the National Health Commission of China.

How do you pay for a doctor’s appointment in China?

The way medical care is paid for in China depends largely on where treatment takes place and whether the patient is enrolled in the public social insurance system. Payment methods, fee levels, and reimbursement processes differ substantially between public and private settings.

Under the Urban Employee Basic Medical Insurance scheme, the costs of healthcare are shared between employer and employee. As a general guide, employers contribute around 6% of the employee’s salary, while the employee contributes roughly 2% of their own salary, though these figures vary across municipalities (as of 2025). Always confirm exact contribution rates with your employer’s HR team or the local social security bureau, as these figures are subject to periodic revision.

Once enrolled, foreign employees receive the same reimbursement entitlements as their local counterparts. Inpatient expense reimbursement rates under these plans remain at approximately 80% for employees and 70% for residents (as of 2024), meaning the patient remains liable for a co-payment on the outstanding balance. Check the NHSA website for the co-payment thresholds that apply in your municipality.

For individuals without public insurance — or when attending private facilities — all costs must be paid out of pocket and can be considerable. At public hospitals and community clinics, consultation fees typically fall in the range of 20–50 RMB (roughly USD 3–8). At private hospitals and clinics, fees may range from 500–3,000 RMB (approximately USD 77–462) per consultation, depending on the specialist involved (as of 2024).

For non-emergency medical treatment, most hospitals require payment before services are rendered. The majority of facilities accept both cash and digital QR code payments via platforms such as WeChat Pay or Alipay. More than 90% of healthcare payments in urban China are now completed through digital wallets. Nonetheless, it remains sensible to carry some cash as a backup in case mobile payment is not available.

If you intend to submit a claim to a private insurer, careful documentation is essential. The most common reasons for rejected claims include missing diagnosis summaries, the absence of itemised billing, and failure to obtain an official invoice (发票 / fāpiào). Standard receipts are often not accepted by international insurance providers.

Do you need private health insurance to see a doctor in China?

Private health insurance is not a legal requirement for most expats who are already covered by China’s public social insurance system through their employment. That said, the constraints of public coverage — combined with the high cost of private facilities and the language difficulties that frequently arise in public hospitals — mean that the majority of expats choose to top up their cover with an international or private health insurance policy.

The UEBMI scheme has notable gaps. It does not fully cover outpatient services, dental treatment, or certain advanced procedures. Many expats make securing international health insurance a priority when relocating to China. The majority of imported Western prescription medications are not included in public insurance plans, and non-employed family members may not be covered even when the working expat holds public insurance.

Private healthcare facilities in China are generally more modern, less congested, and better maintained than their public counterparts. Most expats opt for private or international hospitals in order to access a standard of care similar to what they experienced in their home countries. The fees charged by these facilities can, however, be very high.

Sitting between the public and private sectors, VIP wards — sometimes referred to as international wards — exist within certain public hospitals. These wards are more costly than standard public wards but less expensive than fully private hospitals, and they tend to offer a higher quality of service alongside multilingual medical staff. Many of these wards do not have direct billing arrangements with international insurers, so patients may need to pay in full upfront and then claim reimbursement from their insurance provider.

Regarding visa requirements: China does not universally require proof of health insurance as a condition for all residence permits, though requirements can vary by visa category. Those on long-term visas or applying for permanent residency should check current requirements directly with the National Immigration Administration of China and their nearest Chinese embassy or consulate, as insurance-related conditions are subject to change.

Before attending any hospital or clinic, confirm that the facility is covered by your health insurance plan. Many international hospitals have direct billing agreements with major insurers, which streamlines the payment process. If your insurance is not accepted at that facility, enquire about reimbursement options before proceeding.

How do you transfer your medical records to a doctor in China?

No international mechanism exists for automatically transferring your medical history to a new doctor in China. As an expat, you will need to take the initiative to obtain your records from your home country and bring them with you, or arrange for them to be sent electronically before you arrive.

Before departing your home country, request a comprehensive patient summary from your current doctor or healthcare provider. Ideally, this should cover your medical history, existing diagnoses, ongoing medications, vaccination history, and any known allergies. Where possible, arrange for this summary to be translated into Mandarin Chinese prior to arrival, since many doctors working in public hospitals will be unable to read documents written in other languages.

Medical documentation from your home country can give doctors in China a clearer picture of your health background. When sharing materials with a doctor in China, a concise translated summary will be far more practical than an untranslated multi-page file — particularly during a brief outpatient consultation.

Doctors in China enter diagnoses and prescriptions into an Electronic Medical Record (EMR) system. While some hospitals allow patients to view these records through a dedicated app, most international insurance providers require a physical printed copy for claims purposes. Before leaving the consultation, ask the doctor to print your medical record (请打印病历 / Qǐng dǎyìn bìnglì). In some hospitals this can be done in the consultation room; in others, you may need to use a self-service printer in the hospital lobby, using your registration slip or QR code.

International departments at major hospitals usually provide documentation in English. Standard outpatient departments may issue records in Chinese only, but translations can often be requested. If you need certified translations for insurance claims or for use in another country, engage a professional medical translation service, as documents produced by machine translation are unlikely to be accepted.

China’s public hospitals use nationally networked EMR systems administered under the National Health Commission. For information about your rights as a patient and how to obtain your records, refer to the National Health Commission of China.

What should expats know about language barriers and finding a multilingual doctor in China?

Language is among the most significant practical obstacles expats encounter when seeking medical care in China. The extent of this challenge varies greatly depending on your location and the type of facility you visit.

Communication difficulties are common, as many medical staff in public hospitals do not speak English to a functional level. This creates real barriers for expats who are not fluent in Mandarin or regional dialects. To help address this, some public hospitals have set up dedicated international departments where staff are able to communicate in English, often at a lower cost than fully private facilities.

Many large public hospitals, international hospitals, and private clinics in major cities employ staff with English-language ability. Smaller local clinics are less likely to offer services in any language other than Chinese. In rural areas, multilingual staff are particularly scarce, which can make navigating care considerably more challenging for expats who are not proficient in the local language.

Expats can identify multilingual healthcare providers by looking into international hospitals that employ multilingual staff, such as United Family Healthcare Hospital, Shanghai Jiahui International Hospital, and similar establishments. Among the most widely recognised international providers operating in China are United Family Healthcare (UFH), Oasis International Hospital, and Raffles Medical.

Consulates in Beijing, Shanghai, Guangzhou, and Wuhan maintain lists of recommended doctors, specialists, clinics, and hospitals for foreign nationals. Insurance companies are another useful source of such lists. Reaching out to your local expat community can also yield valuable personal recommendations.

Expat community groups and online forums are excellent resources for gathering trusted referrals from people with firsthand experience. Local WeChat groups in particular can be very helpful for identifying reliable doctors and clinics in your area. Telemedicine is an increasingly viable option in China, especially for routine or non-urgent consultations. Platforms such as Jiahui Health and WeDoctor offer English-language services, allowing patients to speak with a doctor from a distance.

Given the size and diversity of China’s international community, there is also demand for physicians who speak languages beyond English and Mandarin, including Japanese, Korean, Spanish, Italian, German, and French. If you need a consultation in a language other than English or Mandarin, contact international clinics directly or speak to your insurer’s support team about what may be available.

In standard outpatient settings, bringing a Mandarin-speaking companion or using a translation application can help you communicate more effectively. Preparing a written summary of your symptoms and medical background in Chinese before your appointment can make a meaningful difference to the quality of care you receive.

What do expats need to know about prescriptions and medication in China?

China’s prescription and medication system differs from what expats may be accustomed to in their home countries, and it is worth familiarising yourself with these differences before you need medical attention.

A typical visit to a Chinese hospital follows this sequence: Registration → Consultation → Payment → Tests (if required) → Results → Diagnosis and Prescription → Payment → Pharmacy or Treatment. Prescriptions are issued by the treating doctor and can normally be filled at the hospital’s own pharmacy immediately following your appointment.

Foreign nationals can purchase common over-the-counter medicines at pharmacies throughout China, although some medications will require a doctor’s prescription. It is advisable to confirm the intended use and active ingredients before taking anything. If you rely on a regular medication from your home country, bring an adequate supply to cover the initial transition period, as the same branded drug may not be available in China under the same name.

Certain medications may be sold under different brand names in China, or may not be stocked at all. Generic equivalents are generally available. Always inform your doctor in China of any medications you are currently taking. If you need to continue a prescription drug you take on an ongoing basis, ask your Chinese doctor to review the formulation and prescribe the closest locally available equivalent.

China’s public medical insurance covers a defined range of medications. Drug coverage under the National Medical Insurance is governed by a nationally unified Drug Catalogue, based on generic drug names and updated annually. Category A drugs — those regarded as clinically essential and typically lower in cost — are fully reimbursed under National Medical Insurance. Category B drugs are generally higher-cost alternatives, with patients required to contribute a proportion of the cost themselves (as of 2025).

State medical insurance plans cover both prescription drugs and traditional Chinese medicine. However, the majority of imported Western prescription medications fall outside the scope of public insurance. If you depend on a specific imported drug, factor its full out-of-pocket cost into your financial planning and check whether your private health insurance policy covers it.

A unified national drug catalogue currently lists 3,159 medicines covered by the national insurance scheme (as of 2024). For the current list of covered medications, refer to the NHSA Drug Catalogue. A number of major international insurers, including Allianz and MSH, offer complimentary drug delivery programmes, which are especially beneficial for patients with chronic conditions requiring regular medication. Review your insurance policy’s added-value services to see whether this benefit is included.

Responsibility for regulating medicines in China rests with the National Medical Products Administration (NMPA), which performs a comparable role to the EMA in Europe or the FDA in the United States. Consult this authority’s website to determine whether a particular medication is licensed for sale in China.

Frequently asked questions

What do I do in a medical emergency in China?

In the event of an emergency, dial 120 or proceed immediately to the nearest emergency room. Emergency medical centres operating under the 120 system are found throughout mainland China. In Beijing, you may call (+8610) 120 to request pre-hospital emergency services. If you are in a major city, the nearest Tier 3 public hospital will generally be best equipped to handle serious emergencies. International hospitals in large cities also treat emergencies but may ask for upfront payment. Keep your passport and insurance details with you at all times.

Will my pre-existing conditions be covered by Chinese public insurance?

Under the Social Insurance Law of the People’s Republic of China and its local implementing regulations, foreign employees who are legally enrolled in China’s social insurance system are entitled to the same benefits as local employees. However, private insurance plans vary considerably — some policies include specific exclusions for pre-existing conditions, defined as conditions that were present or treated before the policy was taken out. Always read your policy documentation carefully and disclose any existing conditions before purchasing coverage.

How long does it take to register for public health insurance as an expat?

Registration in the public medical insurance system is typically handled by the employer through the local social security centre. From the 15th day of the enrolment month, employees can go to the nearest community affairs service centre with the passport used at registration to collect their medical insurance card, which is issued on the spot. Bear in mind that there may be a gap between starting employment and being fully enrolled — speak to your HR department for precise timelines in your particular city.

What happens to my health insurance if I change or lose my job in China?

Insurance benefits are suspended from the month following the cessation of contributions by the employer. Any balance held in the personal account remains intact. Benefits are reinstated once you re-enrol in the scheme. If you relocate for a new job, the insurance relationship can be transferred between cities. It is advisable to arrange private health insurance to cover any period during which you are between employers and temporarily without public coverage.

Can I use my Chinese public health insurance at a private hospital?

Public social insurance generally restricts coverage to government-run hospitals. A limited number of private facilities do accept social insurance — at certain private hospitals in Shanghai, for instance, social insurance may cover 10–30% of the bill, with the remainder payable by the patient. Always confirm the arrangement with your insurer and the specific hospital before your visit.

Can my family members access healthcare under my Chinese public insurance?

The Urban Employee Basic Medical Insurance scheme is mandatory for employed workers but may not extend to non-working family members. Some city-level schemes do permit family pooling, enabling spouses and children to be included in the same account, though this varies by location. For dependants, private family health insurance is often the most practical solution. Check the current rules with your employer or local social security bureau to understand what applies in your city.

Can I use Chinese public health insurance benefits abroad if I need treatment while travelling?

No. Public medical insurance benefits cannot be used or claimed for treatment received outside China. If you travel internationally while based in China, you will need either a dedicated travel insurance policy or an international health insurance plan that provides coverage for treatment abroad. Confirm the territorial coverage of your policy with your insurer before you travel.

Are there any digital tools or apps to help me navigate healthcare in China?

Platforms such as Ping An Good Doctor and Chunyu Yisheng allow users to search for doctors by location and medical need. For non-emergency consultations, telemedicine services are increasingly available in China; platforms including Jiahui Health and WeDoctor offer multilingual options that allow you to consult a doctor remotely. Many hospitals also have their own dedicated apps for booking appointments and viewing records digitally — ask at the registration desk or international department for details of the hospital’s own digital services.