Health insurance in China

Whatever your situation and the reason for your stay in China for more or less time: a new position, a new professional opportunity, an internship, a university exchange or simply a vacation, it is important to think about to make sure. What do you need to know about the health system in China?

Before you left for China, did you think about taking out China travel insurance? Mondassur allows you to cover all your risks (health, repatriation, luggage…) by choosing international health insurance customized and adapted to all your needs.

The health system in China

The health system in China is mainly based on its public sector of activity. More than 60% of medical graduates work in public hospitals or institutions. Outpatient care is also administered in these health centres, which account for half of all health care expenditure. In China, the price of health care has exploded due to economic and social reforms. Chinese families have spent much more on health care since the 1980s. Access to healthcare is not free, but there are three types of locally managed public insurance that now cover more than 95% of the population. However, the out-of-pocket expenses remain very high. Moreover, there is no possibility to change insurance companies.
For more than 10 years, if you want to expatriate to China to work, you will have to join the Chinese national insurance scheme.
The health care system in Hong Kong is different from the rest of the country, health insurance is fully funded by the state and neither the employer nor the employee contributes to it. More than 40% of the Hong Kong population has supplementary health insurance. Moreover, this unique system is only available to holders of a Hong Kong identity card. Health care in Hong Kong is extremely well developed, comparable to private sector health care. If you seek medical treatment in Hong Kong but do not have Hong Kong health insurance, health care will be very expensive. The fees charged in health facilities are among the highest in the world. If you want to expatriate to Hong Kong, it is really necessary to take out private health insurance to avoid breaking the bank during your stay.

Local Chinese insurance

In China, the policy of access to health care for all is taken to the letter, which is why the basic medical insurance includes 3 different schemes:

• The Urban Employee Basic Medical Insurance (UEBMI) and self-employed people can join voluntarily;
• The Urban Basic Medical Insurance (URBMI) scheme for non-working urban residents, which covers children, the elderly and unemployed people living in urban areas.
• The insurance scheme for rural residents is the New Cooperative Medical Scheme (NCMS).

There is also an exclusive scheme for government employees which is mainly funded by the government. Unlike the other schemes, this one has no deductible and no annual expenditure limit. Only the financial participation of the insured is limited.

How to consult a general practitioner or specialist in China?

The first level of health care is very low in China, as the country has more than 90% of specialist doctors and less than 10% of general practitioners. This is why the majority of Chinese people go directly to the second level of health care for any reason, i.e. hospitals. You will not find a family doctor in China who will follow you and your family members. The cost of a consultation with a general practitioner in a public hospital is CNY 50 in a standard ward and CNY 300 in a western-style or even VIP ward. A consultation with a GP in a private hospital varies between CNY 300 and 1200 depending on the urgency and condition of the patient. While a consultation with a specialist doctor ranges from 600 to 2100 CNY.
If you want to consult a general practitioner or specialist, go directly to the hospital and if you have good private health insurance (which is recommended in China), go directly to the medical centres for foreigners. These facilities are often equipped with state-of-the-art equipment and the doctors there are likely to speak better English than those in public practice. Waiting times in private clinics are shorter than those in public clinics, but health costs are much higher.

Pharmacies in China

China is the second largest pharmaceutical market in the world, so you will not have to worry about finding medicines that you used to buy in your home country. You will be able to pick up conventional medicines in convenience stores (7-Eleven, Circle-K, PARKnSHOP, Wellcome), pharmacies or health facilities such as hospitals and clinics. In pharmacies, you will usually be asked whether you want traditional medicines or modern medicines. For modern prescription medicines, it is recommended that you go directly to the pharmacy of the hospital or clinic where you were treated.
There are more and more online pharmacies where you can buy medicines. You can easily find OTC (Over The Counter) medicines, which represent nearly 95% of the pharmaceutical market.

How to consult a dentist in China?

If you want to see a dentist, you can go to a large international health care facility where you will be attended to by a dentist who is guaranteed to speak English. The average cost of dental treatment will be higher than in a local hospital, but you will find it easier to make yourself understood and the care you receive will undoubtedly be of very high quality. However, there are good specialists in local hospitals, but the likelihood that you will receive quality care is lower. In addition, you may well face a language barrier. In the private sector, a consultation with a dentist will cost between CNY 260 and 460, while a crown will cost between CNY 6,300 and 7,200.

The emergency service in China

If you are faced with an emergency situation, dial 110 as a priority, as it deals with all emergency situations. There is also the number 119 that you can call which will put you directly in touch with the fire brigade and 120 and the first aid and ambulance service. For a traffic accident, call 122.

Hospitals in China

In China, for any medical reason it is best to go to a hospital or clinic. There are several types of medical facilities, both private and public:

• Local hospitals
• International hospitals
• Clinics

Most expatriates go to international hospitals for treatment, as there are expatriate doctors working in these facilities. International hospitals are more expensive than local hospitals, here are some examples of average medical costs in a private hospital

• First outpatient visit: 1130-1840
• Specialist consultation: 1930-2840
• Outpatient emergency: 1450-2840
• Regular hospitalization: 900-2000
• Neonatal intensive care: 1000
• Urine pregnancy test: 110
• Common room bed fee: 7000
• Upper suite bed supplement: 13000 – 19000
• MRI: 10000 – 15500
• Natural childbirth: 66000
• Caesarean delivery: 88000

Paramedical care in China

You will find many physiotherapists in hospitals and clinics. Chinese physiotherapists also practice traditional Chinese medicine, based on two theories: “the Yin / Yang theory” and “the five elements theory.” . As Westerners have been inspired by the techniques of traditional Chinese medicine, some of the techniques may look similar on paper, but the approach is totally different. Chinese physiotherapy is recognised as excellent and effective, so do not hesitate to consult local specialists when you are there. A private consultation costs about 800 CNY, some complementary health insurance companies cover the sessions but not the universal coverage.
There are very few orthoptists in China, it is a very underdeveloped profession in China. You will find a few expatriate orthoptists in the major cities. However, you will be able to get a pair of glasses made very easily at opticians and at very low prices in the popular areas.

There are also many psychologists in China, working in hospitals and clinics. The cost of a psychology session in China is based on the experience of the practitioner you consult:

• a freshly graduated psychologist charges between 100 and 300 CYN;
• a psychologist who has been working for 2 years charges between 400 and 600 CYN, most of them will have trained abroad, have some experience or studied abroad;
• a psychological counsellor is more formal and may charge on average between 800 and 1200 CYN. Some may charge up to CYN 1,500. A counsellor usually has higher qualifications, a general education and very solid clinical experience.

Maternity in China, from pregnancy to delivery

China has excellent international hospitals and qualified health staff, so you can have your pregnancy without fear. You will be monitored during your pregnancy by an obstetrician or gynaecologist. Hospitals in China will offer you packages that include all the consultations, examinations and tests that you will have during your pregnancy. This makes it easier for you to get an overview of your pregnancy schedule and budget.
Preparation for childbirth may not always be available, as not all hospitals offer it. In China, a caesarean section is preferred to a natural or epidural delivery. Be sure to be clear about how you want to give birth.
If you plan to give birth in a private international hospital, you will enjoy a service similar to a hotel. The quality of the modern facilities and service is excellent. However, it is imperative that you choose your health insurance carefully, as a delivery alone can cost up to CYN 70,000, or almost USD 10,500. In addition, you must have “direct billing”, i.e. your insurance must pay your expenses directly to the hospital where you gave birth.

In a private hospital, the cost of a vaginal delivery is 70,000 CYN and a caesarean delivery is 90,000 CYN, or 10,000 USD and 13,600 USD respectively.

Paediatric service in China

Many hospitals and clinics have a dedicated paediatric wing and there are many paediatricians practising in China. The cost of a consultation with a paediatrician is approximately CYN 100, however the cost of consultations has been increasing in recent times. To see a paediatrician, go directly to a hospital and go to the paediatric ward. You can also book a consultation on the hospital’s website.

What vaccinations should I get before going to China for a stay or expatriation?

To go to China, no matter how long your stay, you must be vaccinated against hepatitis A. For long stays, more than 90 days, for an expatriation, an internship or a school semester, it is more than recommended to be vaccinated against :

• Japanese encephalitis ;
• Tick-borne encephalitis;
• Hepatitis B;
• Typhoid.

Malaria has been eliminated in 2019, so there is no risk of you contracting it in China.

Why purchase health insurance before a stay or expatriation in China?

It is imperative that you take out health insurance so that you can seek private treatment if necessary. Indeed, the shortage of general practitioners still affects China (about 1 general practitioner for every 23,000 patients), and even more so in the public sector than in the private sector. It is in the private sector that you will be able to consult a GP more quickly, without waiting for weeks or months. In order to protect yourself from high medical costs, it is more than recommended to take out a private health insurance policy such as Gold Expat which will cover you for 100% of the most expensive medical costs such as hospitalization.

Which international health insurance to buy in China and for whom?

• More and more students and active people are moving to China, either to spend a semester abroad or simply to work there on a long-term basis.
  You are a student and wish to spend a semester or part of your studies in China? Think about taking out international health insurance! Indeed, the Chinese government requires health insurance for students wishing to go to China. Moreover, an insurance like Gold Student will allow you to be covered for expensive medical expenses in private. In order to benefit from the best healthcare in the country, it is essential that you are covered for private healthcare. Our Gold Student insurance will cover you for hospitalization and routine medical expenses up to 100%.
• If you are an expatriate employee, entrepreneur or digital nomad, it is strongly recommended that you take out an expatriate health insurance policy such as Gold Expat or Gold Start. Indeed, as an employee on Chinese territory, you will have to join the Chinese social security system. Good news? Not necessarily, as the Chinese social security system is very limited. Be careful, the reimbursement terms are very low for the medical services covered by the social security system. Nine times out of ten, in the case of a major operation such as a hospitalization, the remaining cost will be extremely high. Especially if you are hospitalised in a private hospital.
• Are you going to China for a tourist visit? It is highly recommended that you take out health insurance that will cover you for private care. Accessing a general practitioner in the public sector in a short time is extremely complicated due to the shortage of doctors in China. Therefore, in order not to ruin your holiday, our experts recommend that you take out travel insurance such as Travel Pass.