Health Insurance Regulations for Expats in China
While there is no state-level legal requirement for expats in China to have health insurance, health insurance regulations and requirements can vary at the local level. Some cities or provinces may have their own specific regulations regarding health insurance for expats.
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Expats in China often rely on private healthcare due to its higher standard, shorter wait times, and better English communication. However, the costs of private medical care in major cities like Beijing and Shanghai can be significantly higher compared to public hospitals.
Expats should carefully consider their healthcare needs and preferences and secure adequate insurance coverage. International health insurance is popular among expats in China due to its stronger benefits and flexibility, especially for those who foresee themselves relocating again.
Regulations on Health Insurance for Expats in China
To purchase health insurance in China, expats typically need to provide employment documents such as an employment contract. Moreover, expats are required to present one of the following documents in addition to a valid passport for identification purposes:
- Foreigner’s Permanent Residence ID Card
- Foreigner’s Work Permit in China
- A residence card specific to the city of residence (e.g. Shanghai Residence Card Type B)
Expats from countries that have signed bilateral or multilateral agreements on social security with China may have to meet specific regulations and follow special procedures for purchasing health insurance per these agreements.
These countries include:
- Germany
- South Korea
- Denmark
- Finland
- Canada
- Switzerland
- The Netherlands
- Spain
- Luxembourg
- Japan
- Serbia
In China, currently, the state sets no legal requirements regarding health insurance for expats in China, and leaves that to the local governments. Many cities or provinces have their own specific regulations regarding health insurance for expats. Let’s take Beijing and Shanghai as examples:
- Beijing: Expats in Beijing who have obtained the “Foreign Permanent Resident ID Card” and do not have basic medical insurance can apply for Basic Medical Insurance for Urban-Rural Beijing Residents.
The application process may require documents such as the household register, resident ID card, photo, and applicant’s bank account number.
- Shanghai: Expats who are working are covered by social security, including medical insurance. Employers are responsible for completing the insurance registration procedure for foreign employees at the local Social Security center within 30 days of work permit issuance.
While health coverage is not strictly required for expats in both places, all expats who are working in these two cities are automatically enrolled in the social security system, and many expats secure private health insurance on their own for the extra benefits available with private healthcare.
An Overview of China’s Healthcare System
China’s healthcare system is characterized by a mix of public and private healthcare providers, offering a range of medical services to both locals and expats. Public healthcare in China is provided through a network of public hospitals and clinics.
Locals as well as expats working in China are entitled to social security benefits, including medical insurance. The responsibility for paying health insurance premiums is shared between the employer and the expat.
While many public healthcare facilities offer medical expertise and services that are on par with Western standards, the quality and accessibility of healthcare services can vary between urban and rural areas.
Private hospitals can be found primarily in major metropolitan areas and offer services that are closer to what expats would expect in Europe or North America. Naturally, private healthcare in China is generally more expensive than public healthcare.
Notwithstanding that the public healthcare system is generally available to expats in China, many of them secure private health insurance from one of the top health insurers in China. One motivation is that expats often find that public hospitals have long wait times and present language barriers.
Private healthcare, by contrast, is popular among expats in China due to its even higher standards, shorter wait times, and English-speaking medical staff. Moreover, public hospitals in China often do not accept expat health insurance, making it necessary for expats to look elsewhere.
Private health insurance, such as international health insurance or expat health insurance, offers greater flexibility and comprehensive coverage. These plans ensure that expats receive quality healthcare throughout China, without the financial burden of paying for medical treatments out of pocket.
Private Health Insurance Options for Expats in China
International health insurance, expat health insurance, and short-term international health insurance are the most popular private health insurance choices for expats in China. Depending on personal circumstances, many expats additionally opt for maternity, family, or medevac coverage.
- International Health Insurance: These plans are designed to provide comprehensive coverage for individuals living or working abroad. These plans provide a wide range of benefits, including coverage for hospitalization, outpatient care, prescription drugs, and emergency medical evacuation.
- Expat Health Insurance: This is another option for expats in China. While these plans do not provide geographical coverage as wide as from international health plans, they also tend to cost less compared to an international health plan with similar benefits.
- Short-term International Health Insurance: For expats in China who require short-term coverage, this is an ideal choice. This insurance is designed to provide temporary coverage for individuals who are staying in a foreign country for a limited period, such as for business trips or vacations.
Some insurers offer the option to convert a short-term policy to a “regular” international health insurance plan later on, but whether this is possible or not ultimately depends on the specific insurer and policy terms.
- Maternity Insurance: Expats intending to conceive while residing abroad should ensure that their international maternity insurance includes comprehensive coverage for essential prenatal and childbirth services, as well as pregnancy and childbirth complications, epidurals, congenital conditions, etc.
Furthermore, international maternity plans for expats often have waiting periods ranging from 10 to 24 months before pregnancy-related benefits take effect. During that time, health insurance coverage must be maintained for the entire duration before pregnancy-related coverage becomes available.
- Family Insurance: Many international family health plans offer coverage for well-child checks and routine vaccinations. To keep premiums affordable, you also have the option to choose emergency and in-patient coverage only.
Expats qualify for international family health insurance if they spend a minimum of three months per year residing outside their home country for more than a year.
- Medevac Insurance: This covers the transportation of an injured or ill person to a medical facility that can provide appropriate treatment. It ensures that the individual will receive necessary medical care in case of a medical emergency while abroad.
Some insurance plans explicitly exclude coverage for injuries incurred during high-risk activities, such as extreme sports like skiing. By contrast, other plans may not have comparable exclusions but typically come with higher premiums.
Frequently Asked Questions
Are expats in China legally required to have health insurance?
Expats working in China are obliged to join the local health insurance scheme. However, many also opt for private health insurance to supplement the national plan, as it often provides more comprehensive coverage and meets the needs of expats better.
How costly is international health insurance in China?
The cost of international health insurance in China can vary depending on factors such as age, benefits, plan design, and deductible selected. On average, international insurance for expats in China costs around USD $5,274 (for individuals) and around USD $16,241 (for families) per year in 2022.
Is English generally understood among medical professionals in China?
In major Chinese cities like Beijing, Shanghai, and Guangzhou, there are Western-style medical facilities with international staff who typically speak English. However, in general, English proficiency among medical professionals in China may vary depending on the location.
Conclusion
In this article, we gave a snapshot of public and private healthcare in China. We explained the health insurance requirements for expats and why it is common for them to secure private health insurance. We trust you are now better informed to make the right choice for yourself and your family.
That said, anyone who has secured health insurance on their own will know that given the plethora of great plans out there, just staying on top of the process is no easy feat. Plus, there is the worry that important details could be overlooked that might have serious ramifications down the road.
That is why it is always advisable to engage a reputable brokerage like Pacific Prime for your insurance needs. With 20+ years of experience and a deep understanding of insurance products, we are dedicated to finding the plan that genuinely meets your needs and provides the best value for your money.
What’s more, our advice and support are yours at no extra cost compared to buying coverage directly from an insurer! The value of this support is easiest to see when our client needs to make a claim because we will help level the playing field and ensure a fair outcome for our client.
So contact us for a consultation or quote, or a FREE, no-obligation plan comparison today!
If you’d like to know more about ensuring access to top-notch healthcare services while in China, Healthcare Access in China for Expats and How to Choose the Best Health Insurance for Expats in China: A Comparative Analysis are must-reads for you!
Since joining Pacific Prime, Martin has become even more aware of the gap between the true value of insurance products and most people’s appreciation of it, and developed a passion for demystifying and simplifying matters, so that more people get the protection they need at a cost they can easily afford.
In his free time, Martin attends concerts of various genres, and plays the violin with piano accompaniment he pre-recorded himself or played live by his niece.
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