Healthcare in China – What You Need to Know

The key to navigating the Chinese healthcare system is keeping costs down by choosing the right medical insurance plan, knowing how to prepare for maternity costs and knowing where to go and how much it will cost.

When expats look to keep themselves safe and prosperous amid the challenges of living and working abroad, they need to know how to make the most out of the Chinese healthcare system, social insurance and additional private medical plans. This article aims to offer a quick shortcut to finding the best solutions to expats’ different needs for financial and medical security.

Health comes first. Expats in China may choose from four different types of healthcare providers. Public hospitals are the most widely available and affordable option, while their VIP wards polish the experience with some English service. International clinics have the highest standard of service and experience – and are also the most costly. Private clinics are the most convenient for quick answers to minor issues.

Choosing the right type of Chinese healthcare provider to match your insurance is crucial in order to keep the costs down. The chances are that if you don’t live in Beijing, Tianjin, Shenzhen, and Nanjing, your employer is not obligated to enroll you in the five types of social insurance which involve pension, medical, work-related injury, maternity and unemployment. Most employers still provide at least the most basic Chinese medical coverage, which some expats may may feel is enough.

Using The Basic Chinese Medical Insurance

If you’re working for a Chinese company, it is likely that the employer has included you in the common medical plan for urban employees.

Having Chinese medical insurance means that you can go to specified Chinese public hospitals and get most of your bills, including check-ups, blood tests and medicine, reimbursed by your social insurance scheme.

The general recommendation is to go to level 2 or 3 public hospitals. Level 3 is the highest, which means it’s a bigger hospital with more advanced equipment and experienced doctors. Most first-tier cities including Shanghai and Beijing have dozens of level 3 clinics. Second-tier cities also have multiple options while the list shrinks in smaller cities.

Public hospitals offer basic services to expats who are ready to wait for hours in line, fight for their right to see the doctor for just a few minutes, and compromise a lack of privacy in check-up rooms. Success in this system requires some basic knowledge of Chinese. A consultation fee to see a GP is generally priced around CNY20 (US$3).

Haste aside, one of the greatest benefits of going to a Chinese public hospital is that their tests are very competitively priced. A blood test can set you back a modest sum from CNY50 to around CNY400 (USD7 to US$57). That said, patients must be ready to translate the diagnosis and test results, written only in Chinese, and even if you do speak Chinese don’t expect much of an explanation or conversation from your doctor before being shunted on.

Before going, one thing to know about these institutions is that they make a big chunk of their funds by selling medicine. This is why once a doctor presents you with a long list of drugs, including intravenous therapy, confirming how necessary they all are is a must!

Another thing to prepare for is the method of payment. Patients may have to settle all registration fees and medicine that may cost hundreds of Chinese yuan in cash. When looking to reimburse these bills, you have to give all the receipts and a booklet where the doctor has written notes about your diagnosis to your employer.

Healthcare Costs in Chinese Hospitals

hospital cost in chinaWhat to Expect From International Hospitals in China

What Chinese public hospitals lack in comfort, international hospitals, such as Singaporean Parkway Health and Chinese joint venture United Family can cover with their extended specialized care that is best teamed with an upgraded insurance plan to keep the costs reasonable.

International clinics excel in many ways, the most apparent of which is that their service is designed for expat needs. Customers can book over the phone in English, get an appointment fast, discuss with doctors for as long as it takes, and enjoy great treatment with new equipment.

Chinese first-tier cities usually have at least one international clinic while that also goes for some second-tier cities such as Chengdu and Nanjing. Those expats who live in third-tier cities may need to travel to a bigger city to find their healthcare providers.

When fast action is needed, international clinics should be the first option for treating victims of life-threatening conditions. Chinese ambulances may lack the means to treat severe health issues such as strokes, heart attacks and damages caused by accidents, as many online information outlets for expats have written.

International insurance plans which cover visits to these institutions are better prepared equipped to help you with emergencies. They usually come with medical evacuation and mortal remains repatriation, which means that the insurer will pay for the cost of flying the patient back to their home countries for specialized treatment if necessary treatment isn’t available locally, or in the event of a tragedy, repatriation your remains home to your loved ones.

Some expat insurance plans include cover which spouses and kids may need and which isn’t included in the basic  Chinese basic medical plan. According to the US, UK and Australian immunization schedules, they suggest a larger number of vaccinations than those offered by Chinese hospitals and clinics.

Medical institutions that employ foreign and English speaking doctors are ten times more expensive than Chinese public hospitals. Just a single consultation fee can set a patient back around CNY1,000 (USD163), which means that already one visit can easily be equal toc1 month’s health insurance premium. Customers may consult with their insurers to find out if the clinics their areas offer direct billing.

Some generous employers and often multinational companies provide expatriate health insurance which covers international clinics.

What if You Want Better Service Than Public Hospitals but Something Cheaper Than International Hospitals?

Besides public and international institutions, Chinese hospitals oten offer a third option for those who are looking for service in English but at a lower cost than what care at international clinics would entail.

Nested inside Chinese public hospitals, there is usually a VIP ward which offers more room and privacy, English-speaking staff and shorter lines than the surrounding departments. These special wards’ consultation fees are priced around CNY500 (USD82).

The downside of these healthcare providers is that they fall between insurance plans. The VIP wards are not covered by the basic urban medical plan. Those expats who have upgraded insurance schemes may as well go directly to the more comfortable international clinics.

These wards are good for those who are not covered by any insurance but need a quick solution for one-time incidents, service in English and want to pay less than CNY1,000 for a consultation.

However, if you’re looking for inpatient treatment which may take a few days to complete, these wards usually ask you to fork out a deposit of around CNY20,000 (USD3,262) to make sure you can cover the costs. A surgery on a VIP ward can easily cost in excess of CNY 50,000. A client of ours had medical bills exceeding CNY 250,000 in a VIP ward of a public hospital in Suzhou (which is normally cheaper) due to the severity of the accident.

What Are Chinese Private Clinics for in China?

Chinese private clinics are a bit of a wildcard. They may be cheaper than international clinics and faster than public hospitals but they also lack some of the safety features and expertise that those larger institutions entail.

This said, some private clinics may be awesome but that may be hard to verify before visiting. Public and international hospitals have tougher procedures for vetting their doctors and they also see hundreds of patients each day so they are likely to have a wider range of equipment and practice.

Community health clinics confirm the same rule of scale. These small public institutions may have a harder time to find the best talent and they store fewer drugs and may thereby lack the right type of medicine to prescribe.

Specialized private clinics can, however, be useful for minor and quick procedures such as dental cleaning, which should cost hundreds of yuan less than at a large international hospital.

Before going, it should be noted that the basic Chinese medical insurance does not cover the costs of private clinics.

What Pension and Maternity Benefits Expats Can Get in China

Besides medical insurance, one other category of social insurance, namely pension, requires particular attention from expats in China.

Without knowing it, expats may be automatically paying around five to 10 percent of their salaries to Chinese pension accounts. In this case, their employers are matching those installments with a sum of around two to three times as large as that. This means that each foreigner should give a thought to their pension before leaving China.

Only those who contribute to their Chinese pension accounts for more than 15 years can harness these funds for regular retirement payments. Those who leave China before that can apply to take out their own part of the savings.

Maternity is an exceptional, easy part of the Chinese social insurance. Even if the length of maternity leave is shorter than in many other countries, just 98 days at minimum, this safety net is provided to all women. If not part of the public insurance system, an expat’s employer must carry the costs and pay all parental benefits.