China healthcare system, explained

If you’re planning on moving to China to live, work or study, you’ll want to know a bit about how the healthcare system in China works. Making sure you have adequate health cover for your personal needs is an essential no matter where in the world you are. Use this China healthcare system overview to figure out what you need to do to stay healthy, and avoid unforeseen bills if you have an illness or accident while you’re there.

As well as an introduction to the medical system in China, this guide covers a brief explanation of the China healthcare system vs United States healthcare provision, so you can understand the differences.

📑 Table of Contents
China healthcare system: overview How does China’s healthcare system work? Does China have a universal healthcare system? Is healthcare free in China? Health care for foreigners and expats Is healthcare free in China for foreigners? China healthcare system vs. United States Important information

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China healthcare system: overview

China’s healthcare system has developed enormously in recent years, and many aspects of the way medical care works are still under review in order to make further strides. Chinese citizens can access universal health care through one of a range of government supported or mandated health insurance plans. There are also a wide range of private healthcare options available, and supplementing public health insurance with private cover is possible.

Let’s start with a run through of the key public and private health insurance options available under the healthcare system in China¹:

Type of coverage	Funding, eligibility and entitlements
Urban Employee Basic Medical Insurance (UEBMI)	Mandatory for urban residents in employment, paid for with employer and employee contributions. Employers may pay 6% - 12% of salary, employees typically pay 2%². Basic primary and specialist care is covered, as well as medication and traditional Chinese medicines
New Cooperative Medical Scheme	Voluntary insurance scheme for rural residents. Covers basic care only — out of pocket expenses are still common for holders of this insurance type
Urban Resident Basic Medical Insurance	Voluntary insurance for urban residents who are not employed or who are self employed. Coverage is not as comprehensive as the employee insurance scheme however, basic care is covered
Private health insurance	Usually required by foreigners in China, also used by Chinese citizens to supplement the government mandated schemes. Range of providers available with different cover packages, fully funded by individuals

How does China's healthcare system work?

Most Chinese citizens can choose to take up government supported public health insurance through one of the schemes laid out above. However, aside from the UEMBI program, cover is not mandatory, which means that some people still need to pay out of pocket for all medical expenses.

Government funding for public health and hospital care varies based on the location. There are differences at a regional level, with additional government support in place for low income and rural areas. Insurance premiums for individuals are generally fairly low to allow more citizens to access these schemes if possible. However, even with public insurance, there are some copay requirements at the point of accessing some care. We’ll look at these in more detail a little later.

Does China have a universal health care system?

The Chinese government has created ways for all citizens to access public health insurance. However, there are fees and insurance premiums to pay, and the schemes are not necessarily mandatory for individuals. This means that not everyone is able to take up the opportunity of public healthcare.

Is healthcare free in China?

Even for Chinese citizens with public health insurance, there may be some fees for care and medication. However, these costs are subsidised heavily, to make care within the reach of as many people as possible.

Copay for care and medication depends on the type of public insurance you have, the healthcare needs you have, the type of hospital you visit and a range of other factors. However, the Commonwealth Fund report the following as typical costs:

Primary care visit	0.71 USD - 2.38 USD
Specialist consultation	6.18 USD - 19.17 USD
Hospitalization (per visit)	1,110 USD - 1,380 USD
Outpatient medication following primary care visit	2 USD - 4 USD
Outpatient medication following specialist visit	9 USD - 16 USD

Wondering how much it would cost you in China’s local currency? Check out the handy calculator below

Not all medication is reimbursed, or there may be limits to the amount patients can claim for some medications. However, discounts on some care exist for retirees. Government support is also available for some people who can not cover copay costs, or who are uninsured. However, this only typically reaches a very small fraction of the population.

Health care for foreigners and expats

As a foreigner in China you’ll almost certainly need to take out private health insurance as you are unlikely to be covered by a government subsidised health insurance scheme. Private health insurance can be used to provide care and also cover deductibles and copay requirements³. The Chinese government is encouraging the development of the private health insurance market to allow both foreigners and higher income Chinese citizens to have a broader range of health care choices.

Private hospitals are available throughout the country, with a bigger choice in the large cities and provincial capitals. There are a reported 21,000+ different private hospitals, excluding community and village private facilities, throughout China.

Is healthcare free in China for foreigners?

Healthcare in China is free for Chinese citizens and Chinese permanent residents. If you’re a foreigner with permanent resident status you may be able to access government supported public health insurance. If not, you’ll need private health cover.

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China healthcare system vs. United States

US citizens traveling to China — and Chinese citizens headed to the US — are often surprised by the differences in the way healthcare is set up.

Here are some of the key differences between China’s healthcare system vs United States healthcare:

95%+ of Chinese citizens have public health insurance — significantly higher than in the US. However, even with public insurance, patients in China need to pay some fees and copay costs US health costs per capita in 2018 hit 10,586 USD, while the equivalent in China was only 688 USD. For reference, the OECD average was 3,994 USD⁴ In the US there are 2 doctors, and 11.9 nurses per 1,000 inhabitants — in China, those figures are 2.6 doctors, and 2.7 nurses⁴, reflecting the differences in how healthcare is accessed and administered across the countries Getting a specialist care appointment in the US can involve a significant wait. In Chinese public hospitals, the process can be faster, and patients may be able to pay more for faster care — either officially or through less formal channels²

If you don’t have the right insurance or cover for your health needs in either China or the US, you could find you have high medical bills. It’s also important to note that private health care is more consistently available in Chinese cities compared to rural areas. No matter whether you’re in the US, China, or anywhere else in the world, getting to know your healthcare options is important, to make sure you can access the care you need, when you need it.

Important information

Emergency number	Call 120 for an ambulance Note: there may be a significant delay in remote or rural areas. You’re advised to have a Chinese speaker call for you, to check the likely arrival time
How to get assistance	Call an ambulance in an emergency — or head to your nearest hospital For planned or routine treatment, check with your private health insurance plan to see what coverage is available
Register for health care	Chinese citizens and permanent residents are entitled to register for free public health insurance through one of the government insurance schemes. Different schemes apply in different areas and based on your employment status. If you’re working in China you may get private health insurance through your employer — ask your HR department. Otherwise it is advisable to sign up to a private health insurance plan which has adequate cover for your needs.

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The healthcare system in China is developing at a rapid pace and has already helped to transform the country in many ways. Further reforms are ongoing, which aim to help all citizens access the care they need, as well as giving additional choices and care options to higher income citizens and residents.

If you’re an expat in China it’s worth understanding the local medical system, even though you’re likely to access care through private insurance and hospitals. Use this guide to help you build a picture of China’s healthcare system, and don’t forget — if you’re paying out of pocket for your medical expenses in China, you’d be better off with a Wise Multi-currency Account. Use Wise to cut the fees for currency exchange in China — or on payments to 70+ other countries around the world.

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Sources:

1. Commonwealth Fund - China
2. SUP China - Healthcare compare: US vs China
3. CBBC - How China’s healthcare system actually works
4. USC - Healthcare in the US and China

Sources checked on 10.11.2021