Do I Really Need Medical insurance in China?

By Ned Kelly, May 12, 2023

Living in China can be tough, not knowing what resources are open to you and what to do under difficult or testing circumstances.

We regularly speak with the UK Government in China to find out what issues they find themselves dealing with, and ask them some questions regarding said issues.

This time it is all about medical insurance (but you can find links to plenty more important subjects at the end of this Q&A).

While their answers are sometimes tailored towards British people, a lot of the advice is general – we hope it is of use to as many of you as possible.

Surely everyone knows that they need medical insurance in China?
Maybe. But the majority of British people that we assist admit to not being properly insured. This can have serious consequences for them, and their family and friends.

I have a decent amount of money saved. Can I just pay for treatment as I need it?
Yes you can. But this could prove difficult or impossible if you are unable to arrange payment at the time (e.g. because you are incapacitated or because the hospital doesn't accept international debit or credit cards).

Costs for complex procedures could be far more than anticipated; nursing fees are chargeable and can be very expensive too. The cost of medical repatriation to the UK can be well over £100,000 (roughly a million RMB).

In addition, many public hospitals do not have English-speaking staff. If you are properly insured, the company can liaise with the hospital on your behalf or might be able to move you to another hospital that does have English-speaking staff.

Can the UK Government help with my costs?
No. The UK Government has a long-standing policy of not paying medical bills incurred overseas (including lending money to pay for bills) and this is strictly adhered to.

So, if you want to save yourself, your friends and your family massive amounts of money and stress and avoid the risk of being denied potentially life-saving treatment, make sure you are properly insured.

I am insured through my employer. Is that enough?
We suggest that you look closely at the terms of any insurance provided by your employer to see whether you think it gives adequate cover (e.g. not all cover the cost of medical evacuation).

Will your policy still cover you if your employment is terminated during ongoing medical treatment / care / hospitalization / quarantine?

When you leave your employer, it is likely your policy will cease at the same time. Remember to take out a new one, including to cover any gap between employers.

Many of our cases involve people who have failed to organize cover after finishing with an employer.

Where can I buy private medical insurance?
You can buy private medical insurance for expatriates through UK or international providers. We have also heard that some local companies offer medical insurance for foreigners in China.

You should always check policies carefully, including seeing whether you could transfer medical cover if you re-locate to other countries in future.

What about mental health coverage?
Mental health problems affect around one in four people in any given year and provision of care is very different in China to in the UK, with families generally being expected to support those affected.

Specialist mental health treatment is therefore far more prevalent in private hospitals in China. Organizations such as MIND have information on insurance cover and mental health including a list of specialist insurance providers.

Is any medical treatment free in China?
No. All treatment has to be paid for. Either individually or through insurance.

What about social insurance?
China has its own social insurance system. The publicly funded element does not cover the full cost of even basic medical treatment, and patients still need to pay part of the cost themselves or with the personally funded balance in their social insurance accounts.

However, for serious illnesses – such as cancer, heart disease, stroke etc. – the actual expenses are normally much higher than the publicly and personally funded elements can cover.

You may be eligible for social insurance if you are employed in China. Speak to your employer to check if this has already been arranged or if they can arrange for you.

If you are unsure as to whether you might be eligible, you can contact your local government hotline: 12345 (some cities provide a multilingual service); or 12333 (Chinese only but specializes in HR and Social Insurance enquiries).

If I can get back to the UK will I get free treatment there?
Not necessarily. Rules on free healthcare provision for Brits returning from overseas vary across the home nations and are subject to a number of factors, including former and/or habitual residency in the UK. You should check online for the most up-to-date information.

Many treatments available on the NHS are also subject to waiting lists that you may need to join upon return.

Anything else we can do?
Consider giving someone power of attorney (POA) to act on your behalf if you become unable to do so yourself (www.gov.uk/power-of-attorney). These can be impossible to arrange if you become incapacitated, when you will likely need it most.

But, of course, we suggest that you seek independent legal advice before entering into one of these arrangements.

Remember to take out separate travel insurance if required and take a look at the Health and Safety pages of our Living in China guide.

Got a question you would like answered? Email it to nedkelly@thatsmags.com and we'll do our best to get it answered for you.