Source: China Daily

1. Overview of China's Medical Insurance System

China has built a medical security system covering over 95% of its population, forming a multi-tiered system with Chinese characteristics. Basic medical insurance includes two main schemes: Urban Employee Basic Medical Insurance (UEBMI) and Urban and Rural Resident Basic Medical Insurance (URRBMI).

Key Statistics:

  • Coverage rate: ~95%

  • Designated medical insurance institutions: 520,000+

  • Medicines in insurance catalog: 3,000+

  • Overseas medical professionals practicing in China: 1,500+

2. Urban Employee Basic Medical Insurance (UEBMI)

2.1 Eligible Groups

  • Foreign nationals legally employed in China

  • Holders of valid work permits (Foreign Work Permit of PRC)

  • OR holders of Foreign Permanent Resident ID Card

  • OR holders of Foreign Correspondent Press Card

  • WITH valid residence permits

2.2 Enrollment Process

Step 1: Confirm Eligibility

  • Officially employed by a registered organization in China

  • Employer must be a legally registered entity (enterprise, public institution, social organization, foundation, law firm, accounting firm, etc.)

Step 2: Prepare Documents

Document

Description

Medical insurance enrollment form

Complete and sign

ID proof

Passport original and copy

Employment proof

Labor contract, work certificate

Photo

1-2 recent photos

Work permit

Foreign Work Permit original and copy

Residence permit

Valid residence permit copy

Step 3: Employer Declaration

  • Employer submits materials to social insurance handling agency

  • Employer completes declaration and payment procedures

  • Enrollment deadline: Within 30 days of employment

Step 4: Collect Insurance Card

  • Available from the 15th of the following month

  • Bring passport to nearest community affairs service center

  • Collect medical record booklet simultaneously

  • Apply for electronic medical insurance certificate

2.3 Contribution Rates

Party

Rate (Reference)

Note

Employer

~6%

Employer's portion

Employee

~2%

Individual's portion

Note: Specific rates vary by region

2.4 Benefits

After enrollment, enjoy:

  • Treatment at designated medical institutions

  • Direct settlement and reimbursement (show insurance card)

  • Electronic certificate for mobile registration

  • Coverage for both inpatient and outpatient care

3. Urban and Rural Resident Basic Medical Insurance (URRBMI)

3.1 Eligible Groups

  • Foreign nationals residing in China but not employed

  • Holders of Foreign Permanent Resident ID Card

  • Voluntary enrollment

3.2 Enrollment Process

Step 1: Prepare Documents

  • Valid ID (passport, birth certificate, etc.)

  • Residence permit

  • Household registration booklet (if applicable)

  • Photo

Step 2: Registration

  • Visit local community affairs service center

  • Some regions support online processing (e.g., Yunnan via WeChat official account)

Step 3: Pay Premiums

  • Annual payment

  • Standards vary by region

  • WeChat, Alipay, bank transfer accepted

Step 4: Get Certificate

  • Apply for electronic medical insurance certificate

  • Use for settlement at designated institutions

4. Insurance Catalog & Reimbursement Scope

4.1 Covered Medicines

Basic medical insurance covers:

  • Western medicines, patent Chinese medicines, ethnic medicines

  • Some Chinese herbal decoction pieces

  • Nationally negotiated medicines

4.2 Main Reimbursement Items

Category

In Basic Medical Insurance

Inpatient care

✅ Yes

Outpatient care

✅ Yes (with limits)

Emergency care

✅ Yes

Health checkups

❌ No

Dental cosmetics

❌ No

Assisted reproduction

❌ No

Imported medicines

Partially covered

TCM treatment

✅ Yes

5. Commercial Health Insurance Supplement

5.1 Why Commercial Insurance is Needed

Despite basic medical insurance coverage, gaps remain:

  • Reimbursement rates limited (typically 60-85%)

  • Imported medicines and advanced treatments may not be covered

  • Limited coverage for dental, ophthalmology, etc.

  • No direct settlement, requires 事后 reimbursement

  • No transportation or overseas rescue coverage

5.2 Types of Commercial Insurance

Type

Monthly Cost (Est.)

Suitable For

Features

Travel Insurance

$50-150

Short visits (<90 days)

Emergency & accident coverage

Local Chinese Insurance

$30-100

Budget-conscious

Lower cost, limited coverage

International Health Insurance

$200-600

Long-term expats

Full coverage, global network

5.3 Selection Tips

Selection Key Points:

  • Confirm if hospitals are in direct billing network

  • Understand outpatient coverage

  • Check pre-existing condition coverage

  • Confirm deductibles

  • Check for emergency evacuation & repatriation

6. Medical Visits & Claims Process

6.1 Basic Medical Insurance Visit Process

  1. Register at designated institution with insurance card

  2. Doctor diagnoses and prescribes

  3. Settle with insurance card; system automatically deducts reimbursement

  4. Pay personal share

  5. Collect medicine or undergo tests

6.2 Commercial Insurance Claims Process

  1. Confirm hospital is in insurance direct billing network

  2. Present insurance card or electronic certificate at visit

  3. For reimbursement claims: Keep all invoices and medical records

  4. Submit claim within specified period (usually 30-90 days)

  5. Await insurance company review and payment

6.3 Important Document Retention

  • Invoice (发票 /fāpiào): Official tax invoice issued by hospital

  • Expense list: Detailed breakdown of all charges

  • Medical records: Diagnosis certificate and examination reports

  • Prescription: Medication details

📌TIPS

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