Information on the national and private healthcare systems and the benefits provided...
The cost of medical insurance is one of the Five Insurances that make up China's social security system. As with the other four insurances, the cost of medical is shared between individuals and their employer. It is normal for employers to handle the administration of both parties' payments.
Employees contribute around two percent of their total wage, employers around 10 percent. Upon retirement, individuals become exempt from making contributions. Each employee's contribution and 30 percent of that made by their employer go to an individual's personal account. The rest goes into a central fund, the "social pool fund".
Basic medical insurance covers people living in urban areas and reduces medical bills in the event of an injury or illness. People must bear some of the costs themselves in most parts of China, although the contribution is usually lower for retired people. As the cover is managed at local level, the system is straightforward when claims are made by people in their home city, where their insurance contributions are paid. When emergency treatment is needed away from home reimbursement is possible, but the procedure for claiming it is more complex.
The cost of basic procedures such as outpatient treatment comes mainly from personal accounts, while the higher costs of complex procedures and longer hospital stays come mainly from the social pool fund. Minimum and maximum payouts from the social pool fund are clearly defined.
Since basic medical insurance is not enough to cover the full cost of treatment, the state encourages employers to provide additional medical insurance for their employees.
The system is under continuous review to improve both the scope of cover and the efficiency of the system.
Private health insurance
The cost of medical care in private hospitals can be high. Foreigners are advised to take out a comprehensive health insurance for themselves and their families. In larger cities like Beijing, Shanghai and Guangzhou there are a number of private and international hospitals with foreign doctors or Chinese doctors who have trained abroad.
The private healthcare industry in other regions of China is currently small and poorly developed. The market for private health insurance is has been growing but still represents less than two percent of total healthcare spending. Most plans provide supplementary hospital insurance to provide broader cover than that provided by government insurance. Always check in advance if the hospital or clinic of choice accepts a private insurance policy.