Can I Use Private Health Insurance at Public Hospitals in China?

Many of us whom are insured with a private health insurance plan, either if it is provided by your employer or purchased yourself, are well aware of the private hospitals they cover snd how the direct-billing works.

But in urgent situations, we may not have much freedom to choose a hospital, and chances are we will go to one of the nearest hospitals for medical care, and that hospital might be a public hospital.

Most major public hospitals that are ranked Grade A Class 3 by the National Health Commission of China are very competent hospitals with experienced doctors, however language barriers and the procedures may hinder those that do not have a good command of Mandarin Chinese.

If you are insured with a private health insurance plan, how does it work if you visit a public hospital for healthcare?

Since most public hospitals in China mainly accept social medical insurance only, you will only be eligible for direct-billing if you are social insurance holder. But you could still pay first and file a reimbursement claim later if you are only a private health insurance holder.

However, some public hospitals are equipped with an international department or VIP clinic, where they are more catered to foreign patients compared to the regular wing. They do charge a higher rate in general, but most of them work with private health insurance and you will be eligible for direct-billing access if that international department or VIP clinic works with your insurance company.

Which public hospitals have an international department or VIP clinic?

Take Beijing and Shanghai for example, in Beijing, public hospitals including China-Japan Friendship Hospital, Peking-Union Medical College Hospital, Chaoyang Hospital, Beijing Friendship Hospital etc., are equipped with an international department. In Shanghai, public hospitals such as Renji Hospital, Ruijin Hospital, Huashan Hospital, Renai Hospital etc., are equipped with an international department.

How does the reimbursement claim work at public hospitals?

If you happen to visit the regular department of a public hospital where you do not hold any social insurance account, you will have to visit as a self-paying patient and pay everything upfront. Then you can apply for a reimbursement claim by collecting the bingli (病历), test results, invoices, bill summary and a duly filled and signed claim form to the insurance company. The claim money can usually be transferred to your bank account within around 1-2 weeks under normal circumstances.

Can I be denied a claim at a public hospital?

Although most private health insurance plans on the market automatically cover the public hospitals in China mainland, It would depend on the specific benefit schedule and contract of your insurance policy. For example, if the treatment taken is excluded from your insurance cover, the claim may be still denied. And even if you visited an international department of a public hospital but it does not work with your insurance company, you may still be required to pay upfront and file a reimbursement claim later.

About the author

I'm an insurance broker at Mingya Insurance Brokers based in Beijing, and my company works with multiple insurance companies in China providing insurance plans eligible for expatriates in China. Our insurance partners include AXA, Allianz, AIG, Bupa, Cigna, GBG, MSH, Medilink, Ping An etc.

I specialise on insurance solution planning for expatriates in China, particularly health insurance. I have been assisting expatriates in China with their insurance solution planning since 2018, as well as group insurance planning for corporates and institutions' foreign employees. Currently our clientele includes international schools, foreign enterprises, embassies and so on.

I was born in Beijing, and am able to communicate in fluent English and Mandarin. I held a financial advisor's license issued by the Monetary Authority of Singapore (MAS) for 2 years, and I am currently holding an insurance broker's license issued by the China Banking and Insurance Regulatory Commission (CBIRC) since 2018.