Reviewed November 2026.
China’s medical insurance system includes statutory basic medical insurance for employees and separate resident coverage for eligible people outside the employee system. If a foreign company already employs staff through its own Chinese entity, China payroll outsourcing can help coordinate the monthly employer and employee medical-insurance contributions alongside salary and other statutory payments. Private health insurance may supplement local coverage, but it does not generally replace mandatory employee enrollment.
What medical insurance is available in China?
| Coverage type | Typical participants | How it is arranged |
|---|---|---|
| Employee basic medical insurance (职工基本医疗保险) | Eligible workers employed in China; certain flexible workers may enroll under local rules | Employer registers and contributes for employees, with employee payroll deductions; local rules govern the rate and base |
| Urban and rural resident basic medical insurance (城乡居民基本医疗保险) | Eligible residents not participating in the employee system | Separate enrollment, contribution and benefit rules; not an employer substitute for statutory employee insurance |
| Supplementary commercial medical insurance | Employees, expatriates and dependants if eligible for the policy | Optional contract purchased separately; exclusions, limits, direct billing and hospital networks are policy-specific |
Eligibility, waiting periods, contribution rates, deductible thresholds, outpatient coverage, designated hospitals and reimbursement ceilings differ by insurance category and location. There is no single nationwide reimbursement percentage or universal list of twelve covered diseases that employers should promise to every employee.
Who must be registered for employee medical insurance?
An employing entity ordinarily arranges statutory social-insurance enrollment for eligible employees. Article 58 of the Social Insurance Law requires the employer to apply for employee social-insurance registration within 30 days of the start of employment. The employee’s local medical-insurance registration and contribution process should be completed under the applicable city rules.
Foreign nationals lawfully employed in China may also fall within statutory social-insurance obligations. Where an applicable bilateral social-security agreement covers a specific insurance branch, any exemption must be verified under that agreement with the required documentation; a work permit or foreign passport does not automatically exempt a worker from all Chinese social insurance.
Employers should confirm the legal employer, place of work, applicable registration city, assessed contribution base and employee status before calculating deductions. An employee may face a coverage gap if an employer switch or move between cities is not coordinated.
How much does employee medical insurance cost in 2026?
There is no nationwide employer medical-insurance rate. Contribution rates and the assessed wage base vary by city and over time. As a dated, verifiable example, Shanghai’s 2026 medical-insurance notice (Hu Yi Bao Gui [2026] No. 2) sets the employer employee-medical contribution rate at 9%—including 8.5% for basic medical insurance with maternity insurance and a 0.5% local medical supplement—and the employee contribution rate at 2%. It applies from March 1, 2026 through February 28, 2027.
| Illustrative Shanghai employee | Calculation | Monthly amount |
|---|---|---|
| Assessed medical-insurance contribution base | RMB 15,000 (assumed valid for this employee) | RMB 15,000 |
| Employer medical-insurance component | RMB 15,000 × 9% | RMB 1,350 |
| Employee medical-insurance deduction | RMB 15,000 × 2% | RMB 300 |
This example covers medical insurance only. It excludes pension, unemployment, work injury, housing fund, personal income tax and any private insurance. The actual contribution base must be assessed under the relevant payroll city’s current lower and upper limits; do not automatically use gross salary without checking those limits.
Since employee maternity insurance is administered together with employee basic medical insurance under the 2019 national integration policy, payroll should not charge a duplicate standalone employer maternity contribution on top of a rate already described as including maternity.
What does basic medical insurance reimburse?
China’s basic medical insurance is not a blanket promise to pay every medical bill. Coverage usually depends on the patient’s medical-insurance category, the participating city, designated medical institutions, eligible medical services and medicines, the policy’s deductible and cap, and the patient’s circumstances.
The practical way to check an expense is to confirm the institution is designated, ask whether the proposed treatment or medicine is included in the applicable reimbursable range, then review the relevant city insurance deductible and co-payment rules. Particular chronic or serious illnesses may have specific local outpatient and special-disease arrangements; using a disease name alone cannot establish reimbursement entitlement nationwide.
If an employee pays a hospital upfront or cannot settle directly, they should retain invoices and the medical documentation the relevant medical-insurance agency requires. Coverage for private or international hospital facilities, VIP wards, imported medicines or care outside approved benefit categories should not be assumed without checking the policy.
How do employees check enrollment, balances and claims?
Employees can use the National Healthcare Security Administration’s service platform through its official app and supported WeChat or Alipay service entry points to check insurance participation and use available digital medical-insurance services. Local official medical-insurance portals and service counters also handle specific account or reimbursement questions.
As a practical sequence, verify the identity and employer enrollment first, check whether the insurance and contribution records have appeared, confirm the designated medical institution and inquire about the coverage rules before treatment. Do not rely on an overseas employer’s commercial insurance portal for information about Chinese statutory contributions.
Can medical insurance move with an employee to another province?
Yes, under the applicable procedures, basic medical-insurance relationships can be transferred when eligible insured people move between participating areas. The national medical-insurance relationship transfer measures cover employee and resident systems and require the transfer of relevant personal insurance records and handling of the employee personal-account balance. The relevant old and new local agencies govern the details; double enrollment and duplicate benefits are not permitted.
Transferring insurance registration and receiving care outside the registered province are distinct processes. A person traveling or working elsewhere may need cross-region medical-treatment filing before direct settlement. The NHSA’s official out-of-province treatment guidance explains filing routes and hospital-network searches. Employers moving workers should coordinate the final registration month, new enrollment date and any employee benefit interruptions.
What is supplementary private medical insurance for?
Companies may choose to offer a commercial health plan to supplement statutory coverage—for example, a broader hospital network, eligible international clinics or dental and outpatient benefits. This can be useful for expatriates or employees who value predictable access to specific clinics. However, private plans vary substantially in geographical scope, pre-existing-condition exclusions, deductibles, co-payments, waiting periods, annual benefit caps and claim procedures.
When assessing a private policy, ask which hospitals are covered, whether inpatient and outpatient benefits differ, whether the employee or insurer pays the hospital first, how emergency treatment is handled, and whether coverage continues after resignation. Do not infer today’s benefits from a provider’s brand name or an outdated list of insurance companies.
HROne’s employment and payroll services do not themselves constitute an insurance policy. A client considering an optional private plan must verify the actual insurance provider, policy document, cost, employee eligibility and claims administration.
What should employers check each payroll month?
- New employees have the correct local employer and medical-insurance enrollment details.
- Contribution rates and lower/upper bases reflect the city and current assessment period.
- Employee deductions and employer charges are not mistakenly added together or duplicated.
- Medical and maternity contributions follow the applicable integrated collection method.
- Staff changing jobs or provinces have a documented transition plan.
- Payroll records, bank payments, declarations and receipts are retained for verification.
- Employees understand where to check their insured status and reimbursement procedures.
For the full range of statutory contributions, see the China social insurance guide. Employers without their own Chinese employing entity should instead assess whether a China Employer of Record is an appropriate legal-employer solution for the role; this is different from outsourcing payroll for an entity they already own.
Frequently asked questions
Is medical insurance mandatory for employees in China?
Eligible employees generally participate in the statutory employee social-insurance system through their employing entity. Foreign nationals may also be covered, subject to the applicable legal framework and any relevant treaty exception.
What is the employer medical-insurance rate across China?
There is no single nationwide contribution rate. Shanghai’s employer rate is 9% and the employee rate is 2% from March 2026 through February 2027, but other cities or periods can differ.
Does employer-provided private health insurance replace the mandatory scheme?
Generally no. An optional commercial policy supplements rather than substitutes for applicable statutory employer contributions.
Can an employee still use insurance after moving cities?
Possibly, subject to the enrollment-transfer and cross-region treatment procedures. Confirm the employee’s actual coverage and any local waiting-period rules before assuming uninterrupted benefits.
Does medical insurance pay all hospital expenses?
No. Eligibility, approved services, medicines, deductible thresholds, co-payments, annual caps and designated institutions determine what is reimbursed. Check the local insurance rules for the actual treatment.
What if an employee has no insurance due to an employer registration error?
The employer should promptly review the registration and contribution records, seek the relevant local agency’s correction process and obtain professional advice on any statutory liability or employee loss. Avoid promising that a commercial plan will retroactively cover every expense.
Legal and benefit information is current to the cited policy dates. Local registration, contribution and reimbursement rules must be confirmed for the individual employee’s city and eligibility.
