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Insurance in China

How medical bills are paid in China, the three payment paths foreign patients usually have, and how insurance direct billing works in practice. This page explains the structure; it does not sell or compare policies.

How care is paid for in China

Chinese hospitals are paid in three ways. Settling which one applies to you is the first thing to do before you travel. This page describes the structure only, not what any policy pays out: that depends on your own terms.

Basic medical insurance
China's public schemes cover people who are enrolled in them, including eligible foreign nationals who work and pay in. They are arranged through an employer or a local scheme and cannot be bought by a visitor. Almost every short medical trip sits outside them.
Paying yourself
you settle the hospital bill directly, and claim back from your own insurer afterwards.
Commercial insurance
a policy bought from an insurer, such as an international health plan, a travel medical policy, or a home-country plan that covers treatment abroad. Whether it pays depends on the terms of that policy.

Three common payment paths for foreign patients

Pay yourself, claim back home.
You settle the hospital bill in China with your own money or card, keep the itemised invoices and medical records, and submit a claim to your insurer once you are back. This is the most common path and the one that depends least on the hospital. It fits when your policy pays for treatment abroad after the fact.
International insurance direct billing.
The hospital bills your insurer for the covered part and you pay only what the policy does not cover, subject to the insurer approving the plan in advance. The hospital and the insurer decide this between themselves; the next section explains it. It fits when your insurer already has an arrangement with that hospital.
Travel medical insurance.
A short-term policy for a trip. It usually covers emergencies and accidents during the journey rather than planned treatment. It fits as a safety net for the trip, not as cover for the procedure you are travelling for.

How direct billing actually works

  1. Pre-authorisation.

    Before treatment, the hospital asks your insurer to approve the planned care and the amount. An approval covers what it names, for the period it names.

  2. Network hospitals.

    An insurer agrees a list of hospitals it will bill directly. A hospital outside that list is usually paid by you, even where the insurer would have covered the same treatment elsewhere.

  3. Paying up front, and refusal.

    Even with direct billing you may be asked for a deposit, or to pay items the insurer excludes, and a claim can be reduced or refused after review. The hospital and the insurer decide. This site does not take part in, arrange or influence that decision.

Common misunderstandings

  • Having insurance does not mean the hospital can bill it directly. Direct billing depends on the insurer and that hospital having an arrangement.
  • Direct billing does not mean free treatment. You still pay for anything the policy does not cover.
  • Travel medical insurance is not the same as treatment cover. It is built for emergencies on a trip, not for planned care.
  • Pre-authorisation is not a promise that the insurer will pay. It confirms the plan was reviewed; the decision comes after the claim.
  • This site cannot confirm whether a given hospital bills your insurer directly. That answer comes from the insurer and the hospital.

What to prepare

  • Your policy document, and the terms pages that describe cover abroad.
  • Any pre-authorisation or approval form your insurer asks the hospital to complete.
  • Your passport and visa, and the hospital's own registration requirements.
  • Your diagnosis, test results and medical records, in the form the hospital asks for.
  • The hospital's international office contact details, so that the insurer and the hospital can reach each other.

What this page is and is not

This page is general information. We are not an insurance broker, we do not sell or compare insurance products, and nothing here is a recommendation to buy a policy.

Insurance partner: Insgeek

Insgeek (保险极客) is a China-based insurance partner we work with. You deal with them directly: their advice, and any policy you take out, are theirs, and we take no commission on it.

Visit Insgeek →

Hospitals that bill international insurers directly

The hospitals below are our pilot group: 13 Shanghai hospitals whose own material, or whose insurer's public direct-billing directory, states that they bill international insurers directly. Every entry is self-reported information (Level B) checked on 30 September 2026. Whether direct billing applies to you depends on your policy, your insurer's approval and the hospital's confirmation - always check with both before relying on it.

This list is not a ranking and not a recommendation. We do not sell insurance and receive no commission. Listings can change; verify with the hospital and your insurer before you rely on them.