Country guide — Asia-Pacific
Expat insurance and health insurance in China
In short
In China, there is no general legal requirement for private health insurance for every French resident, but a foreign employee under a local employment contract has been mandatorily enrolled in Chinese social insurance (including basic health insurance) since 2011. A holder of a Z visa (work) must produce a health insurance certificate for their work permit, and since October 2025, any foreigner applying for a residence permit of one year or more must provide a health certificate. Lacking coverage or a compliant certificate exposes the applicant to rejection of the permit or residence application.
Key figures
- 20,940 French nationals registered in 2025 (20,905 in 2024, +0.17%) — after a marked decline from the peak of 31,334 registered in 2014.
- Life expectancy at birth: 78.0 years in 2024.
- Current health spending per capita: 763.38 USD in 2023, ≈5.94% of GDP.
Local healthcare system
A mixed system built around public social insurance schemes (basic medical insurance for urban employees, and for urban and rural residents), managed locally with reimbursement rates that vary from city to city. Access to public hospitals is open to everyone on a direct-payment basis; reimbursement requires effective affiliation (local employees, permanent residents). For a foreign resident who is not affiliated, access is either through direct payment in the public system (cheaper, limited French/English-speaking staff) or through international clinics and departments (Shanghai, Beijing, Guangzhou, Shenzhen), pricier but multilingual.
Legal and visa obligations
- Mandatory Chinese social insurance for every foreign employee in local employment (since 15 October 2011): 5 branches (old age, health, workplace accidents, unemployment, maternity), contribution shared between employer and employee, rates vary by city.
- Z visa (work): a health insurance certificate is required, minimum coverage of 500,000 CNY, including repatriation of remains included.
- Health certificate (since 1 October 2025): required for any residence permit of one year or more, valid for 6 months.
- X visa (student): medical and accident/death insurance mandatory for the entire duration of studies (typical university contract such as Ping An, ≈800 CNY/12 months).
- Q visa (family reunification): no uniform requirement at the visa stage, but a health certificate is required for a residence permit of ≥1 year.
Cost of some medical procedures
Orders of magnitude from specialised sources, not official fee schedules.
| Procedure | Public sector | Private sector |
|---|---|---|
| GP consultation | 10 to 200 CNY (≈1-26 €) | 500 to 2,000 CNY (≈65-260 €) |
| Specialist consultation | 50 to 300 CNY (≈7-39 €) | 800 to 4,000 CNY (≈105-520 €) |
| Emergency room (access) | 50 to 1,000 CNY (≈7-130 €) | 1,000 to 3,000 CNY (≈130-390 €) |
| Night in hospital | 50 to 200 CNY (≈7-26 €) | 300 to 5,000 CNY (≈40-650 €) |
| Standard X-ray | 50 to 300 CNY (≈7-39 €) | ≈200 to 500 CNY (≈26-65 €) |
| MRI | 500 to 2,000 CNY (≈65-260 €) | ≈1,400 to 2,100 CNY (≈200-300 USD) at a private international hospital |
| Basic blood test | 30 to 150 CNY (≈4-20 €) | ≈150 to 300 CNY (≈20-39 €) for a full panel at a private international hospital |
Social security agreements with France
China is among the « agreements signed but not yet in force » according to CLEISS: a social security agreement between France and China was signed on 31 October 2016, supplemented in 2019, but still not in force as of 22/09/2026 (ratification ongoing on both sides).
- Once in force, it will be limited to temporary secondment (old age and unemployment only, up to 5 years) — health will not be covered.
- As long as the agreement is not in force, a French employee working locally remains exposed to potential double contributions, with no automatic exemption.
- No cross-border coverage of health costs: voluntary affiliation with the CFE or private insurance is necessary.
Which insurance for my profile
General matrix — does not recommend any specific product or insurer.
| Profile | Regulatory constraint | Points of attention |
|---|---|---|
| PVT | No PVT agreement with mainland China (but an agreement exists with Hong Kong, 500 places/year) | Use another visa (student, standard work visa) for mainland China |
| Student (X1/X2) | Medical and accident/death insurance mandatory for the entire duration of studies | Check whether university insurance is sufficient or needs to be supplemented for repatriation |
| Seconded employee / local employment | Mandatory affiliation with Chinese social insurance (5 branches) from formal employment onward | No coordination with the French scheme as long as the CLEISS agreement is not in force |
| Retiree | No dedicated retiree visa; a health certificate is required for any residence permit ≥1 year | Private cover is essential; consider the CFE as a supplement |
| Family (Q visa) | No uniform requirement at the visa stage itself | Health certificate required for a residence permit ≥1 year |
Hospitals and care network
- Shanghai United Family Hospital (Shanghai, several locations) — Sino-American joint venture, an international benchmark since 2004.
- Beijing United Family Hospital (Beijing) — sister facility in the United Family network, an international benchmark in Beijing.
- Huashan Hospital / Huashan Worldwide Medical Center (Shanghai) — international medical centre dedicated to foreign patients.
Practical steps
- Work permit before the Z visa: processing time ≈20 working days, insurance certificate (≥500,000 CNY, repatriation included).
- Z visa application: passport valid for more than 6 months, COVA form, processing time ≈4 working days.
- Residence permit: within 30 days of entry, a health certificate has been mandatory since October 2025 for any permit ≥1 year.
- Affiliation with Chinese social insurance: handled by the employer for an employee in local employment.
- Registration with the roll of French nationals living abroad is recommended beyond 6 months.
Frequently asked questions
Is health insurance mandatory for every French national moving to China?
No, there is no general requirement. But an employee under a local contract must be affiliated with Chinese social insurance, and a health certificate has been required (since October 2025) for any residence permit of one year or more.
Does French social security continue to cover me in China?
Not automatically. The 2016 agreement is still not in force, and even once ratified, it will not cover health. A CFE membership or private insurance remains necessary.
Does an employee seconded to China have to contribute to Chinese social insurance?
An employee under a local contract has in principle been subject to it since 2011. Germany and South Korea benefit from exemptions under their own bilateral agreements; not France, as long as its agreement remains unratified.
Is there a working holiday programme (PVT) between France and China?
No, not for mainland China. France does, however, have a PVT agreement with Hong Kong, which is separate from the rest of Chinese territory.
Can I get treatment in a Chinese public hospital as a foreign resident?
Yes, on a direct-payment basis, at lower rates than the private sector. Reimbursement through Chinese social insurance requires effective affiliation.
Moving to China? Get a quote
Written by Expavy
Sources
- France Diplomatie — China, Health
- CLEISS — Signing of the Franco-Chinese social security agreement
- Sénat — Ratification status (response dated 5/12/2024)
- Dezan Shira & Associates — Foreigner Participation in China's Social Insurance Now Mandatory
- World Bank — Life expectancy, China
- France Diplomatie — Register of French nationals abroad (carte-registre, 2025 data)
- XRayCost.com — X-Ray Cost in China: Public & Private Healthcare Guide
- ChinaMedPass — MRI Cost in China: Beijing Hospital Prices for Foreign Patients