How does healthcare work in China and Hong Kong, and what travel insurance, health insurance or expat insurance do you need?

How does the healthcare system work in China & Hong Kong?

What is the quality of healthcare in China & Hong Kong?

• China and Hong Kong have separate healthcare systems that differ greatly in quality, accessibility and cost.
• In the larger Chinese cities, you can often choose between the local hospital (often good care, but also overcrowded and sometimes chaotic), the VIP department of the local hospital (quieter, more English, cleaner) or a special clinic aimed at foreigners (with better facilities and more recognisable approaches and procedures, although here too you can sometimes be surprised). In rural areas, care is often limited.
• In an emergency or emergency, always ask -where possible- the emergency centre of your health insurance company first which clinic or hospital you can be transported to for further treatment.
• Be aware that the distances in Chinese cities can be large, and there can be considerable delays, depending on traffic.
• Chinese ambulances can sometimes take a long time to arrive; consider arranging your own transport to your preferred hospital if possible. In addition to regular healthcare with doctors, pharmacies, hospitals and clinics, China has of course also traditionally had a very extensive classical Chinese medicine with acupuncture and traditional healing methods.
• The healthcare system in Hong Kong is considered one of the best in the world, with a robust public sector and a high-quality private sector.
• International health insurance is crucial in both regions, especially because many of the best hospitals are private.
• Medicines (on doctor's prescription) are in principle taken and paid for immediately.
• If you are dependent on special medicines, always take a large starting supply with you when you move to China; arrange a medicine declaration in connection with customs control.
• Preferably check the international generic name (active ingredient) of your medicine with your regular pharmacy before departure, separately from the brand, and ask for the name of this medicine in China.
• In the pharmacies in the larger Chinese cities that also focus on foreigners, many medicines are of course reasonably available; inquire in good time (well before your starting supply runs out) about follow-up prescriptions, and/or ask for help from your health insurer.
• Public healthcare in Hong Kong is of very good quality and is provided by the Hospital Authority and the Department of Health. Private healthcare is also of very good quality.
• In Hong Kong you will find pharmacies everywhere, some of which are open 24 hours a day.
• If you are taking prescribed medication to Hong Kong, make sure it is in its original packaging and that you bring the prescription. It may also be useful to have your doctor write a note explaining why you need the medication.
• The emergency services in Hong Kong are quite fast and efficient. If you call 999 in a medical emergency, you will be taken to a public hospital by a public ambulance (free of charge).

How does the public healthcare system work in China & Hong Kong?

• Depending on the type of hospital you visit and the length of your stay in/getting used to China, you may experience a sense of chaos; the most basic (local) hospitals are often overcrowded and procedures are different from what you are used to.
• China has four public health networks:
  • the public health service system for prevention, control, education, child and maternity care, mental health, emergency care, blood collection, health monitoring, family planning plus a network of public health services.
  • the actual health care, with hospitals at district and canton level in rural areas and health centres at village level; in the cities, hospitals and neighbourhood health centres work together at different levels.
  • health insurance: a basic insurance supplemented with additional insurance; a distinction is made between working and unemployed city dwellers, there is a (relatively new) cooperative insurance in rural areas and a relief fund for people in difficulty.
  • a network for medicines, from production to distribution, with one national system for basic medicines.
• The quality of care varies enormously. In large cities, public hospitals are often well-equipped, but in smaller towns and rural areas, care is limited.
• Costs in public hospitals are relatively low, but waiting times can be long. Consultations and medicines are usually paid for immediately (sometimes by credit card).
• Doctors in public hospitals rarely speak English, which can make it difficult for expatriates.
• Most expatriates therefore do not actually use the public system, but opt ​​for private institutions. In addition, the public health care system is also quite expensive and often does not cover everything.
• Hong Kong offers universal health care through the public system, financed by taxes. There is no financial contribution to public health care.
• Health care in Hong Kong is of excellent quality, with well-equipped public hospitals and experienced medical staff. It is also a lot more affordable than private care. Treatments in public hospitals often cost a fraction of what private hospitals charge.
• You can only use public health care if you have a Hong Kong ID card.
• Dental care is not covered by the public health care system, except in cases of absolute emergency. In Hong Kong, a small fee (around HKD 180) is usually charged for an emergency room visit.

How does the private healthcare system work in China & Hong Kong?

• In China, many expats opt for private hospitals and international clinics, where the care is of high quality and you have quicker access to specialists and advanced treatments.
• In a private hospital in China, the medical staff is more likely to speak English and there are more international doctors present.
• In a private hospital in China, the nurses and doctors will generally be less likely to leave you to your own devices.
• The infrastructure and hygiene in a private hospital in China is often good and according to "international" standards. In a government hospital, you can end up in a bed without pillows or blankets, and you can lie together with the local community.
• Private healthcare in China is expensive and you have to pay up front, unless you have good international health insurance.
• Private healthcare in Hong Kong is excellent and is often chosen by expatriates because of the short waiting times, doctors who speak English and luxury facilities. In fact, it is often the case that the government only grants expatriates a visa if the employer provides private health insurance.
• The price tag in Hong Kong is high. A regular check-up in a private clinic can easily cost hundreds of dollars.
• Many employers who bring foreigners to Hong Kong therefore offer insurance that covers private care. However, it can still be useful to take out insurance yourself for repatriation, for example, but also for any costs that are not covered by your employer's insurance.

How is the GP arranged in China & Hong Kong?

• In principle, the general practitioner and the home visit of a doctor do not exist in China. For a medical examination or a simple doctor's consultation in China, you often go directly to the hospital.
• In Hong Kong, general practitioner care is well arranged. You can easily make an appointment with a general practitioner in a private clinic, but often this is not even necessary. The waiting times are generally short, but you pay considerably more for private care. In the public system, you can also go to a general practitioner, but you must make an appointment at least 24 hours in advance.

How is the dentist arranged in China & Hong Kong?

• Dentists in China are available in both public and private clinics. Private clinics in cities like Shanghai and Beijing offer Western standards, but are more expensive.
• Dental care in Hong Kong is of high quality, but like other private healthcare, it is expensive. A check-up can cost $50-100.

How is pregnancy care arranged in China & Hong Kong?

• Maternity care in public hospitals in China is cheaper, but expats often experience a language barrier and crowded conditions.
• Many expats choose private hospitals or international clinics in China where English is spoken. These offer excellent prenatal care, but the costs are high.
• Breastfeeding is encouraged in China, but feeding your baby in public can sometimes be met with mixed reactions.
• Public hospitals in Hong Kong offer excellent prenatal and postnatal care, and the costs are low.
• Many expats choose private hospitals for a more personal experience. The cost of giving birth in a private hospital can run into the tens of thousands of dollars.
• Hong Kong actively promotes breastfeeding, and it is socially acceptable to do so in public.

How safe or unsafe is a trip or stay in China & Hong Kong?

What should you pay attention to in terms of safety in China & Hong Kong?

• China is generally a safe country with a low crime rate. Urban areas have good safety, but pickpocketing occurs in busy tourist areas.
• Avoid political topics, both in conversations and online posts. It can be sensitive and lead to problems with authorities.
• The Chinese government strictly controls the internet and social media. Do not use VPNs to access blocked sites such as Facebook or Google without understanding that this is officially not allowed.
• In rural areas you can encounter poisonous snakes, scorpions and other animals. Be careful in mountainous or forested areas.
• Earthquakes are not uncommon, especially in western China (such as Sichuan). Make sure you are familiar with the safety protocols.
• During the rainy season (especially in summer), flooding is a risk in southern China.
• Hong Kong is one of the safest cities in the world, but beware of pickpockets in busy areas.
• There have been political protests since 2019. Although these have become less frequent, it is important to keep an eye on the situation.
• May to November is typhoon season in Hong Kong. During a typhoon warning signal (T8 or higher), public transport is restricted and businesses are closed. Make sure you have an emergency kit.
• In mountainous areas, there may be a risk of landslides during heavy rainfall.

What should you look out for in terms of diseases in China & Hong Kong?

• It is not recommended to drink tap water in China; drink bottled water instead.
• Air pollution is also a major problem in Chinese cities. Cities such as Beijing and Tianjin often suffer from smog. Wear a mask and avoid outdoor activities on days with high pollution.
• Infectious diseases such as hepatitis and tuberculosis are common in China, especially in rural areas. Vaccinations are recommended, check with your vaccination doctor.
• Tap water in Hong Kong is safe to drink, although some expats prefer to use bottled water.
• There are few health risks in Hong Kong. Dengue and chikungunya (transmitted by mosquitoes) can occasionally occur in certain seasons.

What should you pay attention to when it comes to traffic in China & Hong Kong?

• In large cities such as Beijing and Shanghai, traffic is often an organized chaos. Cars, scooters, bicycles and pedestrians often share the same roads without clear rules.
• In China, roads are often of poor quality in rural areas.
• Many drivers ignore traffic lights, especially at busy intersections. So always be on your guard when participating in traffic, even as a pedestrian.
• Expats need a Chinese driving license to drive legally. International driving licenses are not accepted.
• Getting a driving license in China can be a bureaucratic process, so many opt for chauffeurs or taxi apps like Didi.
• China’s train network is impressive, with high-speed trains connecting major cities. They are reliable, affordable and comfortable. In urban areas, the metro is a fast and efficient way to get around.
• Electric scooters are popular, but the rules vary from city to city. In some cities, helmets are mandatory, while in others scooters are banned.
• Hong Kong’s public transport system is excellent, with an efficient metro system (MTR) and buses. Driving in Hong Kong is not necessary and is often considered stressful due to heavy traffic and high costs.
• Traffic in Hong Kong is much more organized than in China, but it is very busy, especially in the city center.
• Driving is on the left, which is important to remember if you are coming from a right-hand drive country. An international driving license is accepted for short stays. For a longer stay, you must obtain a local driving license.
• Parking in Hong Kong is extremely expensive, and most expats do not use their own car.
• Taxis are relatively cheap, but speaking English is not a guarantee for taxi drivers. Apps such as Uber or Grab can be useful.

What work and travel insurance policies are suitable for short and long stays in China & Hong Kong?

• Is the trip to and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

What emigration and expat insurance can you take out for China & Hong Kong if you are going to live there for a while?

• Make sure your insurance covers medical evacuation as well as coverage in neighboring countries. Read more about insurances for abroad on Expatinsurances.org.