Author
Bowtie Team
Updated on
2025-05-27
Disclaimer: This article is translated with the assistance of AI.
As Hong Kong and mainland China grow closer, an increasing number of Hongkongers are seizing opportunities to live, work, and thrive across the border. But with this exciting shift comes an important question: Who has access to healthcare in China? Let’s break it all down—so you can stay protected, no matter where life takes you.
Types of Medical Insurance in Mainland China
In mainland China, medical insurance is mainly divided into: Employee Basic Medical Insurance , Urban and Rural Residents Basic Medical Insurance , and Commercial Insurance ( medical/health insurance provided by mainland insurance companies).
1. Employee Basic Medical Insurance
Employee Basic Medical Insurance is a statutory and mandatory system in mainland China, designed to protect employees’ basic medical rights through a combination of social pooled medical funds and personal medical accounts.
It is part of social insurance, along with pension, work injury, unemployment, and maternity insurance. It covers employees working in enterprises, public institutions, social organizations, and individual economic organizations with employees, as well as residents engaged in individual business operations and flexible employment.
According to the “Interim Measures for Hong Kong, Macao, and Taiwan Residents Participating in Social Insurance in Mainland China,” Hong Kong residents employed in mainland China must participate in this insurance, while those engaged in individual business operations or flexible employment may participate voluntarily.
2. Urban and Rural Residents Basic Medical Insurance
Urban and Rural Residents Basic Medical Insurance covers minors and residents who are not employed. It integrates the previous urban residents’ basic medical insurance and the new rural cooperative medical system into a unified framework.
According to the “Interim Measures for Hong Kong, Macao, and Taiwan Residents Participating in Social Insurance in Mainland China,” Hong Kong residents living in mainland China may participate voluntarily .
3. Commercial Insurance (Medical/Health Insurance Provided by Mainland Insurance Companies)
Although more than 90% of the population in mainland China has basic medical insurance, serious illnesses often leave expensive imported drugs and specialty medications uncovered, creating a significant demand for commercial medical insurance.
Health insurance in mainland China includes disease insurance, nursing insurance, income protection insurance, and medical insurance. Disease insurance covers critical illness insurance and cancer insurance, while medical insurance includes inpatient medical insurance and accidental outpatient medical insurance.
Additionally, in 2020, mainland China introduced “Inclusive Commercial Medical Insurance,” a collaboration between local government departments and commercial insurance companies, featuring low entry barriers, high coverage limits, and broad protection to encourage public participation. According to the “Insurance Law of the People’s Republic of China,” mainland insurance companies can provide medical insurance to Hong Kong residents.
Mainland China’s social security and welfare system, commonly known as ” social insurance ” or ” five insurances and one fund ,” includes pension insurance, medical insurance, work injury insurance, unemployment insurance, maternity insurance, and housing provident fund. Thus, medical insurance is one component of social insurance.
Similar to mainland residents, Hong Kong people can use their social insurance card to designate one community hospital and one major hospital for treatment, where the reimbursement rate for expenses is highest. If emergency treatment is needed at a non-designated hospital, the reimbursement rate is lower; designated hospitals can be changed once a year.
How Can Hong Kong People Purchase China’s Medical Insurances?
1. Employee Basic Medical Insurance
Hong Kong people employed in mainland China should apply through their employer by submitting the ” Social Insurance Fee Details Application Form .” Employees only need to provide valid identification documents, numbers, and personal contact information, and fill out the application form.
Employers can handle this in person at the tax authority’s tax service hall or online via the Guangdong Province Electronic Tax Bureau or the Yue Shui Tong mini-program. According to local regulations, employers in Shenzhen, Shantou, and Dongguan will assist employees in handling Employee Basic Medical Insurance.
Premiums are paid jointly by the employer and employee. The employer deducts the employee’s portion from their wages and pays both portions together. For example, in Shenzhen in 2023, the employer pays 6% of the wage level for basic medical insurance, while the individual pays 2% of the wage level.
For Hong Kong people operating as individual businesses, they should bring their business license and valid Hong Kong/Macau/Taiwan resident documents to the tax service hall at their registration location to handle it. For Hong Kong people flexibly employed in Guangdong, they must first obtain a Hong Kong/Macau/Taiwan resident permit, then go to the tax service hall at their residence to handle Employee Basic Medical Insurance.
After completing the payment registration at the counter, they can use the Yue Shui Tong mini-program to handle tasks such as signing three-party agreements, adjusting the payment base, settling social insurance fees, changing contact information, and querying payment information.
As for premiums, they are calculated based on the local average monthly wage of urban non-private sector employees. For example, in Guangzhou in 2022, the premium rate is 7% of that average wage.
Since regulations may vary slightly in different parts of mainland China, Hong Kong people need to pay attention to local information.
2. Urban and Rural Residents Basic Medical Insurance
Hong Kong people residing in Guangdong, holding a Hong Kong/Macau/Taiwan resident permit, and not employed can choose to handle it in person at the local medical insurance service hall or through the online methods announced by the local medical insurance department. Those handling it in person should bring their Hong Kong/Macau/Taiwan resident permit, the original of a current personal settlement account from any resident medical insurance collection bank, the account holder’s identification document, valid Hong Kong/Macau/Taiwan resident documents (or social security card) original, and a completed “Urban and Rural Residents Basic Medical Insurance Subscription Registration Form.”
If attending university in Guangdong, it will be handled uniformly by the higher education institution to the local medical insurance agency for Urban and Rural Residents Basic Medical Insurance enrollment. If not attending university, simply provide the required identification documents and information as per school requirements.
3. Commercial Insurance (Medical/Health Insurance Provided by Mainland Insurance Companies)
Hong Kong people can visit mainland insurance companies to arrange insurance or purchase mainland insurance products through Hong Kong insurance agents or brokers. Purchasers need to provide proof of identity (such as ID card or passport), personal information (such as name, age, occupation, etc.), and financial information (such as income proof, bank statements, etc.) for the insurance company to review and verify the customer’s identity and eligibility.
Overall, medical insurance costs in mainland China are lower than in Hong Kong, but Hong Kong people should pay attention to insurance terms, medical networks, reimbursement ratios, and insurance services.
Does Insurance Purchased in Hong Kong Provide Coverage in Mainland China?
Voluntary Health Insurance (VHIS)
VHIS ‘Standard Plan’ is global , so medical expenses in mainland China are also covered; if you have purchased the VHIS ‘Flexi Plan’ or VHIS Premium , whether it covers treatment in mainland China depends on the policy’s coverage area restrictions.
If you purchase Bowtie VHIS ‘Standard Plan’ / ‘Flexi Plan’
Eligible medical expenses for treatment in mainland hospitals (except for psychiatric treatment, rehabilitation treatment, and medical negligence coverage) are covered.
If you purchase Bowtie Pink (VHIS Premium)
It involves Designated hospitals in mainland China outside of the ‘Standard Plan’ compensation limits . If it involves Designated hospitals in mainland China , the relevant eligible medical expenses will be fully compensated.
In other words, if you seek medical treatment in mainland China and want to enjoy full compensation * , you should choose from the designated hospitals in mainland China that are non-premium hospitals.
* Bowtie Pink fully compensates eligible medical expenses for diagnosis, hospitalization, surgery, and specified non-surgical cancer treatments (excluding the US), subject to annual and lifetime coverage limits.
⭐️ VHIS + Critical Illness Insurance: Why Do You Need Both?
First, everyone needs to understand the functions of medical insurance and critical illness insurance are different:
- Medical insurance: In the actual reimbursement form , providing compensation for eligible medical expenses
- Critical illness insurance: In the event the insured unfortunately suffers from a specified serious illness, it provides compensation in a lump-sum form to cover the insured’s living expenses during the period of absence from work due to illness, allowing the insured to focus on treatment and recovery
Therefore, if you unfortunately suffer from a critical illness, having only medical insurance can cover your medical expenses but may not address the long-term issues you need to handle due to the illness. In fact, when you are diagnosed with a critical illness, even if it is not fatal, you may be forced to stop working and lose income, which can affect your quality of life and disrupt your existing plans.
Since medical insurance and critical illness insurance provide non-overlapping coverage, a reliable critical illness insurance policy can replace the income you lose while out of work, providing financial support and reducing the impact on your family, while maintaining your original quality of life.
Moreover, even if you cannot purchase new insurance after falling ill, the critical illness compensation can help you continue paying premiums for your existing medical insurance when necessary.
Critical illness insurance is absolutely an essential form of protection; in addition to medical insurance, the importance of critical illness insurance cannot be overlooked. In any situation, as long as you have a stable income, you should actively consider purchasing a critical illness policy to give yourself an extra layer of protection.
Life Insurance
If the insured unfortunately passes away in mainland China, will Bowtie Life Insurance provide coverage?
After successfully purchasing Bowtie Life Insurance , if the insured unfortunately passes away during the coverage period, Bowtie will provide compensation according to the coverage summary. The plan covers the insured residing in Hong Kong, so if the insured is temporarily traveling or on business in the Greater Bay Area or other provinces in mainland China, they will still be covered.
All Bowtie policies will not be canceled due to a change in residence (except for sanctioned countries/regions) . Bowtie also reminds the insured to update their information with Bowtie in a timely manner, including any changes in residence. If the insured plans to permanently or long-term relocate to the Greater Bay Area, other provinces in mainland China, or abroad, they can contact Bowtie for a case-by-case review; if they have already relocated, they can contact Bowtie at any time for a review.
For Bowtie Life Insurance , if the insured relocates to mainland China (excluding Tibet and Xinjiang), no additional premiums will be required.
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