Medical Insurance in China: Can Hong Kong Residents Purchase It?

As more Hong Kong residents opt to live and work in Mainland China, understanding the local medical insurance landscape has become increasingly important. In this article, the Bowtie team will delve into the various types of medical insurance available in Mainland China, and explore whether insurance bought in Hong Kong extends coverage to the mainland.

Types of Medical Insurance in Mainland China

In Mainland China, medical insurance is primarily categorized into three types: Employee Basic Medical Insurance, Basic Medical Insurance for Urban and Rural Residents, and Commercial Insurance (medical/health insurance offered by mainland insurance companies).

Employee Basic Medical Insurance

The Employee Basic Medical Insurance system is a statutory and mandatory social medical insurance scheme in Mainland China. It aims to safeguard employees’ basic medical rights by combining a pooled social medical fund with individual medical accounts. Alongside pension, work injury, unemployment, and maternity insurance, it forms part of the social insurance framework.

Eligible Participants:

• Employees of enterprises, public institutions, social organizations, and individual economic entities with hired workers.
• Residents engaged in individual business operations.
• Flexibly employed residents.

According to the Interim Measures for Hong Kong, Macao, and Taiwan Residents to Participate in Social Insurance Scheme in the Mainland, Hong Kong residents employed in the mainland must participate. Those engaged in individual business or flexible employment may join voluntarily.

Basic Medical Insurance for Urban and Rural Residents

This scheme targets minors and unemployed residents. It integrates the former Urban Residents Basic Medical Insurance and the New Rural Cooperative Medical Scheme into a unified system known as Basic Medical Insurance for Urban and Rural Residents.

Per the Interim Measures for Hong Kong, Macao, and Taiwan Residents to Participate in Social Insurance Scheme in the Mainland, Hong Kong residents living in the mainland may voluntarily participate.

Commercial Insurance (Medical/Health Insurance from Mainland Insurance Companies)

Although over 90% of mainland residents have basic medical insurance, expensive imported drugs or specialized treatments for serious illnesses are often not reimbursable. This creates significant demand for commercial medical insurance.

Types of Health Insurance in Mainland China:

• Illness Insurance: Includes critical illness insurance and cancer-specific insurance.
• Nursing Insurance: Covers long-term care needs.
• Income Protection Insurance: Provides financial support during income loss.
• Medical Insurance: Covers hospitalization, outpatient accident treatment, etc.

In 2020, Mainland China introduced Inclusive Commercial Medical Insurance, a collaboration between local governments and commercial insurers. It features low entry thresholds, high coverage limits, and broad scope to attract participants. Under the Insurance Law of the People’s Republic of China, mainland insurance companies can offer medical insurance to Hong Kong residents.

The mainland’s social security and welfare system, commonly known as “social insurance” or “five insurances and one fund,” includes endowment insurance, medical insurance, employment injury insurance, unemployment insurance, maternity insurance, and housing provident fund. Medical insurance is one component of this system.

Like mainland residents, Hong Kong residents can use a social insurance card to designate one community hospital and one major hospital as their designated  facilities. Treatments at these designated hospitals offer the highest reimbursement rates. Emergency visits to non-designated hospitals result in lower reimbursement rates. Designated hospitals can be changed annually.

How Can Hong Kong Residents Purchase These Medical Insurance Plans?

Employee Basic Medical Insurance

For Employed Hong Kong Residents

Hong Kong residents working in the mainland should apply through their employers by submitting the Social Insurance Application Form. Employees only need to provide valid identification, ID number, and personal contact details to complete the form. Employers can either visit the local tax service hall in person or apply online via the Guangdong Electronic Tax Bureau or the Yue Shui Tong app. In cities like Shenzhen, Shantou, and Dongguan, employers typically handle the registration process for employees per local regulations.

Premiums:

• Shared between employer and employee.
• Employers deduct the employee’s portion from their salary and pay it alongside their own contribution.
• Example (Shenzhen, 2023): Employers pay 6% of the salary level, while employees pay 2%.

For Self-Employed or Flexibly Employed Hong Kong Residents

• Self-Employed: Bring a business license for individual operations and valid Hong Kong, Macao, or Taiwan resident ID to the tax service hall in the registration locality.
• Flexible Employment: Obtain a Hong Kong, Macao, or Taiwan Resident Permit first, then apply at the tax service hall in the place of residence.

After registering at the counter, individuals can use the Yue Shui Tong app to sign tripartite agreements, adjust contribution bases, settle fees, update contact details, and check payment records.

Premiums:

• Calculated based on the local average monthly salary of urban non-private sector employees.
• Example (Guangzhou, 2022): 7% of the local average salary.

Note: Regulations may vary slightly by region, so Hong Kong residents should check local details.

Basic Medical Insurance for Urban and Rural Residents

Hong Kong residents living in Guangdong with a Hong Kong, Macao, or Taiwan Resident Permit and no employment can apply in person at the local medical insurance service hall or through online channels announced by the local insurance authority.

Required Documents for In-Person Application:

• Hong Kong, Macao, or Taiwan Resident Permit.
• Original personal current settlement account from any bank designated for resident medical insurance collection.
• Account holder’s ID.
• Valid Hong Kong, Macao, or Taiwan resident ID (or social insurance card).
• Completed the Registration Form.

For University Students in Guangdong:

• Universities collectively apply to the local medical insurance authority on behalf of students.
• Non-students need only submit required identification and documents per school instructions.

Commercial Insurance (Medical/Health Insurance from Mainland Insurance Companies)

Hong Kong residents can purchase insurance directly from mainland insurers or through Hong Kong-based insurance agents or brokers offering mainland products.

Required Information:

• Proof of identity (e.g., ID card, passport).
• Personal details (e.g., name, age, occupation).
• Financial information (e.g., income proof, bank statements).

Insurers review this information to verify identity and eligibility. Overall, medical insurance costs in the mainland are lower than in Hong Kong, but residents should note insurance terms, medical networks, reimbursement ratios, and service quality.

Does Insurance Purchased in Hong Kong Provide Coverage in Mainland China?

Voluntary Health Insurance (VHIS)

The Standard Plan under Voluntary Health Insurance offers global coverage, including medical expenses incurred in Mainland China. For the Flexi Plan or premium VHIS plans, coverage in the mainland depends on the policy’s geographical restrictions.

If You Have Bowtie VHIS Standard Plan or Flexi Plan

Eligible medical expenses from mainland hospitals (excluding psychiatric treatment, rehabilitation, and medical negligence coverage) are covered.

If You Have Bowtie Pink (Premium VHIS)

Expenses from:

• Hospitals outside the designated China hospital list,
• High-end hospitals within the designated list, or
• Exceeding designated ward levels

 are reimbursed based on the Standard Plan limits.

In other words, for full reimbursement# in Mainland China, treatment must occur at a non-high-end hospital on the designated China hospital list.

#Bowtie Pink VHIS series fully reimburses eligible expenses for diagnostics, hospitalization, surgery, and prescribed non-surgical cancer treatments (excluding the U.S.), subject to annual and lifetime limits.

Life Insurance

Will Bowtie Life Insurance Provide Coverage If the Insured Passes Away in Mainland China?

Once successfully enrolled in Bowtie Life Insurance, if the insured passes away during the coverage period, Bowtie will compensate according to the policy summary—regardless of location. The plan covers insured individuals residing in Hong Kong, so short-term trips to the Greater Bay Area or other mainland regions for business or travel are also protected.

Bowtie policies remain valid despite changes in residence (except in sanctioned countries/regions). Bowtie reminds insured individuals to update their information, including residency changes, promptly. For those planning a permanent or long-term move to the Greater Bay Area, other mainland regions, or overseas, contact Bowtie for a case-by-case review. If already relocated, reviews are available anytime.

For Bowtie Life Insurance, no additional premiums are required for relocating to Mainland China (excluding Tibet and Xinjiang).

Sources

1. Guangdong-Hong Kong-Macao Greater Bay Area Portal
2. Federation of Trade Unions
3. Qianhai Authority