Hong Kong residents travelling north for medical care? A guide to Mainland China's healthcare and social security systems.

As more and more Hong Kong people travel north to live, work or holiday, and some even choose to settle in the Greater Bay Area after retirement, demand for medical care in Mainland China is also increasing. In Hong Kong, people are accustomed to making appointments at private clinics or waiting for their turn at public hospitals. In the Mainland, however, unfamiliar terms such as “Grade III Class A hospitals”, “social security cards” and “medical insurance reimbursement” may leave them confused.

Should patients visit a small community clinic or a large hospital? How much can “medical insurance” actually help? And can Hong Kong people benefit from this coverage? In fact, to seek medical treatment in the Mainland, you need to understand two key issues: first, where to seek treatment (the healthcare institution system); and second, who will pay for it (the social medical insurance system). This article explains the hospital system in the Mainland and, most importantly, how Mainland “medical insurance” works. 

Medical institutions in mainland China are divided into three levels according to their functions, responsibilities and facilities. “Grade III Class A hospitals” (tertiary Class A hospitals) are currently the highest-level hospitals. They have the most advanced medical equipment and the most highly qualified medical teams, and can provide high-standard specialist medical services. Hong Kong residents can register for an appointment in person at the hospital or make an appointment in advance. Appointment methods include by telephone, online, via WeChat, through a mobile APP and in person.

Medical institutions in mainland China include the following three types:

• Public hospitals: divided into three levels. Level I hospitals are community (subdistrict) hospitals, Level II hospitals are county-level (district-level) hospitals, and Level III hospitals are municipal hospitals. Taking Shenzhen as an example, Grade III Class A hospitals include The University of Hong Kong-Shenzhen Hospital, Peking University Shenzhen Hospital and Shenzhen People’s Hospital.
• Private hospitals: healthcare institutions established with funding from the private sector rather than the government.
• Foreign-funded hospitals: healthcare institutions established with foreign investment. 

The social insurance system in Mainland China consists of the “Five Insurances”: basic pension insurance, basic medical insurance (medical insurance), work-related injury insurance, unemployment insurance and maternity insurance. Among these, “medical insurance” is the basic medical protection covering the entire population. It is funded through contributions from the government, employers and individuals, and is also one of the benefits most commonly used by citizens. The “social security card” is the key document citizens need to access these benefits. When seeking medical treatment or purchasing medication, it is used as a “medical card” for immediate settlement and reimbursement.  

Mainland medical insurance one: urban employee medical insurance for “working people”

This is medical protection designed for employees working in Mainland China (including Hong Kong, Macao and Taiwan residents) and retirees. Its contribution method is similar to Hong Kong’s Mandatory Provident Fund, with employers and employees making monthly contributions to the medical insurance fund jointly. Specifically, medical insurance premiums are based on an employee’s salary, subject to upper and lower limits known as the “contribution base”, with both parties sharing the cost in proportion. As a general principle, employers bear the larger share.

This insurance provides relatively comprehensive cover. According to data from the National Healthcare Security Administration, the reimbursement rate for hospitalisation expenses within the scope of the policy is approximately 84%. It covers not only serious illnesses requiring hospitalisation, but also ordinary outpatient treatment, emergency treatment and chronic illnesses such as hypertension and diabetes. In recent years, the medical insurance medicines catalogue has continued to expand, and many formerly expensive imported targeted medicines and innovative drugs have also been included in the reimbursement scope following negotiations at national level.

In addition, once the required cumulative contribution period stipulated by the local government has been reached (the standard varies by region and is generally 20–30 years), employees no longer need to make contributions after retirement and can enjoy medical insurance reimbursement benefits for life.

Mainland medical insurance two: urban and rural residents’ medical insurance for “everyone else”

This scheme has a wide coverage, including rural residents, non-working urban residents, schoolchildren and students, as well as unemployed Hong Kong, Macao and Taiwan residents who have obtained a residence permit for Hong Kong, Macao and Taiwan residents, and Hong Kong, Macao and Taiwan university students studying in Mainland China. Its aim is to ensure that everyone in society has access to basic protection.

Urban and rural residents’ medical insurance operates on an annual contribution basis. According to 2024 data, individual contributions are no less than RMB400 per person per year, while the government subsidy is no less than RMB670 per person per year.

In terms of the level of cover, residents’ medical insurance is relatively basic, but sufficient to meet essential medical needs. According to official data, the reimbursement rate for hospitalisation expenses within the scope of the policy is approximately 68%, providing a reliable medical safety net for the unemployed, elderly people and students. 

The basic principle is “employment determines the unit, while the absence of employment determines the place of residence”. Hong Kong residents who have been living in the Greater Bay Area for an extended period but are not employed there need to apply for a “Residence Permit for Hong Kong, Macao and Taiwan Residents” to become eligible for local residents’ medical insurance. 

For Hong Kong people wishing to access medical services in mainland China, purchasing mainland medical insurance may be considered. In addition to working in mainland China, they may also purchase basic medical insurance for employees through flexible employment. Those who only hold a Residence Permit for Hong Kong, Macao and Taiwan Residents may also purchase basic medical insurance for urban and rural residents. 

The following are the four categories of people in flexible employment:

1. Individual business operators
2. Part-time employees
3. Workers in new forms of employment (including those who find employment through new business platforms such as e-commerce, ride-hailing, food delivery and express logistics, but who have not established an employment relationship with enterprises associated with these new business platforms)
4. Other people in flexible employment as stipulated by laws, regulations and rules

Regardless of which type of medical insurance they purchase, Hong Kong people must first apply for a residence permit. To apply for a residence permit, they must have lived in mainland China for six months (those working in mainland China can purchase medical insurance directly and do not need a residence permit, so only the residence requirement is considered here). This means that Hong Kong people must purchase or rent a property in mainland China, or live with mainland relatives, for six months before they can apply for a residence permit and purchase medical insurance.

In addition to a residence permit, Hong Kong people must also open a mainland bank account. They can then complete the medical insurance application form and make an online appointment with the local social security bureau, or apply online via the designated webpage or APP. 

As at the end of 2023, the number of people covered by basic medical insurance in mainland China was approximately 1.334 billion, with the coverage rate remaining stable at over 95%. For Hong Kong residents living in the Greater Bay Area, this means they can benefit from the convenience of an extensive healthcare protection network.

However, the issue of the high cost of medical treatment in mainland China has not been fully resolved, as medical insurance does not cover 100% of the costs. There are deductibles (minimum thresholds) and caps, while some imported medicines still have to be paid for out of pocket. For Hong Kong residents seeking more comprehensive protection, purchasing an additional commercial medical insurance policy as a supplement to mainland China’s medical insurance may be worth considering. 

Further reading:
Seeking medical treatment north of the border has become a trend: a comparison of cross-border medical insurance
Travelling between Hong Kong and mainland China: what to do when you fall ill? Compare cross-border outpatient insurance plans now

Note: Specific policies are subject to the latest announcements by the local government. We recommend consulting the local medical insurance bureau or tax department before enrolling to obtain the latest and most accurate information. 

Last updated: 24 July 2025

This English version of this article has been generated by machine translation powered by AI. It is provided solely for reference purposes. In the event of any discrepancy or inconsistency between this translation and the original Chinese version, the Chinese version shall prevail.