In China, the medical insurance policy for foreigners is mainly based on their status, visa type and whether or not they are enrolled in China's social insurance program, and there is no such thing as “free medical care” in the general sense. There is no such thing as “free medical care” in the universal sense:
Foreigners residing in China for a long period of time (e.g., for work, study, settlement, etc.).
If these foreigners are eligible, they are required to participate in China's basic medical insurance (including the Employee's Medical Insurance or the Urban and Rural Resident's Medical Insurance), and the fees are paid by the individual and the organization (or on their own), so that they can enjoy the corresponding medical insurance treatment, rather than “free of charge”. Specifically include:
1. Foreigners holding work visas (Z visas)
According to the Interim Measures on Social Insurance for Foreigners Employed in China, foreigners employed in China (who have signed a labor contract with the employer) are required to participate in basic employee pension insurance, basic medical insurance and other social insurance, with the employer and themselves paying the premiums together. After joining the insurance, they can enjoy the reimbursement of hospitalization and outpatient medical expenses according to the regulations (the specific rate varies according to the region and the type of medical insurance, and they need to pay before reimbursement, which is not “free”).
2. Foreigners holding study visas (X1/X2 visas)
Long-term foreign students (usually more than 6 months) studying in Chinese universities or research institutes are required by some regions to participate in the basic medical insurance for urban and rural residents (e.g. Beijing, Shanghai, etc.), and the fees are paid by the individual or the school, and they enjoy similar medical insurance treatment as local students (with part of the fees paid out of their own pockets). Short-term exchange students (no more than 6 months) are generally not obliged to participate in the insurance, medical expenses need to be borne by themselves or through commercial insurance.
3. Foreigners with a reunification visa (Q1/Q2 visa) or a private affairs visa (S1/S2 visa)
If these people (e.g. foreigners settling in China with their spouses/children) meet the local insurance conditions (e.g. holding a residence permit), they can voluntarily or according to the regulations join the Employee's Health Insurance or Urban and Rural Resident's Health Insurance, and enjoy the corresponding reimbursement treatment after paying the premiums.
Foreigners who come to China for a short period of time (e.g. for tourism, business, etc.)
Foreigners who come to China for a short period of time (e.g. L visa holders for tourism, M visa holders for business, etc.) are not mandated to participate in China's medical insurance, and usually have to bear their own medical expenses. If you need to seek medical treatment, you can choose the following methods:
1. Out-of-pocket payment: direct billing at the hospital, which is more expensive (especially in private hospitals or high-end services); and
2. Commercial insurance: some short-term visa holders will purchase travel insurance through travel agencies or on their own that includes medical coverage to cover the cost of sudden illness (it is necessary to confirm in advance whether the insurance terms include medical treatment in China).
3. Emergency assistance: In case of serious illness or accident, you can contact the Global Consular Protection and Service Emergency Hotline of the Ministry of Foreign Affairs of the People's Republic of China (+86-10-12308) to coordinate with a medical institution for medical treatment, but you still need to settle the expenses by yourself or through insurance.
Foreigners with special status (e.g. diplomats, employees of international organizations, etc.)
According to international conventions (e.g. Vienna Convention on Diplomatic Relations and Vienna Convention on Consular Relations) or bilateral agreements, diplomats, representatives of international organizations in China and their family members usually enjoy immunity from medical insurance, and their medical expenses are borne by the sending country or international organization, and they do not need to participate in China's medical insurance. However, they are required to seek medical treatment at designated medical institutions (e.g., foreign missions' outpatient clinics in Beijing), the specific scope of which is stipulated in the relevant agreements.
Summary
China does not have a “free medical care” policy for all foreigners. Foreigners who are employed or studying in China for a long period of time will be partially reimbursed through the Chinese health insurance (after payment of fees); short-term visitors will have to bear the costs on their own or rely on commercial insurance; and diplomats and other persons with special status will be responsible for their expenses by the sending party in accordance with international rules. Overall, medical expenses are mainly borne by individuals, employers or insurance, rather than being “free”.