Foreign nationals who are legally employed in Shanghai and covered by employee social insurance are required to enroll in employee basic medical insurance as part of the employee social insurance system.

Certain eligible foreign residents, such as unemployed holders of permanent residence in China and eligible family members of overseas talent, can also participate in Shanghai's basic medical insurance for residents.

Frequently asked questions

1. What outpatient and inpatient benefits are available to foreign employees covered by Shanghai's employee basic medical insurance?

Foreign employees enrolled in Shanghai's employee basic medical insurance are entitled to benefits in accordance with the city's applicable rules.

Outpatient and emergency care

Eligible outpatient and emergency expenses are first paid from funds credited to the employee's personal medical account for the current medical insurance year.

Once those funds are used up, an annual deductible of 500 yuan (about $74.4) applies. For eligible expenses above the deductible, the pooled fund pays:

• 80 percent at primary-level medical institutions;
• 75 percent at secondary-level medical institutions;
• 70 percent at tertiary-level medical institutions.

The deductible and the employee's share of expenses after pooled-fund payment can first be paid from funds carried over in the personal medical account from prior years. Any shortfall is the employee's responsibility.

Inpatient care

For inpatient care or stays in an emergency observation ward, employed individuals have a deductible of 1,500 yuan. This amount can initially be covered using funds remaining in the personal medical account from previous years, with any additional amount paid by the employee.

For eligible expenses above the deductible, the pooled fund pays 85 percent. The remaining amount can first be paid from funds carried over in the personal medical account from prior years, with any shortfall borne by the employee.

Annual payment ceiling

For the 2026 medical insurance year, which runs from July 1, 2026, to June 30, 2027, the annual payment ceiling for the pooled fund is 670,000 yuan.

For eligible medical expenses exceeding the ceiling, 80 percent is covered by the local supplementary medical insurance fund, and the individual is responsible for the remaining 20 percent.

 

2. Can foreign residents without employment and their family members join Shanghai's resident basic medical insurance?

Eligibility depends on the individual's status and circumstances.

Under Shanghai's current resident medical insurance rules, eligible foreign residents include:

• unemployed spouses of holders of the Shanghai Overseas Talent Residence Permit, as well as their children under 18 or children attending high school;
• unemployed spouses of overseas talent selected for the Shanghai Magnolia Talent Plan and other eligible talent programs, as well as their children under 18 or children attending high school;
• unemployed holders of a Foreign Permanent Resident ID Card.

3. What medical benefits are available under Shanghai's resident basic medical insurance?

Individuals covered by Shanghai's resident basic medical insurance are entitled to outpatient, emergency, and inpatient benefits under applicable rules.

Outpatient and emergency care

An annual deductible applies to outpatient and emergency care, including home-based medical care:

• 300 yuan for individuals aged 60 or above, as well as university students, primary and secondary school students, infants, and young children;
• 500 yuan for individuals aged over 18 and under 60.

For eligible expenses above the annual deductible, the resident basic medical insurance fund pays:

• 70 percent at community health service centers or primary-level medical institutions;
• 60 percent at secondary-level medical institutions;
• 50 percent at tertiary-level medical institutions.

Eligible outpatient expenses incurred at village clinics are not counted toward the deductible, and the resident basic medical insurance fund pays 80 percent. The same applies to eligible outpatient care received by insured university students at on-campus medical facilities.

Inpatient care

A deductible applies to each hospital admission, including stays in an emergency observation ward:

• 50 yuan at community health service centers or primary-level medical institutions;
• 100 yuan at secondary-level medical institutions;
• 300 yuan at tertiary-level medical institutions.

For eligible expenses above the deductible:

• For individuals aged 60 and above, the fund pays 90 percent at community health service centers or primary-level medical institutions, 80 percent at secondary-level medical institutions, and 70 percent at tertiary-level medical institutions.
• For individuals under 60, the fund pays 80 percent at community health service centers or primary-level medical institutions, 75 percent at secondary-level medical institutions, and 60 percent at tertiary-level medical institutions.

 

4. What medical insurance credentials can foreign nationals use in Shanghai?

As a general rule, Shanghai no longer issues medical insurance cards.

Insured individuals who are enrolled in Shanghai's medical insurance system but are not eligible to apply for a Shanghai social security card may, for the time being, still be issued a medical insurance card.

Foreign nationals who meet the application requirements may, depending on their circumstances, use a Foreign Permanent Resident ID Card, passport, and other required documents to apply for a Social Security Card (Medical Insurance Only) at a district medical insurance affairs center or a community affairs service center authorized to issue the card.

Individuals can also apply for a medical insurance code, or electronic medical insurance credential, for use when seeking medical care, purchasing medications, and paying medical expenses.

The medical insurance code can be obtained and used through the National Healthcare Security Service Platform app, Suishenban, Alipay, WeChat, and other supported channels.

5. How can Shanghai-insured foreign nationals receive medical treatment outside Shanghai in the Chinese mainland?

Eligible individuals covered by Shanghai's employee or resident basic medical insurance can apply for cross-province direct settlement of medical expenses.

Registration for cross-province medical treatment can be completed online through:

• the National Healthcare Security Service Platform app;
• the "国家异地就医备案" (National Cross-Province Medical Treatment Registration) WeChat mini-program;
• the "跨省异地就医备案" (Cross-Province Medical Treatment Registration) mini-program on Alipay;
• the "Suishenban" app.

Registration is also available in person at district medical insurance centers or community affairs service centers.

After completing registration, insured individuals can have eligible medical expenses settled directly at designated medical institutions in the registered destination where cross-province direct settlement is available.

If direct settlement is not possible because of problems with the settlement network or insurance credentials, the patient can pay for the medical expenses upfront and then, within six months, submit an application for reimbursement to the medical insurance authority with the necessary documents.

If an insured individual receives outpatient or inpatient care outside Shanghai without prior registration, they can pay for the treatment themselves and then retroactively register at a Shanghai medical insurance agency within six months. They can also apply for reimbursement for eligible expenses by submitting the necessary documents.

 

6. What happens to the personal medical account if a foreign employee settles outside the Chinese mainland and terminates their Shanghai social insurance account?

If an employee settles outside the Chinese mainland and terminates their Shanghai social insurance account, their personal medical account will be closed from the month following the termination of the social insurance account.

If the personal medical account is closed during a medical insurance year, funds credited to the account in advance will be reconciled based on the employee's actual basic medical insurance contributions. Any shortfall will be credited to the account, and any excess will be deducted.

 

Sources: Shanghai Municipal Medical Insurance Bureau; Shanghai Municipal People's Government; Government Online-Offline Shanghai