Getting sick in China: hospitals, international clinics, pharmacies and how insurance actually works

Most trips to China involve nothing worse than a cold or an upset stomach. But every family with children, every traveller over sixty and every business visitor on a tight schedule asks us the same thing before they book: if something happens, what do I actually do? This guide answers that in the order you would need it.

The short version

1. For anything that is not an emergency, go to an international clinic: English-speaking doctors, Australian-standard care, and direct billing to most travel insurers. There are several in Shanghai and Beijing and at least one in every major city.
2. For an emergency, get to the nearest large public hospital’s emergency department by taxi or private car (usually faster than an ambulance), call your insurer’s 24-hour line, and tell your guide or hotel so someone who speaks Chinese is with you.
3. Travel insurance that covers mainland China is not optional, and it is a condition of booking a tour with us.

International clinics: where Australians should go first

These are private hospitals and clinics set up for foreign residents and visitors, with English-speaking Western-trained doctors, Western pharmacies, and billing departments that deal with Australian insurers daily.

• Shanghai: United Family (several locations including a full hospital in Pudong), Jiahui International Hospital (Xuhui, a large private hospital with an emergency department), Parkway Health clinics (several, including one in the former French Concession), Raffles Medical, and the international wards of the big public hospitals such as Huashan Worldwide Medical Center and Ruijin.
• Beijing: United Family (the original, with a hospital in Chaoyang and clinics around the city), Raffles Medical, Oasis International Hospital, and the international department of Peking Union Medical College Hospital.
• Elsewhere: United Family and Raffles have presences in Guangzhou, Shenzhen, Hangzhou, Suzhou and other cities; a hotel concierge or your guide knows the local one.

A GP-level consultation at an international clinic costs roughly what a private specialist costs in Australia, more for emergency care and imaging. Most accept direct billing from the major Australian and international travel insurers if you give them the policy details on arrival; otherwise you pay by card and claim. They stock Western medications under familiar names.

If you end up in a public hospital

Chinese public hospitals are competent, enormous, crowded and run on a system that confuses foreigners. If an emergency puts you in one, this is the flow:

1. Register at the front desk (挂号), with your passport; a small fee is paid up front, by Alipay or cash.
2. Triage in emergency, or a queue for the department you were registered to.
3. See the doctor, briefly; consultations are short and direct. Tests are ordered on paper or a card.
4. Pay for tests first, at a cashier or a machine, then have them done, then return to the doctor with the results.
5. Pay for the prescription, then collect it at the hospital pharmacy.

Everything is paid as you go, and nothing happens until it is paid, which is why having Alipay set up and a credit card with a decent limit matters. English is limited outside the big hospitals’ international wards; a guide, a hotel staff member or a Chinese-speaking friend on the phone is close to essential. Ask for every receipt (fapiao) and the diagnosis written down; your insurer will want them.

The large hospitals’ international or VIP wards (Huashan Worldwide in Shanghai, PUMCH International in Beijing) give you the public hospital’s specialists with an English-speaking service layer and a calmer waiting room, at prices between the public and private systems.

Ambulances

Call 120 for an ambulance. In Shanghai and Beijing they come, but traffic means a taxi, DiDi or your driver to the nearest big hospital is often faster for anything short of a cardiac arrest or a spinal injury. Operators generally do not speak English; have a Chinese speaker call. Ambulances are not free and take you to the nearest public hospital, not to your choice.

Pharmacies

Look for the green cross. Pharmacies are everywhere, open late, and sell most basics: paracetamol, ibuprofen, antihistamines, cold and flu remedies, rehydration salts, antiseptic, bandages, insect repellent, and a wide range of Chinese traditional medicines. Brand names are different; show the pharmacist the generic name or the empty packet from home, or use a translation app. Antibiotics officially need a prescription and in practice are often sold without one; do not self-prescribe. Prescription medicines from home may not exist in the same form; bring enough for the trip plus a week.

Dentists

The international clinics all have dental departments, and Shanghai and Beijing have several standalone international dental practices. For a broken tooth or a lost filling, same-day appointments are normal and the quality is high. Keep the receipt; most travel policies cover emergency dental.

Insurance: choosing it and using it

• Buy a policy that explicitly covers mainland China (some regional policies exclude it), with medical cover in the millions, medical evacuation, and a 24-hour assistance line. Check the exclusions for pre-existing conditions and declare them; over-seventies should buy early and read the age limits.
• Carry the policy number and the assistance line on your phone and on paper, and give both to your guide.
• Call the assistance line early for anything beyond a pharmacy visit; they can arrange direct billing, recommend a facility and, for serious cases, organise transfer or evacuation.
• Collect documents: fapiao for every payment, the diagnosis and treatment record (ask for an English version at international clinics; at public hospitals you will get Chinese and translate later), and any prescriptions. Claims without these fail.
• Medicare does not apply in China and there is no reciprocal agreement.

Common problems, quick answers

• Traveller’s stomach: rehydration sachets, rest, plain food (congee is the national cure), a pharmacy anti-diarrhoeal; a clinic if it lasts more than two days or there is fever.
• Colds and flu: pharmacies; the international clinic if a child’s fever persists.
• Allergic reactions: carry your own antihistamines and any EpiPen with a doctor’s letter; the food guide covers communicating allergies in restaurants.
• Heat: Shanghai summers cause more clinic visits than anything else; water, shade, mornings out and afternoons in.
• Air quality: asthma sufferers carry their preventers and check the index; a mask on bad days is normal.
• Mosquitoes: present in summer, dengue is rare in the big cities; repellent at dusk in parks and water towns.
• Injuries: the footpath and the scooter lane, as the safety guide says. A clinic for anything needing stitches or an X-ray.

What to pack

Paracetamol and ibuprofen (adult and children’s), antihistamines, rehydration sachets, an anti-diarrhoeal, antiseptic and plasters, any prescription medicines in original packaging with a doctor’s letter (especially anything controlled), a thermometer for children, hand sanitiser, and the insurance details. That kit covers nine trips in ten.

What a guide does when you are unwell

Takes you to the right clinic rather than the nearest hospital, explains the symptoms in Chinese, handles the registration and payments, and stays until you are seen. On our tours the Shanghai office knows which clinic each guide uses and which insurers bill directly. Nobody books a trip hoping to need this; everybody is glad it exists when they do. Tell us about any medical conditions when you enquire and we plan around them quietly.