Q&A on Chinese medical insurance reform

Q1：How does China's medical insurance system for employees work?

A: The healthcare insurance system for employees has been in place for over two decades, comprising mandatory personal accounts and pooled public accounts. About 354 million people are enrolled in the program nationwide.

The public account is made up of employer contributions and is used to pay for hospital stays, outpatient visits for major illnesses and some chronic diseases. The private account, built with both personal and employer contributions, covers regular outpatient visits.

Q2: What are recent medical insurance reforms about？

A: The State Council issued a guideline in April 2021 calling for gradual steps to be taken in order to build a mutual-aid mechanism for covering outpatient bills through public accounts, so that regular outpatient visits can also be reimbursed through unified accounts.

To expand capacity of unified accounts, a number of provinces have begun to transfer a portion of money previously sent to personal accounts of employees to public accounts managed by authorities and cap the amount paid to personal accounts of retirees to the average pension disbursed in a certain region.