When moving abroad, medical coverage is important for expats and their families. Shanghai is home to a diverse expatriate community. For many expats, navigating the healthcare system in a new country can be daunting, especially in a city as vast as Shanghai. Public hospitals in Shanghai offer a wide range of medical services, but understanding how to access and utilize them effectively can be confusing. In this guide, we'll explore tips and insights to help expats confidently navigate Shanghai's public hospitals.

Understanding the System:

Shanghai's healthcare system comprises public hospitals, private hospitals, and international clinics. Most expats are covered by private medical insurance, allowing direct billing from high-cost providers such as United Family Healthcare, Parkway, Jiahui Health. These medical facilities adhere to Western standards and are staffed with English-speaking and international medical professionals.

However, a segment of expatriates residing in the city may find themselves without adequate insurance coverage. Some individuals lack insurance protection altogether, while others may find their employer-provided medical insurance insufficient for their healthcare needs. Although social insurance is obligatory under labor regulations, private medical insurance remains optional. In some cases, corporate insurance policies only extend coverage for accidents and in-patient care, leaving gaps in coverage for routine medical needs. Furthermore, coverage for pre-existing conditions is often limited or subject to substantial premiums, posing financial challenges for those seeking comprehensive healthcare coverage.

Public hospitals, operated by the government, are often the primary choice for locals due to their affordability and comprehensive services. Expats can also access these facilities. Therefore, in this blog, I would like to share a practical guide written by Ms. January Yang to outline your options for accessing much more affordable public healthcare in the city. She is a local Shanghaiese Healthcare Companion and the go-to person to help expats navigate the Public Health System in Shanghai.

Navigating Shanghai's Public Hospitals - A Practical Guide

As a chronic patient for over 20 years, I've navigated the healthcare system in Shanghai through both good and challenging experiences at various hospitals. I aim to explain the differences between all kinds of public hospitals, the major differences in the process between different types of visits, and the comprehensive guidance you may need when you visit public hospitals.

Hospital Differences:

There are three kinds of public hospitals you might consider visiting when needed. You can read the differences explained on Wikipedia to understand the distinctions between them. I'll add a few explanations from my perspective to give you a better idea of them:

Primary hospitals: Community based. Locals usually visit these hospitals for prescription refills (for high blood pressure, diabetes, etc.) or basic tests. The equipment and medicine available there are limited.

Secondary hospitals: Also very community-based. They have more equipment and medicine. Older people like my parents like to go to the secondary hospital nearby for reill and basic tests.

Tertiary hospitals-3B: This is the perfect hospital to visit when you need medical attention. They are well-equipped and can treat many common conditions. I live near a 3B hospital, the go-to hospital for my routine checkups and minor conditions.

Tertiary hospitals-3A: The 3A hospitals in Shanghai are usually crowded with patients from all over the country. You typically need to make an appointment online first before you go. 3As are generally suitable for major conditions that require surgeries or complicated health issues that cannot be solved in 3B hospitals. The specialists there are extremely busy with exceptionally high demands. Securing a slot from them is as difficult as getting a concert ticket for a considerable pop star.

Step-by-Step Hospital Visit Guidance

Step 1: Online Appointment

Download the "随申办市民云" app, register with real-name authentication, click on "Medical Health" on the app homepage, then click on "Appointment Registration" to enter the appointment page. Search for the desired hospital department or doctor's name, pick an ideal time for the appointment, and confirm your information.

Note: For some hospitals (三乙 or 二级 hospitals), you can usually walk in and make an appointment directly. Skip this step if it’s the case.

Preparation for Consultation

Prepare passport and related personal identification documents, organize medical history, list out current medications and drug allergy history, and gather any previous relevant examination reports. Understand what kind of receipts are required for insurance reimbursement before your visit.

Step 2: Arriving at the Hospital

Allocate time for registration and go to the hospital 30 minutes or 15 minutes in advance.

**Card Registration at the Counter for First-time Visitors**
Go to the hospital guide desk to create a personal medical card and fill in basic personal information such as name and phone number.
*Note: A self-pay medical card can only be used in the respective hospital. You must reapply for a medical card if you visit different hospitals.*

Step 3: On-site Registration

Choose between the electronic registration system and the manual registration window

Usually located in the first-floor lobby of the hospital for registration and registration fee payment.

Note: Different hospitals have different registration requirements. Some require obtaining a "triage number" at the guide desk before registration, while others do not. For same-day consultations, you only need to register once. Keep relevant receipts.

Step 4: Consultation - Diagnosis and Prescription of Examination Items or Medications

Follow the indications to go to the consultation department.

Note: Different hospitals have different call-up procedures. Some require going to the "check-in" counter to "check-in" before getting the consultation number, while others can directly watch the electronic screen outside the clinic for the call-up information.

During the consultation, introduce your medical history and describe the current condition clearly and in an organised way to the doctor. Outpatient visits at public hospitals are usually short; the doctor will immediately prescribe examination items after understanding the condition.

Step 5: Make Payment - Examination Items (if any) or Medication Fees

Return to the electronic registration system or the manual payment window to pay for examination items.

After completing the payment, collect the payment receipt and go to the corresponding examination room based on the location indicated on the payment receipt. These rooms are usually on different floors or in another hospital building.

Note: Keep relevant receipts.

Step 6: Examination

Head to the designated examination room and follow the required "check-in" procedures or directly check the call-up screen at the entrance. After waiting, proceed with the examination.

After the examination, you can inquire about the completion time of the report, usually ranging from half an hour to several working days.

Note: Typically, you can wait at the hospital or nearby to collect the examination report on the same day. Once you have the results, return to the initial outpatient area for further consultation. Again, keep relevant receipts.

Schedule an Examination

If the specific examination isn’t available on the same day, go to the examination scheduling window or the respective examination room location to make an appointment. Understand specific precautions and preparations for the examination.

or Follow-up Visit

Submit the examination report to the outpatient doctor for confirmation. The doctor will discuss the results, prescribe medication, or propose further treatment plans. The doctor will fill out the medical record and issue the prescription based on the condition.

Step 7: Follow-up Payment (if any)

Return to the electronic registration system or the manual payment window to pay for medication costs (or further examination items). You can pay with Alipay or WeChat.

Note: Again, keep all the relevant receipts.

Step 8: Medication Pickup

Go to the medication pickup window and queue according to the window on the payment receipt or the electronic screen.

After receiving the medication, check the name on the package and count your medicine at the window before you leave.

Note: You usually only need to present your medical card during medication pickup.

January wants to be your advocate for health and your companion during moments that might otherwise feel overwhelming. She ensures everyone, even foreigners, receives proper medical care. It’s as simple as getting the needed prescribed drugs or sometimes navigating the complexities, and most importantly, she hopes everyone stays healthy and gets well soon. Because your well-being isn’t just a priority, it’s a personal commitment from her.

I thank January for sharing this very comprehensive guide. Her assistance to many foreigners living in Shanghai is tremendously helpful.

As a fluent English, Mandarin and Shanghainese translator, she can guide you from the very beginning to understand your needs, choose the right hospital and secure your outpatient appointment; she makes sure everything you need is ready for the visit. On the day of public hospital visits, she manages your on-site registration and queues, one-on-one in-person translations, and helps you jot down critical medical notes. She can even offer to accompany you from your place to the hospital and back at a cost. Her goal is to make your journey as comfortable and stress-free as possible. After your visit, Medication reminders organise doctor’s notes; if needed, she can help arrange a follow-up visit.

She explained this initiative is a work in progress and appreciates feedback; the rate is subject to change.

Public Hospital Visit Service Charge by Ms Yang

2 hours: 220 RMB

3 hours: 300 RMB

4 hours: 360 RMB

8 hours: 660 RMB

The fee includes per-visit consultation, choosing the right hospital, securing online appointments, and in-person outpatient visit to selected hospital.

Note: The fee does not include your medical fees, meals and transportation.

Service Commitment:

Honesty and Fee Transparency
Accurate translation between you and the medical staff
Completely Confidential

A Practical Guide: Navigating Public Hospitals in Shanghai [Service]