Healthcare in China: compulsory in the Chinese insurance, and you arrange the rest yourself
Whoever works in China must join Chinese social insurance, with a basic medical insurance whose premium employer and employee share. There is no CAK route, and the treaty with the Netherlands does not cover healthcare. For your family and for care outside the public system you arrange something yourself, and that differs per city.
Yes, as an employee in China you are insured for medical costs, but not in the way you know from the Netherlands. Foreigners working for a Chinese employer must join Chinese social insurance, including the basic medical insurance for employees; employer and employee share the premium. The pitfall is on two sides: the Netherlands has no agreements with China on healthcare, so there is no CAK route, and your family is not automatically covered by your insurance.
Why is there no CAK route to China?
The CAK's foreign-residence scheme applies in the treaty countries: the countries of the EU and the EEA, Switzerland, the United Kingdom, and a handful of other countries including Morocco, Tunisia and Turkey. China is not on it. Your Dutch basic insurance ends on the day you deregister, even if you go with AOW or a pension.
There is a social security agreement between the Netherlands and China, but it only covers old-age insurance and unemployment insurance. Whoever is posted to China by a Dutch employer for up to sixty months stays under Dutch legislation for those two. For medical costs the agreement changes nothing. What the agreement means for your AOW is in AOW, pension and tax in China.
How does the Chinese insurance for employees work?
| Part | What the rule is |
|---|---|
| Who | foreigners employed by an employer registered in China, and those sent by a foreign employer to a Chinese branch |
| Which insurances | old age, medical, work injury, unemployment and maternity |
| Enrolment | by the employer, within 30 days of your work permit being issued |
| Premium | shared by employer and employee, under local rules |
| Cover | from the month after enrolment |
| Treaty countries | twelve countries have an exemption agreement with China, including the Netherlands; what is exempt differs per agreement |
The premium rate and what exactly is reimbursed differ per city. Ask your employer before you sign which insurances they contribute to for you, and whether they also arrange private insurance. Local social insurance offices may also implement agreements differently; an employer who wants to exempt you should check with the office first.
What do you arrange for your partner and children?
Your family has no employer of its own, and so does not fall under the employee insurance. In Beijing there is an alternative: the medical insurance for residents is open to the partner and minor children of holders of an A work permit, the category for top talent, if they are not insured elsewhere.
| Beijing, premium for residents in 2025 | Per person per year |
|---|---|
| Adults of working age | ¥ 750 |
| Students and children | ¥ 405 |
| Elderly | ¥ 430 |
You can enrol within 90 days of becoming eligible, or in the annual enrolment period; whoever does not pay for a year loses cover for outpatient and emergency care. If you have a B permit, or do not live in Beijing, ask your employer and the local office what is possible for your family.
Without its own arrangement your family is uninsured. Whoever goes to China on a B work permit must reckon with partner and children not automatically falling under public insurance. Make private insurance for the whole family part of the negotiation with your employer, and have it start on the day the Dutch insurance stops.
Foreigners in China can also take out commercial insurance themselves, with their passport, home address and the details of who is to be insured.
What belongs to the medical side of your stay?
For a residence permit of a year or longer you submit a health certificate, valid for six months from the date of issue. In Beijing a customs health centre examines you, or checks an examination you had abroad in the six months before. How that fits into your first weeks is in your first weeks in China; how to close the Dutch policy properly, in cancelling your health insurance without a gap.
In Vertrekklaar this is phase 3 of 5 of the journey, step 3.1: the same steps, but for your situation — in your order, tickable, and with the deadlines watched. See the whole journey to China or go straight to step 3.1 in the open plan.
What this rests on
The facts in this article come from these official pages. Rules change — when in doubt the source is leading, not this article.
- CAK — the treaty countries (China is not on it) — hetcak.nl
- Beijing — social insurance for foreign employees (five insurances, enrolment within 30 days) — english.beijing.gov.cn
- Netherlands-China social security agreement — only old age and unemployment, postings up to 60 months — wetten.overheid.nl
- Beijing — medical insurance for residents, also for family members of A-permit holders (premiums 2025) — english.beijing.gov.cn
- Guangdong — social insurance for foreigners and the countries with an exemption agreement — en.gdfao.gov.cn
- NIA — commercial insurance for foreigners — en.nia.gov.cn
- Decree 814 (2025) — health certificate for a residence permit of one year or more, valid six months — gov.cn
- Beijing — the medical examination at the International Travel Healthcare Center — english.beijing.gov.cn
Read on
- ChinaClosing the Netherlands4 min
AOW, pension and tax in China: the treaty that doesn't quite do enough
China is on the SVB's list of treaty countries — and yet the AOW (the Dutch state pension) for single people drops there to 50%, because the treaty doesn't arrange export. What it does arrange: posting. Plus the tax treaty that lets the Netherlands levy, and the Chinese six-year rule with its 30-day reset.
Updated 26 September 2026
- BonaireArrival5 min
Healthcare on Bonaire: one hospital, and the flights are in the package
On Bonaire you are insured as a resident by operation of law — no premium, no excess. What the island cannot do, the insurance arranges with medical referrals abroad to Curaçao, Colombia or the Netherlands, including tickets and accommodation. The flip side: a dental package that is almost empty from the age of eighteen, physiotherapy of which the first twenty sessions are at your own expense, and a transition gap you have to insure yourself.
Updated 26 September 2026
- BulgariaOrientation4 min
Healthcare in Bulgaria: from the CAK's S1 to the GP who opens everything
Bulgaria is a treaty country. With a Dutch statutory pension you apply for an S1 form at the CAK, have it registered at the regional office of the national health fund, and choose a GP on a form. That GP is the key to everything: without a referral no specialist. Per visit you pay a small user fee, and the public system is cheap, unevenly spread and often Bulgarian-speaking.
Updated 26 September 2026