Insurance & Claims: The Step-by-Step How-To

Getting your treatment reimbursed is mostly about paperwork and timing. Here’s the real process.

The two models

• Direct billing (直付): the hospital bills your insurer directly. Only some hospitals + some international insurers do this (e.g., certain centers that accept MSH and similar). It’s the smoothest if available.
• Reimbursement (报销): you pay first, then claim from your insurer. This is the most common model for foreign patients in China.

Check with both your insurer and the hospital which model applies to you.

The “report first” rule (报案)

Most policies require you to notify your insurer (报案) before or shortly after non-emergency treatment.

• Plan ahead: for planned treatment, notify your insurer before the procedure.
• Emergency: if you can’t call in time, treat first, then report — policies explicitly allow this (“急诊来不及打电话，先去看病，之后再补打”).

Documents you need for a clean claim

Gather these before you leave China (the official invoice is especially hard to replace later):

• Official invoice (发票) + itemized bill
• Discharge summary (出院小结)
• Diagnosis & procedure report
• All lab results + imaging (USB/CD + print)
• Operative report (if surgery)
• Medication list
• Proof of payment (receipts / bank transfer confirmation)
• Your passport copy and policy number
• English translations of the key medical documents

Filing the claim — a clean process

1. Notify your insurer (报案) — before or immediately after treatment.
2. Pay the hospital; collect the 发票 + itemized bill + all documents.
3. File the claim within your policy’s deadline (often 30–90 days) with the full document set.
4. Follow up — claims with incomplete documents are the #1 cause of delays. Keep copies of everything you submit.
5. Check exclusions — some policies exclude pre-existing conditions, elective procedures, or require a waiting period. Confirm before you book, not after.

Common pitfalls

• Missing the 发票 — get it at discharge; it’s your primary claim document.
• No translation — insurers often need English copies of the key medical records.
• Filing late — most policies have a strict deadline.
• Unlisted exclusions — read your policy’s exclusions and get written confirmation of what’s covered before treatment.

What ChinaCare can do

We can help you confirm your insurer’s process, prepare the document checklist, and make sure you leave China with everything a clean claim needs.

⚠️ Verify before you travel. Insurance terms and hospital direct-billing arrangements vary and change. Confirm your policy’s process and the hospital’s billing model directly before you book.

📮 Want help sorting out your insurance and claim before you travel? Contact us →