In one sentence: Chinese public hospitals run on admission deposits — you prepay, fees are deducted as you go, and any balance is settled or refunded at discharge; outpatient services are paid on the spot; mobile payment dominates, and foreign bank cards can be linked to Alipay and WeChat Pay since 2023; high-end private hospitals widely support international insurance direct billing, while public hospitals almost always mean pay-and-claim. As long as you collect the fapiao invoice and the itemized bill before you leave, the whole process is far less mysterious than it sounds.
This guide follows the order you will actually encounter things: how deposits work, how to pay at each step, what the invoice and bill look like, and what direct billing versus reimbursement requires.
The basic logic of Chinese hospital billing: the deposit system
Inpatient care in Chinese public hospitals generally works on a prepaid deposit: you pay an estimated amount on admission, treatment costs are deducted from it item by item, you top it up if it runs low, and the balance is settled or refunded at discharge. Deposit sizes vary with the hospital tier and the anticipated treatment — a few thousand RMB is common for a short stay or minor procedure, and tens of thousands for major surgery.
Outpatient care usually involves no deposit: registration, tests and medicines are paid for one by one at the time. That means you need a working payment method from your very first visit (more on this below).
Payment method one: Alipay and WeChat Pay
Mobile payment is the default at Chinese hospitals — counters and self-service kiosks are QR-code-first. The good news is that foreign patients now basically do not need a Chinese bank account:
Since 2023, Alipay and WeChat Pay allow linking international Visa and Mastercard credit cards (plus AmEx, JCB, Discover, Diners Club and others), verified with your passport — no Chinese card required.
In March 2024, the People's Bank of China raised the single-transaction limit for foreign users of mobile payment from US$1,000 to US$5,000, and the annual cumulative limit from US$10,000 to US$50,000.
The platforms themselves also impose per-transaction and cumulative caps (for example, WeChat Pay's foreign-card single-transaction cap is around RMB 6,000), so large payments may trigger limit warnings.
Foreign-card transactions typically carry a fee of about 3%, waived for small transactions (under RMB 200).
Practical advice: for everyday payments (registration, tests, medicines), a foreign card linked to a mobile wallet works smoothly. For deposits in the tens of thousands of RMB, both the limits and the fees start to get in the way — switch to the next method for those.
Payment method two: cash, bank cards and international cards
| Payment method | Best for | Watch out for |
|---|---|---|
| Cash (RMB) | Every hospital; safest for small payments | Bulky and risky in large amounts |
| UnionPay | Widely accepted at public hospital counters and kiosks | Confirm international use is enabled before departure |
| Visa/Mastercard | Usually accepted at high-end private hospitals | Public hospital acceptance varies — ask the cashier first |
| Bank wire transfer | Large deposits and surgical fees | Confirm the hospital's corporate account details with the finance office in advance |
High-end private hospitals (such as Beijing United Family or Shanghai Jiahui) usually take international credit cards directly. Public hospitals rely on UnionPay and mobile payment; Visa/Mastercard acceptance varies from hospital to hospital — don't assume, just ask the cashier.
Paying at a public hospital: counters and kiosks
A typical outpatient flow is: registration (counter, kiosk or app booking) → doctor issues orders → pay (kiosk QR code or counter) → tests or pharmacy. For inpatients: register and pay the deposit at the admission office → top up during the stay as needed → settle everything at discharge, with any balance refunded.
Two practical tips: first, most kiosks have English interfaces, but when the flow gets stuck, the staffed counter is usually faster; second, every payment produces a receipt — keep them, they are your basis for checking the itemized bill at discharge.
The fapiao invoice and the itemized bill
This is the most important link in the whole payment chain for international patients.
The fapiao is China's official tax invoice, and it is what nearly every international insurer requires for reimbursement. The itemized expense list breaks down every charge — medicines, tests, consumables, bed fees. Both must be requested at the cashier when you settle at discharge — getting them reissued afterwards is complicated and sometimes impossible.
Public hospitals issue fapiao and bills in Chinese by default. If you need English versions for your claim: international departments can usually help; at regular public hospitals you can print the full itemized list and translate it yourself or through a service. High-end private hospitals (United Family, Jiahui and the like) generally issue English-language bills directly.
International insurance: direct billing vs pay-and-claim
There are two insurance pathways in China, and the experience differs enormously:
Direct billing: the hospital bills the insurer directly, and you only pay your deductible or co-pay. This is fairly common at high-end private hospitals and international departments — Beijing United Family, Shanghai Jiahui, Raffles and similar facilities work with the direct-billing networks of major international insurers such as Bupa Global, MSH, AXA and Cigna. For admissions over 24 hours, the insurer usually issues the hospital a guarantee of payment (GOP); you show your insurance card and ID, with no large deposit.
Pay-and-claim: you pay everything upfront and claim reimbursement from your insurer afterwards with documents. Public hospitals are almost always this route.
Three things must be confirmed in advance: direct billing depends on whether an agreement exists between your insurer and the specific hospital; most policies require pre-authorization for inpatient treatment; and whichever path applies, you should confirm with both the insurer and the hospital's finance office before admission.
Pay-and-claim: the document checklist
If you are on the reimbursement path (most likely at public hospitals), collect the following from the cashier and medical records office before you leave:
Original fapiao invoice — most insurers do not accept photocopies
The itemized expense list
Medical records and discharge summary (request an English version or translate them)
Diagnosis certificate
Test reports and imaging (DICOM source files are ideal)
The insurer's claim form and your bank details for the payout
Requirements differ slightly between insurers, so the safest move is to ask your insurer for its exact document checklist before you travel.
Exchange rates and moving money: practical tips
Foreign cards and mobile payments settle at the card-network or issuer's exchange rate, plus a fee of roughly 3% — negligible per small transaction, but worth watching on large ones.
For bills in the tens of thousands of RMB, the common approach is a bank wire from your home bank to the hospital's corporate account, with the patient's name and medical record number in the transfer notes; confirm the account and clearing time with the hospital's finance office first.
Whatever the method, keep every payment record (receipts, transfer confirmations, the fapiao) — they serve both your claim and your own reconciliation.
How MyMedVia makes costs transparent
The opacity of Chinese medical pricing usually comes from one thing: nobody tells you the total in advance. MyMedVia provides written price ranges before treatment, helps check bills and deposit deductions during treatment, and helps assemble claim documents (fapiao, itemized bills, translated records) after discharge. Start with our analysis of the hidden costs of Western healthcare, get a rough budget in the cost estimator, or read more about how we make Chinese healthcare affordable and transparent.
How to start
Before departure, confirm with your insurer: whether your policy has a direct-billing network in China, whether hospitalization requires pre-authorization, and which documents reimbursement requires.
Prepare two payment channels: Alipay/WeChat Pay linked to a foreign card (small everyday payments) plus an international credit card or bank wire (large deposits).
Put "collect the fapiao and itemized bill before discharge" on your trip checklist — it is easier to forget than you think.
If you would rather have someone liaise with the hospital's finance office and confirm deposits and direct-billing arrangements for you, contact us — MyMedVia can assist throughout.
This article is general information and does not constitute medical advice.
