Before you start

Residence permit and work permit
Employment contract, which triggers social insurance enrolment
Employer private insurance details, if provided
A Chinese mobile number for hospital appointment apps

Step-by-step

1
Confirm the employer has enrolled you in social insurance
The 2011 Interim Measures make enrolment compulsory nationally for foreign employees across pension, medical, work injury, unemployment and maternity. Enforcement varies city by city — check your payslip shows the deductions rather than assuming.
Via employerWho: Your employerMonth 1
2
Check whether a totalisation agreement applies
China has bilateral social security agreements with a number of countries including Germany, South Korea, Japan, Canada, Switzerland, the Netherlands, Spain, Denmark and Finland. Posted workers may be exempted from specified contributions with a certificate of coverage from home. Scope differs by agreement.
Via employerWho: You
3
Register with West China Hospital's system early
West China Hospital is the referral centre for a large part of western China and its specialist clinics are heavily oversubscribed. Register on its app, understand how the international outpatient service works and what it costs, and do this before you need it rather than during an emergency.
Mobile appWho: You
4
Read the private policy before you need it
The key question is whether it admits you to hospital international wings or only reimburses ordinary treatment. Also check whether it covers medical evacuation — in western China, with fewer private international hospitals than the coast, evacuation cover matters more than it does in Shanghai.
Via employerWho: You
5
Manage the winter air
The basin's topography traps pollution under winter inversions and clears it slowly. Air quality has improved with the national trend, but bad episodes still happen. A HEPA purifier for the bedroom and a habit of checking the AQI through the winter is the proportionate response.
Mobile appWho: YouNovember–February
6
Take the sunlight seriously
Chengdu has among the lowest annual sunshine hours of any major Chinese city because of persistent basin cloud. Vitamin D deficiency is a genuine and commonly reported issue among people who move here from sunnier places. It is worth a blood test in your first winter and a conversation with a doctor rather than self-medicating.
In personWho: You

Documents you’ll need

Passport and residence permit
Social insurance card, once issued
Private insurance card and policy number, including evacuation cover
Employment contract
Vaccination and medical history, translated where possible

Things most newcomers don’t know

West China Hospital is a genuine national institution, and it is the reason Chengdu punches above its tier medically.

West China Hospital of Sichuan University is among the largest hospitals in the world by bed count and consistently ranks at the top of Chinese hospital rankings. It is the referral destination for Sichuan, Tibet, Yunnan, Guizhou and Chongqing, which means the specialist depth available here is closer to Beijing's than to a typical second-tier city's. The corollary is that its clinics are heavily oversubscribed — register on the app and understand the international outpatient route before you need either.

Source: community-reported

Low sunshine is a health variable here, not a mood one.

The Sichuan basin's persistent cloud gives Chengdu among the fewest annual sunshine hours of any major Chinese city — locals joke that dogs bark at the sun, and the joke is old. Vitamin D deficiency is commonly reported among newcomers from sunnier climates, and it presents as fatigue and low mood rather than anything dramatic. A blood test in your first winter is cheap and worth doing rather than assuming you are simply not adjusting.

Source: community-reported

Evacuation cover matters more in western China than on the coast.

Shanghai and Beijing have several private international hospitals; Chengdu has far fewer, and the surrounding region has fewer still. If you travel into western Sichuan — high altitude, long distances, limited facilities — the gap between local care and what your insurer will pay to move you becomes significant. Medical evacuation cover is a specific line item to check in an employer policy, and it is rarely the default.

Source: community-reported

Social insurance for foreigners is mandatory nationally and enforced unevenly by city.

The 2011 Interim Measures require enrolment across all five funds, but implementation was devolved to municipalities and the practical result differs — Shanghai ran a voluntary regime until 2021 and enforcement in smaller cities remains patchy. If you are comparing offers across Chinese cities, the payslip deduction for the same nominal salary may not be the same. Ask payroll directly rather than inferring.

Source: Ministry of Human Resources and Social Security

Common mistakes to avoid

Treating social insurance as optional for foreign employees.
Waiting until you are ill to work out how West China Hospital's international service operates.
Assuming an employer policy includes medical evacuation cover.
Dismissing persistent winter fatigue instead of testing for vitamin D deficiency.
Leaving China without starting the pension refund while you still have a local account.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.