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 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, under which posted workers may be exempted from specified contributions with a certificate of coverage from home. Scope differs by agreement.
Via employerWho: You
3
Read the private policy before you need it
The key question is whether it admits you to hospital international wings or only reimburses ordinary public treatment. Check maternity, dental and evacuation terms as well.
Via employerWho: You
4
Learn how ordinary Chinese outpatient works
Register for a department, see a doctor briefly, then tests and pharmacy in the same building. Fast, inexpensive and in Mandarin. Knowing the process means you are not stranded outside international clinic hours.
In personWho: You
5
Book through the hospital apps
Zhejiang University's affiliated hospitals draw patients from across the province and their popular specialists fill days ahead through app-based booking. Walking in usually means a long wait or no slot.
Mobile appWho: You
6
Take the summer heat seriously
Hangzhou summers combine high temperature with very high humidity for weeks at a time, which suppresses the body's ability to cool by sweating. Move exercise to early morning, hydrate deliberately, and treat dizziness or a stopped sweat as an emergency rather than fatigue. Heat illness sends people to hospital here every year.
In personWho: YouJune–September

Documents you’ll need

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

Things most newcomers don’t know

Hangzhou's summer is a genuine health variable, not just uncomfortable weather.

The city sits in the Yangtze delta 'furnace' belt where prolonged high temperature combines with humidity high enough to impair evaporative cooling. Weeks near 38°C with little night-time relief are normal. The practical consequences are real: exercise before seven in the morning or after dark, do not assume your usual tolerance transfers, and treat cessation of sweating, confusion or dizziness as a medical emergency. Hospitals here admit heat illness every summer.

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 city by city — Shanghai ran a voluntary regime until it lapsed in 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.

Source: Ministry of Human Resources and Social Security

The international wing and the ordinary department are usually the same doctors.

Zhejiang University's affiliated hospitals run international or VIP outpatient services with English support, appointments and short waits, staffed by the same senior physicians who see the ordinary queue at a fraction of the price. If you are self-funding, the ordinary department with a Mandarin-speaking friend gets you to the same clinician. If your policy covers the international wing, use it.

Source: community-reported

The individual portion of your pension is refundable on leaving, and the paperwork needs a local account.

Foreign employees leaving China permanently can generally apply to withdraw the individual portion of their pension account; the employer's contribution is not refunded. The application needs contribution records, a bank account and evidence of departure, all far easier to assemble while you still have a Chinese account and a local HR team. Most people who leave first never recover it.

Source: Ministry of Human Resources and Social Security

Common mistakes to avoid

Treating social insurance as optional for foreign employees.
Exercising outdoors at midday in a Hangzhou July.
Finding out at the hospital desk that your policy excludes the international wing.
Turning up at a Zhejiang University hospital without an app appointment.
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.