Before you start

Residence permit and work permit, or student enrolment
Employment contract, which triggers social insurance enrolment
Employer or institution insurance details
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. Check your payslip shows the deductions rather than assuming.
Via employerWho: Your employerMonth 1
2
If you are a student, read the compulsory insurance policy in detail
International students in China are required to hold a specified insurance policy, usually arranged through the university. It is inexpensive and correspondingly limited — typically capped, with exclusions and no coverage in the international wings. Understand the caps before you need them, and consider topping it up privately.
Via employerWho: You
3
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
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. For students on basic insurance this is the route you will actually use, so learn it early with a Mandarin-speaking friend.
In personWho: You
5
Book through hospital apps and mini-programs
Nanjing's teaching hospitals take appointments through apps and WeChat mini-programs, often days ahead. Walking in usually means a long wait or no slot.
Mobile appWho: You
6
Take the summer heat seriously
Nanjing is a furnace city — prolonged high thirties with humidity that removes evening relief. Move exercise to early morning, hydrate deliberately, and treat dizziness or a stopped sweat as an emergency rather than fatigue. This sends people to hospital here every summer.
In personWho: YouJuly–August

Documents you’ll need

Passport and residence permit
Social insurance card, once issued, or the student insurance policy
Private insurance card and policy number, if held
Employment contract or enrolment documents
Vaccination and medical history, translated where possible

Things most newcomers don’t know

Compulsory student insurance in China is real cover, and it is thin cover.

International students are required to hold a specified insurance policy, normally arranged by the university at low cost. It works — it will pay for ordinary treatment at designated hospitals — but it is capped, carries exclusions, and generally does not extend to hospital international wings or to treatment outside the city. In a student population that skews young and healthy this rarely matters until it suddenly does. Read the caps, and top up privately if you can afford to.

Source: Ministry of Education / community-reported

Nanjing's summer heat is a health variable, not just discomfort.

The city is traditionally counted among China's furnace cities, and July and August combine high thirties with humidity high enough to impair evaporative cooling, in a basin ringed by hills that traps the heat overnight. The practical consequences are real: exercise early or after dark, do not assume your usual tolerance transfers, and treat cessation of sweating, confusion or dizziness as a medical emergency.

Source: community-reported

The university teaching hospitals are the good option, and they are oversubscribed.

Nanjing Drum Tower Hospital and Jiangsu Province Hospital are among the strongest in the province and draw patients from across Jiangsu. Their specialist clinics fill days ahead through app booking. Register on the app and understand how the international outpatient service works before you need either — doing it during an emergency is much harder, and walking in without an appointment usually means no slot at all.

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.

Source: Ministry of Human Resources and Social Security

Common mistakes to avoid

Assuming compulsory student insurance covers what a private policy would.
Treating social insurance as optional for foreign employees.
Exercising outdoors at midday in a Nanjing August.
Turning up at a teaching 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.