Payment Guide
How to pay for medical services in China — digital wallets, cards, hospital billing, and currency exchange tips.
China runs on mobile payments. With 92% of transactions happening through smartphones, the country has leapfrogged cards and cash into a QR-code-first economy. For international medical tourists, this raises an obvious question: how do I actually pay for things?
Good news: Dramatic policy changes since March 2024 have made paying in China significantly easier for foreigners. Alipay and WeChat Pay now accept international credit cards, transaction limits have been raised, and the government has mandated that hotels, attractions, and large merchants accept foreign bank cards. This guide covers everything you need to know.
Payment Landscape
China's payment ecosystem is dominated by two mobile apps: Alipay and WeChat Pay. Together they process over 90% of consumer transactions. QR codes are everywhere — from high-end hospitals to street food carts. Cash and cards still work, but mobile wallets are the path of least resistance.
of transactions via mobile payment
fee-free threshold per transaction
Alipay single transaction limit
new POS terminals in Shanghai alone
Bottom line: Set up both Alipay and WeChat Paybefore you travel, link an international Visa or Mastercard, and carry ¥1,000–2,000 in cash as backup. This combination covers virtually every payment scenario you'll encounter in China — from hospital bills to taxi rides.
Mobile Wallets: Alipay & WeChat Pay
| Feature | Alipay | WeChat Pay |
|---|---|---|
| Single transaction limit | $5,000 USD | $5,000 USD |
| Annual limit | $50,000 USD | $50,000 USD |
| Fee (≤200 RMB) | 3% | Free |
| Fee (>200 RMB) | 3% | 3% |
| Languages | 16 languages | English + Chinese |
| Best for | Hospital payments, large purchases | Daily life, social, small purchases |
Setting Up Alipay
- 1
Download Alipay
Search "Alipay" in the App Store or Google Play. Make sure you download the official app by Ant Group.
- 2
Register with your phone number
Use your international phone number to create an account. You'll receive an SMS verification code.
- 3
Link your international card
Go to "Me" → "Bank Cards" → "Add Card". Visa, Mastercard, JCB, Diners Club, and Discover are accepted.
- 4
Complete identity verification
Upload your passport photo and take a selfie. Verification usually completes within minutes.
- 5
Start paying
Open the app, tap "Scan" to scan a merchant's QR code, or show your payment QR code for the merchant to scan.
Setting Up WeChat Pay
- 1
Download WeChat
Search "WeChat" in the App Store or Google Play. The app is published by Tencent.
- 2
Enable WeChat Pay
Go to "Me" → "Services" → "Wallet". Follow the prompts to activate WeChat Pay.
- 3
Link your international card
Tap "Cards" → "Add Card". Visa, Mastercard, and JCB are accepted. Enter your card details.
- 4
Verify your identity
Upload your passport and complete facial recognition. New international users get a 60-day fee-free promotion.
- 5
Enjoy fee-free small payments
Transactions under ¥200 (~$28) are fee-free. Use for taxis, meals, convenience stores, and vending machines.
Tip: Set up both apps before traveling. Use Alipay for large hospital payments (better language support, higher reliability for big transactions) and WeChat Pay for daily expenses under ¥200 (fee-free). Having both ensures you always have a backup.
Hospital Billing: How It Works
- 1
Registration fee
Pay ¥50–300 at the registration window or self-service kiosk to book your consultation slot. International departments charge more than standard departments.
- 2
Doctor consultation
See the doctor, who will order tests or prescribe treatment. You'll receive a printed order slip.
- 3
Pay for tests & diagnostics
Take the order slip to the cashier or self-service kiosk and pay before tests are performed. Blood work, imaging, and other diagnostics are paid upfront.
- 4
Pay for medications
After diagnosis, pay for prescribed medications at the cashier, then pick them up at the pharmacy window.
- 5
Pay for procedures / surgery
For inpatient procedures, you'll pay a deposit (¥3,000–50,000+ depending on the procedure) at admission. The final bill is settled at discharge.
- 6
Collect your fapiao (发票)
Request an official tax invoice (fapiao) at the cashier. This is essential for insurance reimbursement claims. Ask for itemized bills too.
International vs. Standard Departments
| Feature | International Dept | Standard Dept |
|---|---|---|
| Payment methods | Cards, Alipay, WeChat, cash, wire transfer | Alipay, WeChat, cash, Chinese bank cards |
| Language | English + Chinese | Chinese only |
| Pricing | 2–5× standard department rates | Standard government-regulated rates |
| Wait times | Minutes to same day | Hours to days |
| Insurance assistance | Staff help with international claims | No assistance for foreign insurance |
| Receipts | Bilingual itemized receipts | Chinese-only receipts |
Our recommendation: Use the international departmentwhenever possible. Yes, prices are 2–5× higher than standard departments — but they're still dramatically cheaper than Western hospitals, and you get English-speaking staff, international card acceptance, insurance assistance, and much shorter wait times. See our Hospital Culture guide for more details.
Cards & Cash
Where International Cards Are Accepted
- International hospital departments (Visa, Mastercard, sometimes Amex)
- 3-star and above hotels (mandated by State Council since March 2024)
- 4A and 5A tourist attractions (mandated since March 2024)
- Major shopping malls and department stores
Where International Cards Are NOT Reliably Accepted
- Standard hospital cashiers and pharmacies
- Small restaurants, street food vendors, and local shops
- Most taxis and ride-hailing (use Alipay/WeChat in-app)
- Wet markets, convenience stores, and neighborhood businesses
Cash Tips
- Carry ¥500–2,000 RMB in cash as backup — useful for small vendors, emergencies, and places where your phone payment might not work
- No merchant can legally refuse cash— it's against Chinese law. If a vendor claims they only accept mobile payment, insist on paying with cash
- Import limit: ¥20,000 RMB — you can bring up to ¥20,000 in RMB cash into China without declaration. Foreign currency over $5,000 USD equivalent must be declared at customs
Pro tip: If your bank offers a UnionPay card, bring it. UnionPay is China's domestic card network and is accepted at virtually every POS terminal in the country — far more widely than Visa or Mastercard. Some banks (especially in Asia, Europe, and the Middle East) issue UnionPay cards.
Currency Exchange
| Method | Rate | Convenience | Notes |
|---|---|---|---|
| Bank branches (Bank of China, ICBC) | Best | Medium | Bring your passport. Major branches in city centers. Best rates with no commission. |
| ATMs (UnionPay network) | Good | High | Widely available. Your home bank may charge 1–3% FX fee + flat fee. Withdraw in RMB. |
| Alipay / WeChat Pay | Good | Highest | Automatic conversion at Visa/Mastercard rates. 3% service fee applies (free under ¥200 for WeChat). |
| Airport exchange counters | Worst | High | Rates 5–10% worse than banks. Only use for small amounts on arrival if needed. |
Insurance & Reimbursement
Private international hospitals
Direct billing available with major international insurers (Cigna, Bupa, Allianz, Aetna). The hospital bills your insurer directly — you may only pay a co-pay.
Public hospital — international dept
Some departments offer direct billing with select insurers. Most require you to pay upfront and submit claims for reimbursement after returning home.
Public hospital — standard dept
100% out-of-pocket payment required. No direct billing. You must collect all documents (fapiao, itemized bills, reports) and file reimbursement claims yourself.
Documents You'll Need for Claims
- Official fapiao (发票) — the Chinese tax invoice, required by all insurers
- Itemized bills — detailed breakdown of every charge (medications, tests, procedures)
- Diagnostic reports — imaging results, lab reports, pathology reports
- Referral letter — from your home doctor if your insurer requires pre-authorization
- Discharge summary — for inpatient stays, including diagnosis and treatment summary
- Prescriptions — copies of all prescribed medications
- Travel receipts — flight and hotel receipts if your policy covers medical travel
Critical: Request all documents before leaving the hospital. It is extremely difficult to obtain fapiao, itemized bills, or medical records remotely after you've returned home. Ask the international department to prepare everything on your last day — including English translations if available.
Fees & Tipping
| Fee Type | Amount |
|---|---|
| Alipay service fee | 3% per transaction |
| WeChat Pay (≤¥200) | Free |
| WeChat Pay (>¥200) | 3% per transaction |
| Home bank FX fee | 1–3% (varies by bank) |
| ATM withdrawal fee | ¥10–30 + home bank fee |
| Airport exchange markup | 5–10% worse than bank rate |
Tipping in China
China has no tipping culture. Do not tip doctors, nurses, hotel staff, taxi drivers, tour guides, or restaurant servers. Tipping is not expected and can cause confusion. In a medical context, offering money to a doctor or nurse can be seen as inappropriate or as an attempted bribe. Simply express your gratitude verbally — a sincere "thank you" (谢谢, xièxie) is always appreciated.
Recent Changes (2024–2026)
China has made sweeping changes to improve payment access for international visitors. Here's a timeline of the most important policy shifts:
- 1
March 2024 — State Council mandate
All 3-star+ hotels, 4A/5A attractions, and large merchants must accept foreign bank cards. Major enforcement push began.
- 2
April 2024 — Alipay limits raised
Single transaction limit raised to $5,000 (from $2,000). Annual limit raised to $50,000. International card linking simplified.
- 3
May 2024 — WeChat Pay fee-free promotion
WeChat Pay introduced fee-free transactions under ¥200 for international card users. 60-day fee-free welcome period for new users.
- 4
Mid 2024 — POS terminal expansion
Shanghai alone added 45,000+ new POS terminals accepting foreign cards. Beijing, Guangzhou, and Shenzhen followed with similar rollouts.
- 5
Late 2024 — UnionPay "Nihao China" card
UnionPay launched a prepaid card for tourists, loadable at airports and hotels, usable everywhere UnionPay is accepted (virtually everywhere in China).
- 6
2025 — Hospital payment upgrades
Major hospitals began upgrading cashier systems to accept Visa/Mastercard directly, not just in international departments.
- 7
Ongoing — Continued improvements
The government continues to expand foreign payment acceptance. Each quarter brings new merchants, better app translations, and higher transaction limits.
The trend is clear: The Chinese government is actively removing payment barriers for international visitors. Each quarter brings new improvements — higher limits, lower fees, wider card acceptance, and better app translations. The payment experience for foreigners in 2026 is dramatically better than it was even two years ago.