Hospitalised in China with the CFE: costs, direct billing and emergencies for French expats

If you are hospitalised in mainland China as a CFE member, the CFE reimburses 31% of the real cost of the stay, because China is in CFE zone 4. The CFE has no direct billing (tiers payant) with any hospital in China, so you pay the hospital yourself and claim afterwards. At international hospitals where a standard room alone costs 3,000 to 4,000 CNY a day, that leaves most of the bill, and all of the cash advance, with you unless you have a top-up.

This guide sets out what the CFE pays, what some hospitals in Shanghai and Beijing charge, what is and is not established for emergencies, how to claim, and what to look for in a top-up. For the wider picture, read is the CFE enough in China.

How much does the CFE reimburse for a hospital stay in China?

For care given since 1 January 2026, the CFE pays a hospital stay in medicine, surgery or intensive care, day surgery included, at 31% of the real cost in zone 4. Some care around a stay has its own rate:

Two points people often miss. A long-term condition (ALD) recognised in France raises some outpatient rates abroad, but not hospital stays: the CFE states that stays abroad are reimbursed the same way with or without that exemption. And the CFE pays only if your rights are open, which means no waiting period running and contributions paid before the care.

Source: CFE, guarantees 2026 (arrêté of 17 December 2025, care from 1 January 2026); CFE membership guide 2026 (pages 15 and 35 to 36), read 4 Nov 2026.

What do hospitals in China charge, and what does the CFE pay back?

International and private hospitals in China set their own prices, and few publish them. The figures below are those printed by the hospitals themselves, converted at the European Central Bank reference rate of 3 November 2026 (1 € = 7.4590 CNY).

Beijing United Family's room rate covers the room, meals, general nursing and non-chargeable consumables. Parkway bills the daily inpatient consultation on top of the room.

Example: three nights at Parkway Shanghai

Three nights in a standard room with the daily inpatient consultation come to 3 × (3,000 + 600 to 1,200) CNY, so 10,800 to 12,600 CNY, or 1,448 € to 1,689 €. The CFE pays 31%, 449 € to 524 €, and leaves you 999 € to 1,166 €. That is before tests, imaging, drugs or theatre fees, which a real bill adds.

Example: gallbladder removal at Jiahui

Jiahui's Shanghai fee schedule gives 45,000 to 60,000 CNY for a laparoscopic cholecystectomy, or 6,033 € to 8,044 €. The CFE pays 1,870 € to 2,494 €, and you or your top-up pay 4,163 € to 5,550 €. The schedule was updated on 15 January 2024 and is marked "for reference only", so ask the hospital for a current estimate before a planned operation.

Births: a fixed amount, not 31%

A delivery is paid as a fixed amount covering mother and baby care and practitioners' fees: 3,164.11 € for an uncomplicated vaginal birth and 3,573.64 € for a caesarean. Shanghai United Family's 2024 Premium package was 59,000 CNY (7,910 €) for a vaginal birth with 2 nights, which leaves 4,746 € after the CFE amount, and 80,000 CNY (10,725 €) for a caesarean with 3 nights, which leaves 7,152 €. An epidural (7,000 CNY) and a complicated-delivery surcharge (10,000 CNY) were extra. The hospital says new packages are coming, so treat these as 2024 prices. Our guide to giving birth in China with the CFE covers maternity in detail.

Deposits at admission

None of these hospitals publishes the deposit it may ask for at admission, and we will not guess one. Ask the admissions desk before a planned stay, and ask your top-up insurer whether it can send the hospital a guarantee of payment instead.

Sources: Parkway Shanghai price list (sheet effective 30 June 2026); Jiahui fee schedule for the Shanghai region (updated 15 January 2024, "for reference only"); Beijing United Family price list (undated); Shanghai United Family 2024 prenatal and delivery packages; ECB reference rate of 3 Nov 2026; CFE guarantees 2026; all read 4 Nov 2026. Self-pay list prices; the final bill depends on your case.

Is there CFE direct billing in hospitals in China?

No. The CFE runs hospital direct billing (tiers payant hospitalier) through a partner network in 33 countries, where it pays 70%, 80% or 100% of the invoice depending on the country. China is not one of them, and neither is any zone 4 or zone 5 country, Hong Kong and Singapore included. In China you therefore:

1. pay the hospital yourself, when and how the hospital requires;

2. send the CFE the hospitalisation claim form completed by the hospital, with the paid invoice;

3. receive 31% of the real cost of the stay, in euros, by bank transfer.

For a planned operation like the one above, that means advancing 45,000 to 60,000 CNY yourself before any reimbursement.

Source: CFE list of countries by zone, with the direct billing column; CFE membership guide 2026 (pages 14 and 15), read 4 Nov 2026.

Do you need prior approval (accord préalable) before a hospital stay?

An ordinary stay in medicine or surgery is not on the CFE's list of care abroad that needs prior approval. The CFE requires it for:

• land transport over 150 km, and any air transport;

• psychiatric hospitalisation;

• hospitalisation for aesthetic, reconstructive or bariatric surgery;

• follow-up and rehabilitation stays;

• placement of disabled children and teenagers.

The request goes with the medical prescription to the CFE's medical adviser, by email to servicemedical@cfe.fr or by post. An incomplete request is rejected and cannot lead to any reimbursement, so send it complete and well before the planned date. For any other question about a planned stay, the CFE asks you to contact it through your personal space.

Source: CFE, prior approval request for care abroad; CFE membership guide 2026 (page 13), read 4 Nov 2026.

What happens in a medical emergency in China?

Some rules are clear, and one important point is not published.

What is established

• If you are admitted, the stay is reimbursed at 31% of the real cost, like any hospital stay, and there is no CFE direct billing.

• Imaging done in the emergency department (X-ray, CT scan, MRI) is reimbursed at 20%.

• You pay the hospital and claim afterwards, and your rights must be open: no waiting period running, contributions paid before the care.

• For transport, the CFE's table gives 2.44 € per km by ambulance. Air transport and land transport over 150 km need prior approval.

What is not established

Emergency visits are expensive at international hospitals: Jiahui's 2024 schedule lists an emergency consultation at 800 to 1,800 CNY (107 € to 241 €). The CFE's 2026 table does not say which of its amounts applies to an emergency-department visit abroad, and we have not been able to establish it. Before you count on any amount for an emergency visit that does not lead to admission, ask the CFE.

Medical evacuation, to Hong Kong or to France for example, is a separate question. If you want someone to organise and pay for it, check whether your top-up or first-euro formula includes assistance and evacuation, and on what conditions.

Source: CFE guarantees 2026 (pages 1 to 3); Jiahui fee schedule (15 January 2024), read 4 Nov 2026.

How do you claim a hospital stay from the CFE?

1. Before you leave the hospital, get the detailed, paid invoice and ask the hospital to complete the CFE hospitalisation claim form.

2. Claim in your personal space on cfe.fr ("Déposer une feuille de soins étrangère ou TOM"). Enter the amounts and the currency exactly as they appear on the invoice, here in CNY. One claim can include up to 5 items from the same invoice.

3. Receive the payment in euros by bank transfer. Foreign claims filed online were processed in 4.9 days on average in 2025.

4. Keep the originals for 27 months. You have 2 years from the first day of the calendar quarter after the care to claim.

The CFE also has a social-action fund that can, case by case, improve reimbursements in countries where medical prices are higher than in France. It acts only on paid invoices and cannot advance costs.

Source: CFE membership guide 2026 (pages 15, 28, 32, 34 and 35); CFE annual report 2025 (page 17), read 4 Nov 2026.

Why does a top-up with direct billing matter in China?

For two reasons, one about the bill and one about cash. On a stay or an operation like those above, the CFE leaves 69% of the bill with you. And because the CFE has no direct billing in China, you advance the whole amount, then wait for the CFE's 31%.

A CFE top-up pays what the CFE leaves, up to its own limits. If the insurer has direct billing with your hospital, it can settle the bill with the hospital so you do not advance it. Before you choose, ask:

• which hospitals in your city are in its direct-billing network;

• whether it pays on the real cost or only completes the CFE's share up to a limit;

• how a guarantee of payment is requested for a planned stay and in an emergency;

• whether it includes assistance and medical evacuation.

If you would rather have one contract without the CFE, compare a CFE top-up and first-euro insurance. If you have not joined the CFE yet, read our guide to joining the CFE from China.

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How Alea helps

Alea is the official CFE representative for Hong Kong, China and Singapore. We help you join the CFE, then compare top-ups and first-euro formulas from more than 50 insurers, with a close look at direct billing and assistance at the hospitals you are likely to use in China. Start with our CFE page, or talk to an advisor: the quote is free and without commitment.

Source: CFE, complementary insurers and referents, read 4 Nov 2026.