Yes, travel insurance is worth carrying for a trip through Changsha, the capital of Hunan province, and especially so if Zhangjiajie's dramatic sandstone peaks are part of the itinerary. Most visitors use Changsha as a staging point before continuing on to Zhangjiajie National Forest Park, a few hours away by high-speed rail or domestic flight, and that onward leg brings a different risk profile than a routine stay in a major Chinese city.
Changsha itself is a large provincial capital with substantial hospital facilities, and routine care is generally adequate here, though anything highly specialised may still mean transfer to a larger hospital elsewhere in China depending on the case. Confirm your policy covers treatment and transfer between Chinese cities rather than assuming a routine clinic-visit benefit extends to a genuinely complex case.
Zhangjiajie's terrain is the real activity risk on a Changsha-based trip - the park's quartz-sandstone pillars and glass walkways draw hikers onto steep, sometimes exposed trails and cable-car routes, and injuries from slips or falls on uneven stone steps are a real possibility rather than a generic disclaimer. Check that your policy covers hiking and does not treat the park's more adventurous walkways, including any glass-bottomed bridge or skywalk, as an excluded activity requiring a separate rider.
Keep hospital invoices, any trail-related incident reports from Zhangjiajie, and receipts for treatment or medication, since Chinese providers generally issue standard paperwork on request but claims involving two cities need documentation for both. Check whether your policy pays hospitals directly or requires you to pay first, and confirm the wording covers domestic transfer between Changsha and Zhangjiajie or any onward hospital.
Check whether your existing health cover extends abroad and specifically to China before you rely on it, since coverage rules differ by country of residence and this page cannot answer that for you. A standalone policy naming both hiking activity and domestic medical transfer is the more reliable option here.