Navigating the health insurance maze is hard enough, and having to do it in China can add an additional layer of frustration and difficulty. James D, Senior Consultant at China Expat Helth, answers some of the most common questions and concerns when it comes to finding the right coverage for your family during your time in China.
Why is health insurance coverage in China important?
Health insurance is one of the major concerns for expatriates moving to or living in China. First, you need to know that in China, hospitals (public or private) and ambulances won’t usually treat you if you don’t have insurance, or if you’re not able to pay for the treatments upfront.
Usually not eligible for any social scheme in China and/or willing to go to an international hospital, expatriates need to subscribe to private medical insurance to cover medical costs that can occur.
What should people look for in an China insurance provider?
Benefits: What is covered in my plan? What is not covered? Where am I covered? Which hospitals can I access? The answers depend on the level of coverage you’re looking for. The more comprehen- sive the benefits, the more expensive the premium will be.
Service: How efficient is my insurer when an issue arises? We recommend you contact a broker who has experience working with most of the insurers so they can help guide you to the one that best suits your family’s needs. Note: the premium offered by a broker should be the exact same as the one offered by the insurer.
Stability of the Insurer: If an insurer looks too good to be true, get more information from an impartial source. Some insurers will offer excessively attractive rates to enroll a maximum of clients. When claims arise they might not be able to honor the rates they initially promised and you might have a renewal offer with a 100 percent increase.
What are the main types of health insurance?
It’s difficult to identify a main type of health insurance as different pro- files (i.e. age, nationality, single, family, etc.) will have different requirements, and have different sensibilities and knowledge about medical insurance they want and/or need.
What is normally covered and what isn’t?
The level of coverage depends on the type of plan you choose. Generally speaking, insurers cover the risk of an event to occur. Therefore, they should cover you if you declare symptoms that did not exist be- fore joining the plan. Insurers can also choose not to offer coverage for conditions that happened before joining the plan (pre-existing conditions), but this depends on the insurer.
How much does China health insurance cost?
There are many factors to take into consideration when it comes to the cost of insurance, such as age, level of coverage, family status, etc. It’s best to receive quotes from different insurance companies in order to compare what’s available on the market.
What if people move to China with their own health insurance plan? Would it cover them in China?
Some people move to China with their own health insurance and it’s perfectly fine. Just make sure that the benefits and sub-limits are high enough to offer good coverage in China. Also, it’s crucial to make sure your insurer has the experience to offer a Guarantee of Payment to the hospitals in case of hospitalization. Otherwise, you will need to pay out-of-pocket and then claim the money back.
Finally, it’s most important to know how long your insurer will allow you to renew your plan while your primary country of residence is China. There are cases where people are no longer eligible to keep their plan from home because they have been living in China for more than two years. This would end continuation of coverage and can be tragic for people who develop medical conditions while abroad.
Private Medical Insurance for China Expats
Though local hospitals are cheap in China, international hospitals are expensive. This means a good healthcare plan is essential. Local hospitals often require you to queue and lack English speaking doctors; they may be fine for minor ailments, but in the case of serious illness or injury, the last thing anyone needs is a long waiting list and a culture barrier.
Health insurance plans with companies such as Cigna and Aetna give you a card you can carry on your person. You can then show the card when you go to hospital and your treatment should be taken care of; each insurance plan has a set of terms and conditions that details which kinds of healthcare are covered, and which hospitals/clinics the card can be used at. High end plans should cover treatment at all international hospitals in Shanghai, including expensive hospitals such as the Shanghai United Family hospital.
Another point to check on your insurance policy is the benefits cover. Ensure that there is adequate outpatient cover, and that the area of cover includes China and any other countries you may be spending time in. Most policies come with a maximum pay out of eight million US dollars for inpatient treatment, which should be enough to cover all contingencies. A good plan should also pay for emergency evacuation. You might need to be evacuated if you fall ill in a remote area, or if you become sick in Shanghai and need to be repatriated.
If you have additional family members to insure, or your work doesn’t offer health insurance, you can arrange health insurance yourself. Buying insurance independently, you are free to adjust the policy according to your personal needs. You can approach insurance companies independently or use a broker. A good broker will give you a range of options as they work with several insurance companies and understand the market. Reputable brokers also help with any claim disputes that may arise.
Check that your broker is legally licensed to sell insurance in China. Also be careful to buy a legal plan: some reputable international companies sell insurance in China although they are not registered to trade in China. These health insurance policies may work, but if there is a dispute you will have no options to resolve it. Make sure your insurance provider and your broker are both legally registered.
The price of your insurance will be determined by whether you take options such as dental insurance, as well as by your age and any pre-existing conditions. For a thirty-year old, a general plan will cost 15,000 RMB to 25,000 RMB annually.For a fifty year old, a plan with the same cover might cost 40,000 RMB a year.
With health insurance being both expensive and essential, it can be tough if you’re on a budget. One option for those in excellent health is accident insurance.This kind of insurance doesn’t cover anything except accidents, but can cost as little as 1,000 RMB a year. If you choose this kind of insurance, be aware that a range of conditions that can happen to young, healthy people, from food poisoning to malaria, won’t be covered. If you choose to travel to remote areas or nearby countries on accidental insurance, consider supplementing it with travel insurance.
For short term visitors to China, a sound travel insurance plan might be a good option. It’s often better to buy travel insurance before leaving home, as some companies won’t offer travel insurance if you have already left your home country.
What You Must-know About China Health Insurance
As an expatriate living abroad, it’s both more important and more difficult to understand the details of your health insurance. Here are six points to consider when shopping for coverage.
Buy it before you need it
At the very least you need a health insurance policy that includes inpatient services and emergency evacuation. Outpatient services aren’t that expensive to pay out-of-pocket but add a lot to your premium.
Emergency evacuation coverage is key
You never know where you’ll be when you need it. So make sure you have adequate emergency evacuation cover. And by adequate it means the overall limit should be sufficient to provide evacuation to the nearest center of medical excellence.
Know your healthcare options and preferences
You need to consider your healthcare options when deciding how much and what kind of coverage you need. Will you use western, local or overseas facilities? For example, are you just going to use western clinics and want to evacuate offshore if you have a serious emergency? Will you use a mix of local and western facilities? Or will you head for those nearby countries that have top international hospitals but at much lower cost such as Thailand, Singapore and the Philippines?
Place your coverage locally
If you’re not covered under your company’s global policy, then it’s best to place your coverage locally through one of the legally registered local insurance providers (e.g. AXA-Minmetals, Goodhealth, Ping An, GBG/TieCare). Placing your coverage locally has several advantages. First of all, you have local staff that speak the language, can help you navigate the local system and can negotiate with local hospitals and doctors. Secondly, in cases where direct billing isn’t an option then a good local provider will send agents directly to your clinic to pay the claims directly (for inpatient cases). And finally, with an offshore product, you won’t have any consumer protection. In China the China Health Insurance Regulatory Commission (CIRC) regulates and maintains the legal and stable operation of the insurance industry. But if your provider isn’t here, they can’t help you.
The devil is in the detail. Read your policy
Does it extend overseas? What does it cover? Where doesn’t it cover? For example, we offer worldwide coverage and then worldwide coverage excluding the U.S. The latter decreases your premium, but won’t cover your medical expenses if you want to go to the U.S. for treatment (with the exception of a small amount of emergency coverage). Sometimes people will bring domestic plans from Hong Kong and find out too late that these plans don’t actually cover everything they need. For example, there’s a higher probability of evacuation from mainland China and their Hong Kong-based policy won’t necessarily cover that.
Insurance and the local healthcare system
Some local hospitals will handle direct billing (your insurance company will have a list), but most don’t. They have plenty of local paying business, so they don’t have a need to cater to foreigners. Even if you don’t use a local hospital it’s a good idea to find a Chinese doctor who speaks English. They’ll be able to navigate the local system and services for you should you need something a western clinic can’t provide.