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The Private Medical Insurance

The options of private medical insurance that are available in China.

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The Public Insurance in China

The benefits and the negative issues related to public insurance in China.

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Handling emergency situations

Important information and contacts to handle emergencies in China.

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The Private Medical Insurance 


If you need a private medical insurance in China, you have several options:

1. International Insurance Companies:

  • Examples: Cigna, Bupa, Allianz.

  • Coverage: these plans often cover medical expenses both globally and within China, catering specifically to expatriates.

2. Local Chinese Insurance Companies:

  • Examples: Ping An Health, AXA Tianping, Taikang.

  • Coverage: plans tailored for expatriates living in China, often including access to both local and international healthcare facilities.

3. Employer-Provided Insurance: many multinational companies provide comprehensive private health insurance as part of their employment package for expatriates.

4. Expatriate-Specific Insurance Plans:

  • Examples: plans from companies like MSH International or Now Health International.

  • Specialized insurance plans are designed for the unique needs of expatriates, including comprehensive medical, dental, and emergency evacuation coverage.


Benefits of Private Medical Insurance:

1. Access to High-Quality Healthcare: coverage often includes access to high-quality international hospitals and clinics with English-speaking staff, ensuring better communication and understanding of medical conditions and treatments.

2. Comprehensive Coverage: plans typically cover a wide range of medical services, including outpatient and inpatient care, emergency services, specialist consultations, and sometimes dental and vision care.

3. Flexibility: insurance plans can be customized to meet individual or family needs, offering different levels of coverage and optional add-ons.

4. Direct Billing: many international hospitals have direct billing arrangements with insurance providers, reducing the need for out-of-pocket expenses and simplifying the claims process.

5. Global Coverage: international plans often provide coverage not just in China but also globally, which is beneficial for expatriates who travel frequently or may return to their home country periodically.


Risks of Private Medical Insurance:

1. High Premiums: private medical insurance can be expensive, especially for comprehensive international plans, which may not be affordable for everyone.

2. Policy Exclusions and Limitations: certain conditions, treatments, or pre-existing conditions may not be covered, or there may be significant limitations on coverage.

3. Complex Claims Process: navigating the claims process can be complicated and time-consuming, particularly if the insurance provider is based outside China or if the process involves multiple steps.

4. Network Limitations: some insurance plans may have limited networks of approved hospitals and clinics, restricting where you can receive care.

5. Changes in Coverage: insurance terms and conditions can change annually, potentially affecting coverage and costs, making it necessary to review and possibly switch plans periodically.


Suggestions for Subscribing to Private Medical Insurance in China:

1. Assess Your Needs: Consider your and your family’s health needs, including any pre-existing conditions, required medications, and frequency of medical care. Tailor your insurance plan to cover these specific needs.

2. Research and Compare Plans: Compare different insurance providers and plans. Look at coverage details, premiums, deductibles, co-payments, and network hospitals. Use comparison tools and read reviews from other expatriates.

3. Check Provider Networks: Ensure that the insurance plan includes reputable hospitals and clinics, particularly those that are convenient and preferred by expatriates. Verify if the plan includes direct billing arrangements with these facilities.

4. Understand Exclusions and Limitations: Carefully read the policy’s fine print to understand what is excluded or limited. Pay attention to coverage for pre-existing conditions, maternity care, dental and vision care, and emergency evacuation.

5. Consult with Experts: Consider consulting with insurance brokers who specialize in expatriate insurance in China. They can provide personalized advice and help you navigate the various options.

6. Review Customer Support Services: Evaluate the insurance provider’s customer support services. Ensure they offer reliable, 24/7 support, preferably with English-speaking representatives.

7. Plan for Long-Term: Consider how long you plan to stay in China and choose a plan that offers the flexibility to adjust coverage as your needs change over time. Ensure the plan can be extended or transferred if you move to another country.

 

The Public Insurance

 

A foreigner employed in China is typically required to pay (together with his employer) social contributions for public health insurance. These contributions are part of the mandatory social insurance system and include several types of insurance.

 

The types of public insurance:

  1. Pension Insurance

  2. Medical Insurance

  3. Unemployment Insurance

  4. Work-Related Injury Insurance

  5. Maternity Insurance

Both the employer and the employee share the responsibility for these contributions, with specific percentages and caps varying by city and region.

 

Benefits of the Employee Basic Medical Public Insurance Plan:

  1. Access to Public Healthcare Facilities: foreign employees have access to a wide network of public hospitals and clinics for both outpatient and inpatient services.

  2. Reimbursement for Medical Expenses: the plan covers a substantial portion of medical expenses, reducing the financial burden of healthcare costs. Reimbursement rates vary by region and the type of service provided.

  3. Coverage for Prescription Medications: a significant portion of the cost for prescribed medications is covered, which is particularly beneficial for managing chronic conditions.

  4. Preventive Care Services: preventive services such as vaccinations and routine health check-ups are often included.

  5. Hospitalization Coverage: hospitalization costs, including surgery and other inpatient services, are covered to a significant extent.

  6. Maternity Benefits: coverage for prenatal care, childbirth, and postnatal care is provided, which can be a major benefit for expatriates planning to have children in China.

  7. Specialist Consultations: access to specialist consultations, though often requiring a referral, is included in the plan.

  8. Rehabilitation Services: certain rehabilitation services, such as physical therapy, are covered under the plan.

 

Negative issues related to Employee Basic Medical Public Insurance Plan:

  1. Language Barriers: communication difficulties can arise due to the limited availability of English-speaking staff in public hospitals.

  2. Quality and Comfort of Care: the quality and comfort level in public hospitals can vary widely, with some facilities being crowded and having longer wait times compared to private or international hospitals.

  3. Network Restrictions: coverage is often limited to a designated network of hospitals and clinics. Seeking care outside this network can result in higher out-of-pocket expenses or no coverage at all.

  4. Reimbursement Process: the process for claiming reimbursements can be bureaucratic and slow, requiring meticulous record-keeping and submission of various documents.

  5. Limited Scope of Coverage: certain advanced treatments, specialized procedures, or newer medications might not be covered or may have limited coverage under the public health insurance plan.

  6. Administrative Challenges: navigating the healthcare system and understanding the specifics of what is covered can be challenging, particularly for those unfamiliar with the local healthcare regulations and procedures.

 

Suggestions:

  1. Supplement with Private Insurance: To cover gaps and ensure access to high-quality care, consider supplementing public health insurance with private medical insurance.

  2. Understand the Coverage: Thoroughly review and understand what is covered under the public health insurance plan, including network hospitals, covered services, and reimbursement policies.

  3. Maintain Detailed Records: Keep meticulous records of all medical expenses and required documentation to facilitate the reimbursement process.

  4. Consult with HR and Experts: Work closely with your employer’s HR department and consult with insurance experts to understand your rights and benefits under the social insurance system.

 

 

Handling emergency situations

 

Main information to handle emergencies in China:
1. Contact Emergency Services:
– Medical Emergency (Ambulance): Dial 120
– Fire Emergency: Dial 119
– Police Emergency: Dial 110
2. Language Assistance:
– In order to ask for help, say “我需要帮助 (wǒ xū yào bāng zhù)” which means “I need help”.
– Use translation apps or have pre-written emergency phrases in Chinese.
3. Contact your Embassy or Consulate: have the contact information and the emergency number of your country’s Embassy or Consulate. They can provide assistance and advice in emergencies.
4. Contact your Insurance Provider: notify your international health insurance provider as soon as possible. They can guide you to the nearest approved medical facility and assist with payment arrangements.
5. Seek help: if you are in a public place, ask for help from locals. Translate and show them any written information in Chinese about your condition or needs.
 6. Main International Hospitals:
– United Family Healthcare (Beijing): +86 10 5927 7000
– Parkway Health (Shanghai): +86 21 6445 5999
– Global Doctor (Guangzhou): +86 20 8360 3960

 

Prevention Activities for Foreigners in China:
– Ensure you have comprehensive international health insurance that covers emergency medical evacuation.
– Carry your medical card with essential information such as allergies, chronic conditions, blood type, and emergency contacts.
– Familiarize yourself with the nearest hospitals, clinics, and pharmacies and have a list of recommended healthcare facilities from expat communities or your embassy.
– Learn basic Chinese phrases related to medical emergencies and learn how to use translation apps like Google Translate or Pleco.
– Keep a list of emergency contact numbers, including local friends or colleagues who can assist in an emergency.
– Maintain regular health check-ups to monitor and manage any chronic conditions.
– Follow local health and safety guidelines, including traffic rules and food safety practices.
– Prepare a basic emergency kit with first aid supplies, copies of important documents, a list of medications, and contact information.

 

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