Something we all came across in our lives – health insurance and how to get the most out of it. Vast majority of expats in China lack overall general knowledge on how private medical insurance works in the country and what are the options available. How can you shop for the right plan if there is 300+ options available?
At first, we have to find out in details what each insurance plan can include.
Components of a Health Insurance Policy
Most medical insurance plans can be broken down into the following three categories:
Category 1: Core Benefits (inpatient only coverage) – this category covers only hospitalizations (overnight stays and longer), ambulatory care, evacuations, serious conditions and emergencies that will require you to spend at least one night in a hospital.
Category 2: Core Benefits + Outpatient Benefits – this category includes core coverage plus coverage for clinic doctor visits, prescription drugs, MRI’s, X-rays, day surgery, physiotherapy, chiropractic care, and other same-day doctor visits.
Category 3: Core Benefits + Outpatient Benefits + Premium (Optional) Benefits – this category includes all of the above + optional extras such as dental care (routine, complex and orthodontics), annual wellness check ups, vision care (glasses, eye checks), and maternity (natural birth, C-sections, and complications of pregnancy).
As a summary we can use the below guidelines:
Inpatient Benefits = Hospitalization, any over night stays
Outpatient = Clinic doctor visits, treatments that do not require you to be hospitalized
Premium/Optional Benefits = Dental, vision, and maternity (pregnancy)
Each insurance company has different terms and conditions, but in general, here are the benefits offered for each category to use as a guide for medical insurance in China.
When it comes to China market, a lot of international companies have adjusted their plans to meet certain unique demands of local residents as well as foreigners living in the country. Some of them have a substantial impact on how your insurance premium can be set, both making it cheaper as well as more expensive. Most noticeable of those are below.
What are other pillar that impact the insurance premium the most in China mainland?
- Area of cover. Don’t travel often? You can go for China only cover. Almost always with your plan you will still be covered outside of the country but only for emergencies. Check exact definition of emergency under your plan to see what it entails.
- Do you need access to expensive medical facilities? Due to a lot of changes these years many expensive facilities are not categorized as such, example are United Family in Shanghai. Same applies to Parkway or Sino-United in Shanghai. Same applies for other cities like Beijing, Suzhou and Chengdu. If you used to go to go to some of the expensive places (some companies refer to them as “high cost providers”) that required you to pay extra for your insurance premium, there is a good chance this might not be a case any longer so be sure to explore that option with your insurance company or broker.
- Do you live in Tier 2-3 cities? There are options that provide location discount. Same plan for instance if you live in Suzhou can cost you up to 10% lower compared to if you were living in Shanghai without making any changes to terms of cover or benefits structure of the plan.
Based on our experience, 89% of expats in the country had experience with one of the below listed companies. Quite regularly though china expat health insurance plan undergo price reviews and sometimes benefits adjustments, which with time mostly go up.
Price point is however another topic when looking for the right plan. Local insurance companies like PingAn or ZhongAn can provide you solid cover for less than RMB 5,000 which are very popular solutions among those expats who are fluent in Chinese. So do make sure to check all your options available when signing up for the plan beforehand.