For families living in Beijing, good health insurance is essential. While some people may be tempted to rely on the Chinese public health system, which offers decent, affordable care, the attraction quickly wears off if you require a long hospital stay or a medical repatriation flight. Though both are rare events, they are very expensive and potentially bank-draining. To avoid any nasty surprises and to safeguard your family, here are some must-have tips on finding a health insurance plan.
Dollars and Sense
Some good advice is to find an international plan in hard currency (USD, GBP or EUR) with a USD 1.5 million overall annual lifetime limit. All policies are a compromise between cost and coverage, and coverage in China does not come cheap. "Some expats think China is a cheap place for healthcare, so they expect the insurance premiums to be less than they are," says Paige Mushinsky, a healthcare consultant from Expat Solutions. "Frequency of use and choice of medical facilities by expatriate customers are costly to the insurers. The international clinics and the insurance providers are private businesses and are run for profit, so [their]pricing reflects this," she adds.
If you want to keep your premiums (yearly fees) low, one thing you can do is accept a high deductible, also known as an excess. The deductible is the amount of eligible medical costs you have to pay from your pocket before your insurance comes to the rescue. A USD 1,000 deductible means that you pay the first thousand dollars, and the insurance pays for everything beyond that. Some policies set a deductible for the calendar year, while others are per claim.
Insurance company Chartis China says health insurance for a family of four can range anywhere between RMB 25,000 to RMB 150,000, depending on the package. Their Chartis GlobalHealth basic plan is around RMB 32,000 per year for two healthy adults and two children under 10 years old. Mushinsky offers a much lower overall price tag, claiming a family of four can expect to pay between USD 1,000 (approx. RMB 6,600) to USD 10,000 (approx. RMB 66,000).
If your family doesn’t go to the hospital very often, you can also lower your premium by selecting a higher co-pay – the percentage of every medical expense that you pay directly. However, you shouldn’t settle for a plan that puts low limits on nightly room rates or other hospital services, as Beijing’s Western-style medical facilities are not cheap. A night at Beijing United Family Hospital will set you back roughly USD 1,000, and that’s without any procedures or treatments.
Mushinsky advises families not to be put off by a certain plan because they have to pay a little more out-of-pocket. "The mistake is thinking that just because a plan doesn’t cover USD 50 of a doctor visit, it isn’t worth buying. A torn Achilles tendon, requiring surgery, after-care and physical therapy will cost more than USD 10,000. It’s a good idea to protect yourself from such an expense, even if your insurance has a co-pay."
Other factors affecting insurance policy prices are coverage of regular check-ups, dental care, maternity and confronting items like "repatriation of remains." The more comprehensive policies cover dental, vision, outpatient and routine benefits like vaccinations. Most policies won’t cover you for pre-existing conditions, and this includes pregnancy. The few that do will be two to three times more expensive than a normal policy. Remember: As a general rule, babies will need their own insurance after the first 30 or 40 days post-birth. In most cases, Chartis covers newborns automatically from 15 days after birth or 15 days after discharge from hospital, whichever is later. If the parent has been covered by the same policy before the pregnancy, coverage is free.
Children generally require more frequent trips to the doctor, whether for vaccinations, check-ups for treatment of common illnesses such as colds and flu or diarrhea. Chartis states that the general rule for healthy young adults is to have a higher deductible and lower charge, while for children, it’s the other way around. For families on a budget, including these extras in your package can become costly. Mushinsky recommends, "The family accountant should budget vaccinations and annual check-ups as an out-of-pocket expense, above the insurance premium." One area parents shouldn’t skimp on is sports coverage. Read the fine print and ensure your plan doesn’t have any exclusions or limitations in this area. You should also factor in school camps and any overseas schools trips that are on the horizon. For peace of mind, a parental accommodation benefit is worth considering. "It can be a big relief if the insurance could cover the cost of a parent staying overnight with child in hospital," says Chartis.
Where In the World
If the insurance policy extends to North America, it will cost a lot more because of the higher price of medical care there; unless you spend a large portion of your time in the US, consider excluding this area to save money. Casual trips out of China can be covered by short-term travel insurance. Be careful with plans set up by regional offices in Asian countries where medical costs are cheaper, as they may not take into account the higher cost of Beijing joint-venture and international facilities.
As a side note, if you’re expecting care at an international hospital or clinic, be sure this is clearly communicated before you sign on the dotted line. "In an effort to control their premiums and stay affordable, some plans that have had a lot of clients in the China market have reduced their coverage at the more expensive medical facilities. Those may cap coverage at USD 80 per doctor visit or 80 percent of the doctor visit, before factoring in co-pays, excesses and deductibles," says Mushinsky.
If you travel a lot, consider purchasing a medical evacuation package, just in case you get stuck in a remote part of China. International SOS, among others, provides this membership service for USD 600-800 per year. Other services, such as GlobalDoctor and MedEx, can be purchased back home through your insurance agent. These services have alarm centers in various cities throughout the world, and can answer your medical questions remotely, even patching you to doctors in other parts of the world if necessary.
If you do need to get insurance in Beijing, where do you go? Unfortunately, there’s no master directory of insurance providers. You can search online for foreign or domestic insurers, ask a reputable agent to narrow down the options based on your family’s needs, or even ask your doctor if they can refer an agent or insurance company. If you opt for a foreign insurance company, Chartis recommends families check if they have domestic operation offices. "It is easier to have a local contact for help when in need of protection." Be wary of fly-by-night outfits that exist only long enough to snap up your first year’s premiums. Don’t be afraid to ask questions, and don’t ever skip the fine print.
Insurance companies are for-profit businesses. If you file a lot of claims, you won’t win in the long run, since rates are adjusted annually. Pay for cheap TCM treatments or visits to your local clinics with cash, as the time and energy taken to process your claims will be more than it’s worth for both you and the insurance provider. A plan that includes direct billing options with local hospitals and clinics will save you a lot of time and hassle, but be vigilant about claims made to your insurance company by the hospital, to avoid possible over-billing. Should you have any suspicions or concerns, don’t hesitate to talk to your agent.
When searching for a provider or considering changing plans, Mushinsky reminds parents to be realistic. "Good cover is not a bargain. However, taking a high deductible can save you money. Calculate your out-of-pocket expenses, including the insurance premium, plus co-pays and non-covered expenses that you might have spent in a year, and look at the new options with this budget in mind."
Ultimately, you’re paying a sizeable amount of money and the quality of service you receive from your insurer should reflect that. Chartis puts it perfectly: "Insurance is a promise to pay in the event of a loss. A reliable insurer should be fully committed to providing its customers with the service expected at the time when they most need it."
Expat Solutions Consulting
Contact Paige Mushinsky at
130 0123 6963
Chartis Insurance Company China
9A15-16, Hanwei Plaza, Guanghua Road, Chaoyang District (5969 2888)
International SOS Clinic
Daily 24hrs. Suite 105, Wing 1, Kunsha Building, 16 Xinyuanli, Chaoyang District (6462 9112, firstname.lastname@example.org) www.internationalsos.com