Understanding, obtaining and utilizing health insurance can be a confusing and expensive challenge for expatriate families in Beijing. There are a wide variety of vendors and options available for review, but it is like looking into a basket of Chinese vegetables during harvest season. All these choices look similar on the surface, but taste totally different. To help navigate the scene and gain insight into your healthcare choices in the capital, beijingkids spoke to two families with totally different experiences.
The Cronan-Dixon-Garner Family
This Cronan-Dixon-Garner family (pictured here) hails from Australia and has been living in Beijing for over five years. Dave Garner owns an investment management company called New Wave Capital, which handles mergers, acquisitions and divestments, capital raising, strategic consulting and investment. His wife Ren Cronan-Dixon stays busy with a variety of organizations around Beijing, Miles (7) goes
to the British School of Beijing and Reuben (4) attends Children’s House International Montessori Kindergarten. As such, the family had to find private insurance coverage.
Ren, what kind of health insurance does your family have?
I sat down with an insurance broker, who was recommended by Austcham, to talk about the best options. We use two different companies for health insurance. The children and I use International Medical Group Insurance (IMG) whilst Dave uses William Russell. Dave has a pre-existing condition that IMG wouldn’t insure. The children and I have what is called a Global Select plan. It costs us a whopping USD 10,972 annually. Our insurance became significantly more expensive this year due to the incredibly high costs of medical treatment and evacuation in China. As a result China is now considered “Area 3,” but this also means our insurance includes treatment in the US and Canada. David has a Silver Plan with IMG, which costs him USD 3,333 per annum. So all up, as expats in China, our insurance is a major but necessary annual expense.
Which health care providers do you use?
We use mainly Beijing United Family Hospital (BJU), because IMG and William Russell have an agreement with that hospital for direct pay [instead of]paying out of pocket and then claiming the money back. We have had some very bad luck with illnesses in the past few years, so we have also had to use hospitals in Macau and Hong Kong. I was shocked by how incredibly expensive health insurance is here.
What unique experiences have you had?
We have had some great experiences and some that were not so fantastic. My eldest son Miles broke his leg when we first arrived. We were advised by a local to go to a hospital where they made me hold Miles’ leg for the X-ray and maneuver it for the X-rays. They then decided that they couldn’t treat him, because he was under the age of eight. I finally decided not to listen to the locals’ advice and went to BJU. We should have just gone there from the start. I luckily had the number programmed in my phone so I phoned ahead and there was an emergency team waiting for us at a back door. I was so relieved I nearly cried. Another instance is that our younger son Reuben started
having febrile convulsions when we were in Macau, which was a very scary experience. We have since been to the emergency ward at BJU on several occasions where the doctors have been fantastic.
Another experience was when I had to fly down to Hong Kong for an operation on a broken metatarsal in my foot that could not be properly treated in Beijing. Even with all of the money we pay for insurance each year, I was put into a shared, substandard room and still had to pay for everything out of my own pocket and claim it back. On top of that, my flights were not covered. That was an expensive little exercise. I learned the hard way how important it is to fully understand what is covered, and where, in advance of receiving treatment.
What advice do you have for new expat families regarding insurance in China?
I would have a look at a broad section as each company offers different options with their packages and they will have to take into consideration any pre-existing conditions. Also, if you are working for a company, I would make sure that it is included in your package because it is a lot of money out of your pocket if it’s not.
The Monaghan Family
The Monaghan family (pictured right) has also lived in China for over five years. Their situation has changed quite a bit since they first arrived, as the older kids have graduated from high school and gone off to new experiences. They have been fortunate to be consistently insured through Danielle’s multinational employers.
Danielle, can you tell us a little about your family?
I am originally from South Africa, though Joe and the kids all hold US passports. I currently work as an HR Director for Cisco Systems, and was previously an HR director for Microsoft Corporation in China. Joe works as an expat counselor for Santa Fe Relocation. Michael, 21, has just returned from a year of Arabic language study in Amman, Jordan after studying Chinese at Beijing Language and Culture University. He is currently interning at Novotel. Emma, 18, is taking her gap year and has just returned from Bordeaux, France after eight weeks of French immersion studies. She will soon head to an elephant sanctuary in Thailand as a volunteer. Alex, 16, is a junior at the International School of Beijing where he participates in soccer, rugby, film and other activities requiring international travel. Global insurance has been very important to us, especially coverage for our kids beyond age 21. Fortunately, our insurance covers them to age 26.
What kind of health insurance does your family have?
We have the Cigna Envoy Global Coverage package. Co-payments are reasonable and our kids are covered no matter where in the world they are. However, we are also users of alternative medicine – such as Chinese medicine, Tibetan Shambala meditation and qigong – [which]we pay for out of pocket [since]insurance does not cover it.
How has your situation changed during your stay here?
We are fortunate that both Cisco and Microsoft offered this same insurance for expatriates, so it has been quite stable. If anything, our choices have become better as the quality of medical care providers have improved. Also, our confidence in Chinese medicine has really improved over the years. For example, Joe came to China with calcium deposits on both shoulders. The treatment in the US to relieve discomfort is a painful cortisone injection once a year. Our ayi suggested zhongyi (Chinese medicine), so Joe went to a Chinese medicine hospital in Chaoyang where the doctor immediately took his pulse and diagnosed his shoulder problem. He prescribed an herbal medicine, which Joe heated and took every morning for a month. By the end of the month, the pain was gone and when he had the shoulders X-rayed, the calcium deposits were gone. After that experience, Joe did a Chinese medicine course at the China Culture Center and regularly uses moxibustion (directed heat from burning moxa leaves) for muscle stiffness.
What options were you given in selecting your program?
We were not provided with options, but we did research alternatives on our own. There were not too many choices six years ago when we started on this journey, so we had to make a leap of faith that we would be taken care of. Our insurance covers us both in China and for global travel and we have SOS emergency evacuation coverage if that were ever needed.
How does your insurance differ from what you had in other places?
Our insurance coverage has been relatively consistent. However, the quality of care, modernity of facilities, training of doctors and nurses and general bedside manner has been vastly different. In China, we have had some really great caregivers, but also many indifferent and uncaring individuals. Turnover of medical professionals is fairly high, because the good ones have so many opportunities all over the world. One of the greatest diagnostic doctors we have ever worked with recently returned to the US to start her own hospital. I am so happy for her, but we really miss the consistency of having a family doctor that knows us. For those doctors out there treating our family today; we think you are great. Please stay a little longer!
What unique experiences have you had regarding health care while living in China?
Most have been related to language and cultural differences. I once went in to ask a plastic surgeon what it would take to tighten the piercing in my left earlobe. Soon after, his assistant called to let me know they had booked an operating room for the ear and eye operation. I quickly had to find my translation software to explain that I was just inquiring about the ear. Although the eyelift surgery may have been more becoming, I doubt the operation would be covered by my insurance. Another example was an instance when Joe sliced his toe on the escalator at the Hong Kong airport. He called our insurance and they were quickly able to identify a clinic around the corner to take care of it. He went there and immediately received stitches and medication. Our insurance company guaranteed payment, so he was well taken care of.
What advice do you have for new expat families regarding insurance in China?
My advice is to work closely with your human resources department in China and your country of origin to help find the best possible options. Spend time understanding the coverage before you embark on this great adventure which is China (and it really is a great adventure). Many multinationals do not understand the unique healthcare challenges in China and often underinsure their expats. Chinese hospitals, even the VIP wings, can be difficult for expats to use until they speak decent Chinese, so it is helpful to fully understand well in advance what your healthcare benefits are, where and how they are delivered and how they are billed. Many expats are used to direct-billing, but few facilities offer that option. If you have an international family with spouse or kids in different countries, you can often find yourself with no coverage outside China. Finally, if you have special needs for medication, you must consult your home country doctor early on to determine viable alternatives. Most pharmacies that cater to expats can import medications or equivalents, but it can be quite expensive if your insurance does not cover this.
There are a wide variety of options to consider for your medical insurance needs in China. You may choose to work directly with an insurance company, or to get quotes from multiple companies through an agent, or may consider membership in a clinic. Below are some highlights of the options that are available, as well as contact information.
Chartis Insurance Company China
Contact: 5969 2888, Echo-J.Xu@chartisinsurance.com, www.chartisinsurance.com
Chartis will launch a revamped product for expatriates, called Global Health Advantage. This high-end medical insurance offers annual premiums per person ranging from USD 500 to several thousand USD, based on coverage scope, deductible, options and age of the insured person.
For example, if an expatriate family of four (two adults, 35 years old; two kids, 10 years old) chooses the middling plan of Global Health Advantage plans, the cost will be USD 9,622 for the annual premium for the family. This provides worldwide coverage (excluding Cuba, Burma, Iran and Sudan) with maximum benefit as high as USD 3,000,000 per person per year without deductible, including hospitalization, out-patient surgery, private nursing, organ transplant and emergency benefits.
Pacific Prime Insurance Brokers
Contact: 21 6445 4592 (China office), +852 3588 2926 (Michael Lamb), email@example.com, www.pacificprime.com
BUPA/AIC (part of the BUPA group, the world’s largest provider of IPMI policies) provides a Worldwide Health Options package that offers up to USD 2,550,000 in benefits per policy year including coverage for: in-patient, out-patient, maternity, newborn care, cancer treatments, psychology, transplant services and traditional Chinese medicine including acupuncture and homeopathy. There are also options for dental and emergency evacuation. Policy premiums are calculated based on the number and age of family members and optional coverage benefits chosen, with a range of deductible options. Per-person annual premiums range from USD 425 to 8,500. Policyholders are able to receive treatment at the highest quality facilities such as Beijing United Family Hospital, or they may seek treatment overseas in countries like the US.
Contact: +852 3588 2926 (Michael Lamb), firstname.lastname@example.org
Another locally licensed insurance provider is AXA-Minmetals, which offers policy benefit limits ranging from USD 850,000 to 3,400,000 to per person annually, depending on options, co-pay and deductibles selected as well as the number and age of family members. Coverage benefits include outpatient, dental, alternative therapies, and emergency evacuation coverage. Maternity is covered under a supplemental policy. For large families, the company will allow the inclusion of the second, third and fourth child under the policy free-of-charge. This is often an attractive benefit for families willing to overlook the high costs of the plan’s maternity coverage.
International SOS Clinic
Contact: 6462 9112, 6462 0555 (Richel Zhao), email@example.com, www.internationalsos.com
International SOS Membership allows 24/7 access to International SOS’ worldwide infrastructure and resources, which includes its clinics, logistics coordinators, doctors, security professionals and network providers like hospitals, physicians, ambulances, aviation and evacuation resources. There are a variety of different membership options.
Individual Membership provides 24-hour expert advice and medical assistance to prepare for travel worldwide or for immediate care whilst abroad such as emergency and routine medical advice, clinic/doctor referrals, in-patient and out-patient arrangement, guarantee of payment, medical monitoring, medical evacuation and repatriation. Annual fees range from RMB 2,530 to 5,040 per person, depending on the coverage chosen. In addition, this membership offers discounted member rate for clinic visits at International SOS Clinic in Beijing.
Clinic Plan Membership provides clinic access and a chosen set of covered services, products and procedures. The annual price ranges from USD 1,490-1,840 per person, or USD 4,470-5,520 per family.
Expat Solutions Consulting Limited
Contact: 130 0123 6963 (Paige Mushinsky), firstname.lastname@example.org, expat.solutions on Skype
Expat Solutions provides two examples for consideration:
1) A popular, value-for-the-money option for worldwide
coverage (excluding North America) includes hospitalization, outpatient consultations, and prescribed medicines. USD 2.5 million lifetime cap, USD 200 deductible per person per year with a 10 percent co-pay after the deductible has been met. Annual check-up at 90 percent coverage with no deductible, up to USD 500 per year. Vision benefit: USD 300 every 24 months, includes exam, lenses, contacts. Annual child preventative care: Birth-12 months: USD 350; 13 months until 18: USD 200. Direct billing at most well-known international and Chinese facilities. Family of four, if parents age 25-29: USD 4,272; if parents age 30-34: USD 4,703/yr.
2) A popular “bells and whistles” option for worldwide coverage offers a USD 0 deductible and a USD 3 million lifetime cap. Coverage includes: 100 percent for hospitalization, outpatient consultations, prescribed medicines. Annual check-up, with 10 percent co-pay and no deductible up to USD 750. Vision benefit: covered up to USD 300 every 24 months, includes exam, lenses, contacts. Routine dental included in health plan, covered up to USD 1,500. Annual child preventative care: Birth-12 months: USD 350; 13months-1yr: USD 200; until 18: USD 200. Direct billing at most well-known international and Chinese facilities in major cities. Family of four, if parents age 25-29: USD 11,116; if parents age 30-34: USD 12,239.