A trip to the doctor isn’t cheap, especially to an international hospital. Healthcare costs can be a nightmare to settle if you’re uninsured. In most expat remuneration packages, medical insurance is an attractive benefit. Students are usually covered through their institutions of higher learning, while younger students are included in their parents’ insurance, as an advice we will like to let you know shopping for health insurance is something that must be done carefully.

However, as the profile of Beijing’s international community changes, with fewer traditional expats posted here by big companies, and more entrepreneurs paying expenses out of their own pockets, increasing numbers have no insurance at all. They gamble that they will stay healthy, or that they can pay for treatment if it’s needed. But it’s a risky gamble, particularly for families with children, and if you have a medical emergency, you don’t need a financial emergency at the same time.

Understanding Medical Insurance

Your employer may have an insurance scheme which you can join, or you may need to arrange your own. There are three essential questions to consider:

1. What do I need? This includes an assessment of your current health status and family health history.

2. What do I want? Dental, optical and maternity care are often separate from the main package.

3. What can I afford? This may be the most important consideration, as premium packages offering a full range of care at the best hospitals can run into thousands of dollars.

Hospitals require a Guarantee of Payment (GOP) from incoming patients and sometimes the insurance company needs to be notified to ensure that the insured gets the medical coverage they require, and the hospital knows that the bill will be settled. Brokers can act as an intermediary between the insurance company and insured.

Evaluating Brokers and Insurance Companies

If you need to find your own insurance, a broker can help. Brokers are usually compensated through commissions taken from the premiums charged to policyholders (i.e. you) by the insurance company, so their services are free for clients. Be sure to seek out an advisor who specializes in medical insurance for expats living in China.

Though both brokers and agents act as a bridge between the client and the insurer, an agent usually represents an insurance company like Cigna, Aon, Allianz, Bupa, IMS, or Aetna. Both agents and brokers must be legally licensed to work in China.

If you currently have medical insurance but are looking to change plans, your current insurer would be the most logical place to start. However, the insurance company may not extend coverage to China, or may limit the list of hospitals you can go to. If you’re set on going to a particular facility, check the hospital’s or clinic’s website for a list of insurers they currently have direct billing relationships with.

FACTORS TO CONSIDER

We asked Jason Zhang, General Manager at Abacare Beijing, what was the most important factor for families newly arriving in Beijing to consider when looking at medical insurance.

“They should think about how long they expect to stay in China,” he told us. “If they’re only here for a short time, they need to check whether the plan is portable. If not, after maybe two years, they might have to do it all again. And there’s a risk that, if any health problems have arisen during that time, that they won’t be able to get insurance.”

Emergency coverage – including inpatient and emergency evacuation – is another important benefit for families. Other considerations include vaccination coverage, outpatient coverage, annual health check coverage, and the hospitals covered by the plan. Here’s a quick rundown:

Annual Limit

An annual limit is the cap on benefits that your insurer will pay in a year. If the dollar amount of covered hospitalizations, treatments, and prescriptions exceeds the annual limit, you’ll need to pay all healthcare costs for the rest of the year. Annual limits range from USD 100,000 to several million per year depending on the plan. The higher the limit, the more expensive the premium.

Annual Rate Increases

Smaller and mid-range insurers with less financial stability usually have more erratic rate increases. Some even increase the premium in response to claims. Larger, more reputable insurers have more gradual increases, both annually and with age.

Child Coverage

Medical care for children (including checkups and immunizations) is often included, but confirm this with your insurer. Families with older children who may or may not live at home as dependents may be included, but check if there are any age caps and details of the “global” part of “global insurance coverage” if your kids don’t live in China.

Discounts

Some insurers offer a family discount, which can be especially cost-effective for large families. No-claims discounts or first-year discounts are sometimes also offered, but keep in mind that a 10 percent first-year discount carries a 10 percent (plus age, plus annual) increase at renewal.

Maternity Coverage

Couples planning to conceive should note that most insurers require a waiting period of 10-12 months of paid maternity insurance before pregnancy, birth, and/or newborn coverage kick in.

Medical Evacuation

Evacuation is an essential consideration. Take a moment to think about the cost of out-of-pocket repatriation in case of an emergency. Evacuation would cover transport for essential surgery, medical treatments unavailable here, or a health epidemic. Check whether the plan covers return transportation to Beijing. Insurance for evacuation can be overkill if your primary policy covers most or all possibilities, so make sure it complements rather than overlaps existing coverage. Note that medical evacuation doesn’t necessarily cover treatment in your home country or a third location like Hong Kong.

Outpatient Treatment

Consider how often you or your dependents are likely to visit the doctor in a given year. Policies with high deductibles to minimize the cost of monthly premiums may be more cost-effective if you’re not expecting to see a doctor more than twice a year.

Pre-Existing Conditions

Some insurers will cover certain pre-existing medical conditions, but the trade-off is a higher premium. Coverage for high blood pressure or cholesterol may seem expensive, but keep in mind you’d also be covered for heart attacks.

Travel Insurance

International travel goes hand-in-hand with living in Beijing; getting travel insurance is important as a backup on your rider. This is often available as a small package when you have visitors, either through your current insurance plan or through an international hospital or clinic membership. US citizens should note that many global policies don’t cover treatment in the US or only cover it for a limited number of days (usually 30-45).

OTHER

Additional considerations include coverage for children with special needs, deductible and copayment options, dental and visual insurance, coverage for second opinions on major treatments, and emergency protocols (e.g. whether pre-authorization is required).

In addition to health insurance, international hospitals such Beijing United Family Hospital or primary care clinics such as Raffles Medical have memberships that offer patients additional discounts and extra services for an annual fee. These memberships can supplement company-sponsored insurance packages; they can also be appealing for expats who select packages based on low upfront fees, or those who must pay for treatment out-of-pocket.

This article appeared in the beijingkids June 2019 Home & Relocation Guide issue.

A trip to the doctor isn’t cheap, especially to an international hospital. Healthcare costs can be a nightmare to settle if you’re uninsured. So here are some of the factors to consider when getting insurance.

Emergency coverage – including inpatient and emergency evacuation – is perhaps the most important benefit for families. Other considerations include vaccination coverage, outpatient coverage, annual health check coverage, and the hospitals covered by the plan. Here’s a quick rundown:

Annual Limit
An annual limit is a cap on benefits that your insurer will pay in a year. If the dollar amount of covered hospitalizations, treatments, and prescriptions exceeds the annual limit, you’ll need to pay all healthcare costs for the rest of the year. Annual limits range from USD 100,000 to several million per year depending on the plan. The higher the limit, the more expensive the premium.

Annual Rate Increases
Smaller and mid-range insurers with less financial stability usually have more erratic rate increases. Some even increase the premium in response to claims. Larger, more reputable insurers have more gradual increases, both annually and with age.

Child Coverage
Medical care for children (including checkups and immunizations) is often included, but confirm this with your insurer. Families with older children who may or may not live at home as dependents may be included, but check if there are any age caps and details of the “global” part of “global insurance coverage” if your kids don’t live in China.

Discounts
Some insurers offer a family discount, which can be especially cost-effective for large families. No-claims discounts or first-year discounts are sometimes also offered, but keep in mind that a 10 percent first-year discount carries a 10% + age + annual increase at renewal.

Maternity Coverage
Couples planning to conceive should note that most insurers require a waiting period of 10-12 months of paid maternity insurance before pregnancy, birth, and/or newborn coverage kick in.

Medical Evacuation
Evacuation is an essential consideration. Take a moment to think about the cost of out-of-pocket repatriation in case of an emergency. Evacuation would cover transport for essential surgery, medical treatments unavailable here, or a health epidemic. Check whether the plan covers return transportation to Beijing. Insurance for evacuation can be overkill if your primary policy covers most or all possibilities, so make sure it complements rather than overlaps existing coverage. Note that medical evacuation doesn’t necessarily cover treatment in your home country or a third location like Hong Kong.

Outpatient Treatment
Consider how often you or your dependents are likely to visit the doctor in a given year. Policies with high deductibles to minimize the cost of monthly premiums may not be the most cost-effective if you’re only planning to see a doctor twice a year.

Pre-Existing Conditions
Some insurers will cover certain pre-existing medical conditions, but the trade-off is a higher premium. Coverage for high blood pressure or cholesterol may seem expensive, but keep in mind you’d also be covered for heart attacks.

Travel Insurance
International travel goes hand-in-hand with living in Beijing; getting travel insurance is important as a backup on your rider. This is often available as a small package when you have visitors, either through your current insurance plan or through an international hospital or clinic membership. US citizens should note that many global policies don’t cover treatment in the US or only cover it for a limited number of days (usually 30-45).

Others
Additional considerations include coverage for children with special needs, deductible and copayment options, dental and visual insurance, coverage for second opinions on major treatments, and emergency protocols (e.g. whether pre-authorization is required).

In addition to health insurance, international hospitals as such Beijing United Family Hospital or primary care clinics such as Raffles Medical have memberships that offer patients additional discounts and extra services for an annual fee. These memberships can supplement company-sponsored insurance packages; they can also be appealing for expats who select packages based on low upfront fees, or those who must pay for treatment out-of-pocket.

Photo: jarmoluk via Pixabay
This article appeared on p32-33 of the beijingkids July 2018 Home & Relocation Guide issue

A trip to the doctor isn’t cheap, especially to an international hospital. Healthcare costs can be a nightmare to settle if you’re uninsured. In most expat remuneration packages, medical insurance is an attractive benefit. Students are usually covered through their institutions of higher learning, while younger students are included in their parents’ insurance.

However, as the profile of Beijing’s international community changes, with fewer traditional expats posted here by big companies, and more entrepreneurs paying expenses out of their own pockets, increasing numbers have no insurance at all. They gamble that they will stay healthy, or that they can pay for treatment if it’s needed. But it’s a risky gamble, particularly for families with children, and if you have a medical emergency, you don’t need a financial emergency at the same time.

Understanding Medical Insurance

Your employer may have an insurance scheme which you can join, or you may need to arrange your own. There are three essential questions to consider:
1. What do I need? This includes an assessment of your current health status and family health history.
2. What do I want? Dental, optical and maternity care are often separate from the main package.
3. What can I afford? This may be the most important consideration, as premium packages offering a full range of care at the best hospitals can run into thousands of dollars.

Hospitals require a Guarantee of Payment (GOP) from incoming patients and sometimes the insurance company needs to be notified to ensure that the insured gets the medical coverage they require, and the hospital knows that the bill will be settled. Brokers can act as an intermediary between the insurance company and insured.

Evaluating Brokers and Insurance Companies
If you need to find your own insurance, a broker from sites like moneyexpert.com can help. Brokers are usually compensated through commissions taken from the premiums charged to policyholders (i.e. you) by the insurance company, so their services are free for clients. Be sure to seek out an advisor who specializes in medical insurance for expats living in China.

Though both brokers and agents act as a bridge between the client and the insurer, an agent usually represents an insurance company like Cigna, Aon, Allianz, Bupa, IMS, or Aetna. Both agents and brokers must be legally licensed to work in China.

If you currently have medical insurance but are looking to change plans, your current insurer would be the most logical place to start. However, the insurance company may not extend coverage to China, or may limit the list of hospitals you can go to. If you’re set on going to a particular facility, check the hospital’s or clinic’s website for a list of insurers they currently have direct billing relationships with.

This article appeared on p32-33 of the beijingkids July 2018 Home & Relocation Guide issue

Health Insurance is a hot topic for many foreigners in China as people look to protect themselves and spread the costs of hefty medical bills. International hospitals in China are now some of the most expensive in the world. Take this into account when family planning in Beijing.

Your need for insurance does not start when you have your first baby, it actually starts at least a year before.

Much can be written about this subject so in this blog I will focus on the key areas of family policies. The first point to note here is that your need for insurance does not start when you have your first baby, it actually starts at least a year before.

Maternity Cover
Most policies will enforce a waiting period before you will be covered for maternity related claims and this period is usually 12 months. Thus, the policy needs to be in place 12 months before you can claim for pre-natal packages, scans, delivery and so forth. Of course this pre-planning is not always possible but it will likely save you thousands of dollars if followed.

Most policies do not have an unlimited amount that you can claim in maternity expenses. There will be upper limit caps, most often between USD7,500 to USD20,000 per pregnancy.You should first decide on which hospital you intend to use for your pregnancy and research how much their packages cost. You can then choose a policy that will have an upper limit that will accommodate the hospital and package that you choose. Here in Beijing you will find that many of the full maternity packages at international hospitals are approaching the USD10,000 mark, and perhaps not coincidentally the most common upper limit on a policy is USD10,000. If you want to be covered for anything outside of a ‘normal pregnancy’ you may need a higher upper limit and thus an increase in your monthly premium.

When maternity cover is included the insurers are expecting you to use it, so the monthly premiums reflect this fact as the insurers look to protect themselves before a big claim is made. If you are cost focused, then a great way to substantially reduce your premiums is to remove ‘Luxury Providers’ from the policy. Many insurers will group the most expensive hospitals into this category, so if you are happy to use a more local style hospital then you may find your premiums will drop by up to 40%. If you do your research you will find that many of these local hospitals have a good standard of care and often have VIP departments that speak English.

Family Policies
If you are looking to insure more than one person on a policy then you need to consider whether a family policy is right for you. If you try to get an insurance quote with at least one parent and at least one child on the policy then usually you will be automatically given a family policy quote. This is a double edged sword as there are specific benefits on these polices such as new born cover and child related wellness benefits that most people want, but you may end up paying for benefits that you will never use.

I will give you two common scenarios that I regularly come across to highlight this issue. Firstly, there is the couple who are planning to have their first child. For those who are not on expat packages, this is often the first time they have decided to take out a family health insurance policy. It would seem logical to obtain a quote to cover both persons ensuring that maternity is included. The quote that you will receive will cover both persons to the same level and the premium will reflect this. The upshot of this is that the male on the policy is effectively covered for maternity as well, a benefit that would be very impressive if he was ever able to use. It may well be more beneficial and cost effective to have two separate polices with the woman having a more comprehensive cover to include maternity but for the man to have a separate policy focusing on inpatient and A & E cover.

The second common scenario is for two parents with one or more children to be insured. A similar consideration should be given as to whether the man really wants to be on the same policy as the rest of the family if you are looking to save money. The benefits that the children get on the policy are exactly the same regardless of whether there are one or two parents on the same policy. Maternity cover will usually come as standard as there are children on the policy, so it may well be cheaper to insure the mother and the children on one policy and the father on another separate policy.

I am regularly asked whether children can be insured on a policy on their own. Generally speaking, children under the age of 16 cannot be insured on their own as they do not have legal capacity to enter into the contract so at least one parent will also have to be on the policy.

Heath Insurance in China in 2016
The landscape for insuring expats in China is rapidly changing and unfortunately this is driving prices higher year on year. Many insurers now group China, Hong Kong and Singapore into a higher premium category than ever before as International hospitals start to reach near USA level prices.

I have noticed that some Insurance companies are starting to remove Direct Billing from top international hospitals in a bid to reduce regular claims, so make sure you check that your hospital of choice has direct billing set up with the insurer before taking out a policy. If not,you will be paying cash and filling out forms for each claim, which is not much fun.

As an overview there are three key factors to a health insurance policy: price, cover and will the insurer actually pay out. The price and cover are the two that most people focus on as they are easy to compare and contrast between different insurers and different policies. Whether the insurer will actually pay out is grossly overlooked and you should always remember that with insurance you usually get what you pay for as it is such a competitive market. If you see a policy that has the same benefits as ten other competitors but is 30 percent cheaper, then you need to really consider where they are making their savings.A common criticism that is leveled at the China domestic insurance market is that the prices are cheap but the insurers willingness to pay on claims is questionable.

Finally, you can take insurance out online or through a professional broker or financial adviser. The prices are always exactly the same whether you go direct to the insurance company or through a third party broker, as brokers and advisers are paid a flat commission from the insurance company.Always the best advice is to talk to an independent professional as they will be able to tailor the correct policy and insurer to suite your specific needs.

Photo: hubspot.net, Quinn Dombrowski (Flickr)

Recently I have been asked by a lot of families in Beijing about life insurance. Maybe my article two months ago on wills and trusts got people thinking, or more likely it’s the pollution and crazy Beijing roads.

Regardless of what it is in life which makes people inquire about life insurance, there should be only one key driver….’if I were to die tomorrow what would happen to my family and loved ones.’

Currently I am in the process of helping a client with his life insurance. Things in his life are great, he has just had a little boy and like any new father he is very happy. However, the birth of his son has brought back some painful memories. When he was around ten years old, his father fell ill and tragically died. My client was extremely fortunate that his father had put in place a life insurance policy that allowed him to continue his life as his father would have wanted. It is therefore of no surprise that when he found he was going to be a father his attention quickly turned to protecting his new family. My client is not really in a position where he has that much spare cash to spend on life insurance, particularly with all the costs a newborn can bring. Nevertheless, he wanted to put in place as much protection as he could afford.

I deal with many clients that do and do not have life insurance. For the ones that do not it is the first thing I talk about every time I see them. I believe it’s your duty to have something in place if you have children.

No one wants, or likes, to talk about death and this is understandable. However, that should not make planning for it any less important. One thing we know for sure is that death is inevitable, so we have to think about it at some point.

So how much insurance do you need? Some people I meet have great insurance benefits as part of their job. Others have substantial personal wealth so that they can self-insure through their savings. Unfortunately, the vast majority of people I meet are underinsured. Alarmingly, a lot of people I meet do not have any insurance because they think they can’t afford it. Let’s make one thing clear now; insurance is always affordable when you consider the risk to your family not having it. Insurance that you put in place now could be what allows your family to keep their home or your children to attend college.

I often hear the phrase ‘life insurance is the worst investment you’ll ever make’. People say this because the only way to get a return from it is if you die. While I understand the sentiment of this statement, I do not agree with it. Life insurance is the one best investments you can make with your money. What we must understand about life insurance is that it increases the power of our money. Paying USD 1 for insurance might mean my family will receive USD 1,000 if I die. That’s a 1,000 percent return on my investment; pretty good if you ask me.

What are my options?

Term Insurance – This is very simple, what you do is nominate an amount of money you would like your loved one to receive if you die. How much? At the very least I advise everyone to have insurance that will pay off major debts such as a mortgage. If you are the primary wage earner, I also recommend an amount of money that is capable of generating 75 percent of your income.

Whole of Life or Universal Life – As the name suggests this type insurance covers you for the whole of your life. A key feature of this insurance is that it has a cash value that you can redeem at anytime. You can take a look at quotes for life insurance over 80 and find many exciting life insurance plans. A lot of the people I speak to like this because they can cash the policy in and receive an investment back which can make the insurance very cheap or even free.

Critical Illness – This type of insurance pays a cash amount on the diagnosis of a terminal illness such as cancer. I find it is often overlooked by people as something they do not need. However, the fact is you are 75 percent more likely to die of a terminal illness than natural causes

As a point to close on, I would like to repeat that anyone who has financial dependents has a duty to have some form of protection in place for their loved ones! How much differs for everyone, but trivial matters such as time and cost should never stop you planning.

About William Frisby
William originally arrived in Beijing as a finance guy on a bicycle and will probably leave as a finance guy on a bicycle. He works for Premium Finance Group (PFG), a financial consultancy that has been established in China for over ten years. PFG offers clients no-nonsense, personalized advice and serves the whole of China from their Beijing and Shanghai offices. Services include international property, investment, insurance and financial planning. To contact William, email william.frisby@premiumfinance-group.com.

Photos: stockMonkeys.com (flickr)

It has remained on my to do list for the past, oh, seven years or so. We have insured our lives against the unthinkable, saved for the unimaginable, and invested for the inevitable, but we haven’t hammered out a will. Deciding to draft a will makes perfect sense to me, but I always get to that question, ‘where do I start?’ and then I see some cute kittens on the Facebook and get distracted. Okay, I’m not that easily distracted (hang on, someone’s texting me….)

Where was I? Oh yes, will power. Since this is a recurring discussion in our household, I thought the process might be useful to my dozen or so readers (thanks Mom). So, I’ve decided to take a journey into the how to of writing a will for us and hopefully it will shed some welcome light on the subject for others too. I’ll be meeting with some Beijing based experts, but also looking into online solutions that might be as simple as cutting and pasting into a document, filling in the blanks, and then getting things notarized by a lawyer. However, living abroad also adds a layer of complications that hopefully can be easily sorted.

For us, I found a great place to get started was the cheekily named getyourshittogether.org website that was started by a woman whose life was devastated by her husband’s death in a car accident in 2009. She found that since their legal and financial affairs were not organized prior to his death, life for her and her children was greatly complicated afterwards and she spent months trying to get things sorted out. She created the website to raise awareness and make it easier for people to get organized in life so that death is less traumatic and stressful. If you have been putting off getting your own financial house in order, the site is a good place to get a simple checklist of what you should do and to get started.

Photo courtesy of Ken_Mayer (Flickr)