Medical Insurance in China - A Quick and Simple Guide

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1 Buying Medical Insurance in China

2 OUR MISSION L ooking for Medical Insurance or Medical Treatment in China? The Chinese market for medical insurance is unique, and it can be daunting with many options available all promising to meet your needs. The pressure can mount when choosing medical facilities for your treatments as well. This brief guide has been created to make finding medical insurance a little easier and explains why China is so different. Contact us for any further assistance: Hong Kong: Shanghai: +86 (0) Dubai: +971 (0) Singapore: info@pacificprime.com 02

3 An Introduction: A Range of Different Plans Buying medical insurance in China is difficult when comparing it to other countries in the world. This is due to the high number of plans available, along with an equally diverse array of premiums on offer. There are two key factors that contribute to this: Insurance Preferences As China grows in hosting different types of expatriates, the range of insurance preferences and needs grow. A variety of plans has surfaced on the market in an attempt to suit everyone. Range of Facilities Low-cost hospitals stand side by side with, modern and expensive facilities across China, making it a country with a significant range of care available. 03

4 TABLE OF CONTENTS Chapter 1 - China Health Insurance Local Compliancy Payment and Reimbursement Local Servicing Direct Network Access 5 6 Chapter 3 - Choosing an Insurer 11 Market Experience 12 Servicing Standards. Payment and Future Security Chapter 2 - Choosing a Hospital. 7 Affiliation and Reputation 8 Cultural Awareness 9 Suitable Treatment Costs 10 Chapter 4 - Choosing a Plan 15 What is the likelihood of needing treatment? 16 Does the cover match the hospital?.. 17 Contact 18 04

5 CHAPTER 1 CHINA HEALTH INSURANCE The growth in choice of local licensed providers in China has caused a shift from policyholders opting for international based plans, to more localised services. Some of the main reasons for choosing a local Plan: 1. Local Compliance 2. Payment and Reimbursement 3. Local Servicing Why do I need insurance in China? 4. Direct Network Access 05

6 CHAPTER 1 CHINA HEALTH INSURANCE 1. Local Compliance Having a plan that is regulated by the China Insurance Regulatory Commission (CIRC) ensures all features of the plan adhere to the local requirements for medical coverage, and guarantees local assistance in the event of an issue. 2. Payment and Reimbursement Only plans regulated by the CIRC will allow for payment of premiums and reimbursement of claims to be made in the local currency (RMB), meaning you will be issued a local receipt, or fapiao, for tax reasons. 3. Local Servicing Having an insurer with a local servicing team will ensure that all aspects of your policy are handled accurately, whilst avoiding delays when dealing with overseas servicing teams. 4. Direct Network Access Local insurers will have direct and immediate access to all hospitals within their network, eliminating delays if you require immediate treatment. 06

7 CHAPTER 2 CHOOSING A HOSPITAL Choosing the best facility to visit can be difficult with so many hospitals available in China. Considering these main points will help when choosing a facility: Which hospital is best? 1. Affiliation and Reputation 2. Cultural Awareness 3. Suitable Treatment Costs 07

8 CHAPTER 2 CHOOSING A HOSPITAL 1. Affiliation and Reputation Ensure your hospital is dependable. International Credibility Look for facilities boasting international awards, affiliations with renowned medical universities or those celebrated for specific medical areas. Accreditation and accomplishments show quality mental and medical merit. A Local Identity Speak to people in your city to learn of the top facilities and look for feedback on specific information from anyone with any experience of the hospital and their services. Online Recommendations There are expatriate websites featuring forums where users post about their experiences in local hospitals. These can be dedicated specifically to different types of treatment, such as physio therapy or maternity, and can help shed light on what to expect. 08

9 CHAPTER 2 CHOOSING A HOSPITAL 2. Cultural Awareness Ensure your hospital will provide the services and treatment you expect. Communication It is always best to check if nurses and physicians are able to speak the same language as you to avoid potential confusion. Treatment Philosophies Make sure that you will receive the exact type of treatment and medication you would normally expect, especially if you are in an area with different philosophies or treatment styles to your home country. Service and Standards Always ensure the staff at the facility are trained to meet both service and general standards, and more importantly your own personal expectations. 09

10 CHAPTER 2 CHOOSING A HOSPITAL 3. Suitable Treatment Costs Ensure your hospital provides treatment at a fitting cost. For Your Insurance Always check you are comprehensively covered by your plan, and without any risk of out of pocket expenses in case of limits of treatment. Many facilities have different charges for the same treatment. For Your Area Check the costs for any treatment you may need across a selection of different facilities in your area. Make sure the costs are not too high, as the facility may be overcharging, or under changing and offering limited treatment. For Additional Costs Any treatment may require follow up depending on the nature or seriousness of any health related issue. If you need follow up treatment, make sure it is comprehensively covered and you are pleased with the service. Alternatively, you can source the additional treatment elsewhere. 10

11 CHAPTER 3 CHOOSING AN INSURER With several options available, it can be difficult to see the differences between insurers. Consider these points to help choose an insurer. Which insurer is the best? 1. Market Experience 2. Servicing Standards 3. Payment and Future Security 11

12 CHAPTER 3 CHOOSING AN INSURER 1. Market Experience It is important to ask how long the plan has been available in the market. Many companies launch products that are based on success in other regions, yet do not necessarily match the needs for your area of cover. The best questions to ask: How long has the plan been on the market? Time is always the true test. If the company has been processing policies for a long time in China, they are more likely to properly suit the necessary requirements. How many clients are on the plan? There is a certain safety in numbers. A high number of clients on the policy, as well as a high retention rate, are indicative of an insurer with plans that are suitable for the needs of the market. 12

13 CHAPTER 3 CHOOSING AN INSURER 2. Servicing Standards A plan may appear attractive on paper, but investigate the insurance company s success in upholding promises. The degree of success should strongly signal whether you will face any unexpected problems. The best question to ask: Who does the servicing? or Who underwrites the plan? Many plans are created to attract expatriates, however they may not have been designed specifically to retain clients over a long term period. If the plan is from an international insurer, with a joint venture in China for local licensing, it is much more likely to uphold international servicing standards. 13

14 CHAPTER 3 CHOOSING AN INSURER 3. Payment and Future Security The laws in China regarding payment in all industries are highly regulated. Something as simple as your treatment fee s and filing an insurance claim can be troublesome when dealing with difficult insurance companies. Also, make sure your plan covers potential life changes in the future. The best questions to ask: Who is paying and how Know that your chosen company accommodates your preferred payment methods. If your insurer is paying from overseas, will they accept an international transfer? If you are paying yourself, can they accept your credit card? Do you need to be issued a Chinese Fapiao? Enquire whether your insurer is able to reimburse you in the same currency as your chosen bank account. Your Future If leaving China in the future is a likely possibility, you may wish to have the insurance continue with you. Always make sure the plan has the ability to transfer internationally with continuation of cover. 14

15 CHAPTER 4 CHOOSING A PLAN Looking closely at the actual level of benefits offered in each plan is the next step in choosing the best medical cover. Some main points to consider: 1. What is the likelihood of needing treatment? 2. Does the cover match the hospital? How do I choose the best cover? 15

16 CHAPTER 4 CHOOSING A PLAN 1. What is the likelihood of needing treatment? Take a look at your own personal situation and asses the likelihood of needing medical treatment. Who needs the cover? If you are a young, fit and healthy individual, you may only require basic hospital cover. If on the other hand you have a family with young children, you will need to include routine trips to a family doctor in your cover. Do I need to wait? If you need cover for specific treatment such as Maternity or Dental, the insurer will usually have a waiting period (referred to as a moratorium in insurance speak). Make sure you are prepared for the future if you need this treatment, and choose a plan with a suitable waiting period. Is there a history to consider? If you have a family history of chronic medial conditions, or if you have a personal medical history that needs to be covered, make sure coverage of these conditions are suitable on the plan you choose. 16

17 CHAPTER 4 CHOOSING A PLAN 2. Does the cover match the hospital? Always make sure the cover you have matches the type of treatment you expect to receive, at the facilities you have chosen. Philosophies in Treatment Ensure the actual treatment type you would expect to receive is covered. For example, if you are more comfortable with eastern style medication, make sure the plan covers it. Are the limits enough? Always investigate whether the financial limits for treatment match the cost. If not, you could end up paying extra out of pocket. If you would prefer to receive treatment at home, find out whether the limits adequately cover home treatment. What is the worst case scenario? If during an emergency, treatment is unavailable locally, you may need to be airlifted to a neighbouring country; the costs for which can be astronomically high, leaving you with a potentially severe financial burden. Always make sure evacuation is covered by your plan if you are visiting countries which do not have the necessary medical equipment or procedures. 17

18 CONTACT All you need to do is ask. Pacific Prime is ready to advise you on all aspects of your international medical insurance. We have over 200 trained professionals in 4 different countries, providing advice in over 18 languages. HONG KONG SHANGHAI DUBAI SINGAPORE Unit th Floor One Hung To Road Kwun Tong Hong Kong Room 608 Building 15 Dong Ping Road Shanghai China Office 603 Building JBC 1 Po Box , Dubai UAE 3 Pickering Street #02-27 China square Central Singapore UAE P P (0) P (0) P Info@pacificprime.com Legal disclaimer The content of this booklet is for informational purposes only and is not an offer of insurance. It is a basic summary of health insurance information and may not reflect a specific individual s personal circumstances and as such you should consult with a health insurance advisor before you purchase insurance. Information in the booklet was correct at the time of publication but from time to time facts and circumstances change so please take advice before buying insurance. All information in this booklet is the property of Pacific Prime and should not be reproduced or further disseminated without the express permission of Pacific Prime. 18