The Chinese government introduced a considerable social security reform in 2011. Foreign employees working in major cities are now included in various forms of coverage. This also extends to public health insurance in China.
However, expats shouldn’t rely on this way of getting health insurance in China. Medical coverage is essential for everyone living abroad. There are several reasons, though, why the new legislation may not provide what expats need.
Firstly, it varies from city to city how the local authorities implement the new social security regulations. In some cases, health insurance in China is not included for foreign residents. In other cities, most notably in Shanghai, foreign employees neither contribute to social security, nor are they entitled to any benefits.
Secondly, even if you have access to public health insurance, your non-working family members may not be covered. And lastly, public healthcare in China comes with several well-known issues.
Even patients enrolled in a government-run scheme have to make considerable co-payments. For some kinds of outpatient treatment (e.g. monitoring chronic illnesses like diabetes), there is little reimbursement, and patients have to pay for it themselves.
Public health insurance in China also has some conspicuous gaps in its coverage. For example, it doesn’t usually cover the cost of evacuation or repatriation, and access to private facilities is not available. If you have to rely on public healthcare, please keep in mind how it can affect your overall cost of living in China.
Expats often prefer private clinics for a variety of reasons. The staff mostly consists of foreign nationals, as well as Chinese doctors who have trained abroad. Therefore, there’s no language barrier, and culture shock will also be minimized.
Moreover, private facilities in popular destinations offer top-notch standards of medical care. On the downside, most are very expensive. Some patients claim that the same treatment can cost up to ten times as much as at a public hospital.
Most expatriates take out private health insurance in China – both for themselves and for their families. Several global providers have established themselves in this limited, but lucrative market, including Cigna, Aetna, MSH, Bupa, Axa, InterGlobal, and Allianz.
An independent broker could be of assistance when it comes to choosing private health insurance in China. They can help you compare various companies and packages. Frequently, the same company might offer a cheaper budget plan (e.g. hospitalization and emergencies only), as well as comprehensive coverage.
A good broker will encourage you to think carefully about how much you can spend on health insurance, as well as what definitely needs to be covered. Also have a look at our articles on expat health insurance and international health insurance in the Expat Magazine. They provide a useful overview of key points to consider.
There’s one thing you should never do, though. Don’t buy any unlicensed plans from an offshore company who isn’t registered to trade in the mainland market. Their medical coverage may still be valid, but in case of any disputes, you have no legal recourse whatsoever.
If you take out international health insurance in China, please be aware that public hospitals might not accept or recognize it. Your global provider may cover the costs for any bills from public clinics, but you’ll have to pay in cash first. And in the case of, say, surgery after a major accident, the costs can be rather steep.
However, private health insurance in China is a growing market. Due to the above-mentioned problems with public healthcare, many middle-class and upper-class residents buy medical insurance from local companies. This helps them to avoid paying out of their pocket and to get access to "VIP wards" in public hospitals.
So-called VIP facilities in Chinese clinics also employ English-speaking doctors, and offer better conditions and care than the average local hospital. They are still cheaper than the private clinics aimed at Beijing’s or Shanghai’s international population.
Therefore, getting health insurance in China from a local provider could be a suitable alternative for cost-conscious expats. However, this decision has certain disadvantages. The paperwork is often available in Mandarin only, and it is more difficult to get in touch with an English-language hotline.
Furthermore, the existing portfolios for private coverage are often a confusing bundle of policies. Make sure that you understand what exactly the plan covers. Financial protection in case of "dreaded diseases"? Accident insurance? Premium access to VIP wards? Anything else?
Sometimes, your employer will offer you and your family healthcare coverage. In this case, you should still make sure, however, to find out what exactly the plan entails. Maybe you ought to take out additional plans to supplement their cover.
Once you have signed up with one or several providers, you shouldn’t forget about these things:
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