How to select good health insurance in China?

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China Social Security Card

With the recent COVID-19 pandemic, many expatriates in China are still wondering if their health insurance would cover the medical costs associated with the new coronavirus. Treatments may result in substantial medical expenditures, particularly if the patient becomes critically ill as a result of COVID-19. The average medical cost in China for a COVID-19 case treatment is RMB 17,000 per patient, according to China Daily, emphasizing the need of having adequate medical insurance coverage.

To avoid unpleasant surprises and to address the concerns of the majority of our expatriate friends, here are some extremely important issues to consider before getting health insurance.

Benefits of Health Insurance

01 – Coverage Areas

Insurance firms may offer various levels of geographic coverage, ranging from Mainland China to the entire world. You should pay special attention to that point and select wisely based on your requirements.

02 – Total Annual Maximum/Sum Insured

This is the total amount your insurance will pay out throughout the course of the policy period.

03 – Type of Medical Provider

In China, most health insurance plans include two types of provider coverage:

  • Public and private hospitals/clinics: Your plan will cover top public and private hospitals/clinics. A “VIP wing” or “International wing” is found in many public hospitals. Of course, private hospitals have greater facilities, English-speaking doctors and personnel, and a similar quality of treatment to what you would get at home.
  • High-priced providers: this choice allows you to visit high-priced private hospitals and clinics. Your premium will go up if you choose this option.

To combat COVID-19 in China, the government quickly established a wide network of “fever clinics” where everyone experiencing symptoms of the new coronavirus should go. Only public hospitals have been recognized as fever clinics thus far, with the foreign wing of most hospitals remaining closed during this time. As a result, some of the benefits you are accustomed to may not be available right now (direct billing, good English-speaking doctors, etc.).

04 – Medical Requirements for Underwriting

  • Pre-existing conditions: Most insurance companies will evaluate the applicant’s medical history to determine whether or not they can issue her/him a policy and whether or not the policy would include pre-existing condition exclusions.
  • Waiting period (if any): Insurance companies may need a future member to complete a waiting period, which lasts for a set period of time, before the insured coverage is fully activated. Furthermore, claims filed during the waiting period may not be eligible for benefits.

05 – Co-payments and Deductibles

When looking for health insurance, this is an important factor to consider. Indeed, this can cause large variations in the price of your premium (the monthly or annual fee for your insurance).

  • A deductible is a set amount of money you pay for a health insurance claim before the coverage kicks in and the insurance company begins paying you. After you’ve paid your deductible, the insurance provider will cover the rest of the claim up to the policy limits, subject to the terms and conditions of the policy. You can pick between a “per claim” deductible and an annual deductible in most cases.
  • A co-payment is a percentage of any medical expenses that you choose to pay. If you choose a 20% co-payment, you will always be responsible for paying 20% of each bill, with the insurance company covering the rest. If you want to save money on your insurance premium, you could opt for a 20 percent or 100 percent co-payment at high-cost providers.

06 – Day Case/Inpatient

Inpatient therapies necessitate a stay in a hospital or surgery. This covers life-threatening conditions like cancer and its treatments. In most cases, the patient is admitted to the hospital for at least 6 hours. When you opt to enroll in health insurance, you will almost always be required to be inpatient. Please keep in mind that inpatient treatments usually require pre-authorization.

COVID-19:

If you exhibit signs of the new coronavirus in China, such as fever, coughing, or difficulty breathing, you will be hospitalized. As a result, inpatient coverage is critical, and having it is valuable.

07 – Outpatient treatment

As long as symptoms are present, outpatient treatment implies daily care from doctors or experts, including prescriptions and accompanying exams (CT scan, blood test, MRI, etc.). This usually refers to situations where a patient visits a hospital for treatment but does not stay overnight.

If you have a fever, a sore throat, back discomfort, or any other type of physical pain, you should seek treatment outside of the hospital.

08 – Benefits for Maternity and Newborn Infant Care

When it comes to health insurance, you should pay special attention to maternity benefits. In most cases, there is a waiting period (generally 1 year).

09 – Optional Benefits

Optional benefits like wellness, dentistry, and vision may be offered by insurance carriers.

  • Wellness: Preventive and routine testing, as well as related doctor expenditures, are usually covered (immunizations for example). If you don’t have any COVID-19 symptoms but still want to be tested and the findings come back negative, your wellness benefits will pay the test costs.
  • Vision: Cover the cost of an ophthalmologist or optometrist examination. One pair of spectacles or contact lenses may also be covered.
  • Dental: Depending on the policy of the insurance provider, this benefit may include preventive dental procedures as well as orthodontic or restorative treatments.

Provider of Health Insurance Services

What characteristics distinguish an excellent service provider for expatriates in China?

When you enroll in health insurance, you must also ensure that your future health insurance service provider will be able to assist you whenever and wherever you require it.

  • Hotline service is available 24/7.
  • Ability to provide service in two languages: English and Chinese.
  • Medical advice from professionals.
  • Assistance in an emergency.
  • To avoid upfront payment, a large direct billing network is used.
  • Claim is simple and quick.
  • Response time to a pre-authorization request is quick.
  • For hospitalized cases, you’ll need a lot of management skills.
  • Chronic disease medication is delivered by pharmacy.
  • E-claiming, online appointments, hospital networks, and other good online self-service platforms.