5 things to know about health insurance in China for 2023

Whether you are a new arrival or in the renewal process, be aware that health insurance in China is not standardized and can be confusing. Most people do not review their insurance policies thoroughly and can find themselves in difficult situations. Here is our guide to choosing your insurance in 2023.

What is health insurance?

Quite simply, the health insurance covers your medical expenses, i.e. expenses for hospitalization, medical consultation with your doctor or specialist, examination, medicine and other health-related services. .

Although health insurance is not mandatory in China unlike some countries, it is a good idea to purchase private health insurance to cover ever-increasing local health costs as well as costs abroad if your policy allows. Although the public sector in China remains relatively good, many foreigners prefer the private sector to avoid queues and find doctors who speak perfect English. It is therefore recommended to have health insurance.

In China, a large number of companies also offer a complete package including local or international private insurance, but it is best to inquire to avoid surprises. In fact, group plans are quite different from individual plans, more information in this article.

Regardless of your situation or the coverage you already have, here are 5 things you need to know about medical coverage in China for 2023.

1. Your family may not automatically be covered by the occupational health insurance included in your group scheme

If you are covered by group health insurance, it is necessary to check whether your spouse and children are covered. In fact, this is not always the case. If you have a single cover and want to cover your spouse and children, the premiums will be adjusted accordingly. On the other hand, most group plans allow family membership, to know if it will be at your expense or not.

Some policies offer special “family” rates, while others have an “individual” rate per person. person, depending on age. It is best to check with an advisor as insurance schemes in China are not standardized.

➜ Please note: only children under 18 or students can be covered by a family plan

2. The difference between property and comprehensive insurance

Basic:

  • Hospitalization / Overnight: Basic benefit that must always be withdrawn and which covers hospitalizations, operations, cancer etc. In other words, what will cost you the most in the event of illness or accident.

➜ Warning: Check coverage limits carefully

Full:

  • Outpatient/outpatient: Service used to reimburse consultations with general practitioners and specialists.

➜ Note: Regarding hospitalization, please check the coverage limits which may be per session, per number of sessions or even with an annual limit.

  • Dental and Optical: These are generally optional benefits because dental and optical care are very expensive in China in private hospitals. It is possible to remove these benefits to reduce the cost of the cover.

➜ Note: It is rare for insurance companies to offer dentists and opticians without waiting periods (period during which you are not covered)

  • Maternity: Maternity cover is usually an expensive and optional benefit.

➜ Please note: for individual plans, maternity cover is always subject to a waiting period of between 10 and 12 months on average

There are still other categories such as evacuation, repatriation, health checks and vaccination. All of these benefits and their associated costs should be carefully explained to you and weighed against your personal circumstances.

3. Your coverage area, where are you geographically covered or not?

The most common geographic coverage areas are: worldwide, worldwide excluding the US and China only.

It is up to you to know your needs in terms of cover, for example if you return to your home country often or if you have to travel often. It is actually possible to save money by taking out a cover that only covers you in China.

➜ Note: It is a crucial choice, yes, between economy and the comfort of being able to be treated anywhere in the world, it will be necessary to choose.

4. Exclusions: pre-existing conditions

This is a very important topic and it is actually extremely difficult to get coverage if you have a pre-existing condition. In terms of individual health insurance, both “international” and “local” insurers discriminate against “known” pre-existing conditions.

The list is long and can include conditions as diverse as asthma, eczema, diabetes, back pain, history of cancer, chronic migraines, psoriasis, hypertension and HPV.

➜ Note: It is necessary and mandatory to clearly mention the pre-existing conditions in order not to be deleted. It is still possible that the insurance company will accept your file by raising the price or excluding the pathology in question. There is a solution for the French and Europeans with CFE.

5. How can I lower my premium for 2023? excess and co-insurance

Indeed, 2023 will not be spared the annual increases expected to be very strong in this exit from COVID, all sectors have been affected and insurance companies are no exception to the rule. Fortunately, some insurance plans offer the option of adding a deductible to reduce premiums. There are different types of franchises:

1) annual deductible per person or family;

2) deductible by condition or by action;

You may also be able to choose coinsurance options to reduce premiums. With a coinsurance of e.g. 20% you have to pay 20% of the medical bill, but the annual premium is greatly reduced. A good solution for people who do not need to go often to consult.

➜ NOTE: It is also possible to remove the direct invoicing (Third-party payment) from your insurance, this can also reduce your insurance premium significantly, because it makes the insured responsible, who must pay themselves before being reimbursed. It is e.g. one of the mechanisms of CFE.

6. CFE: the best value for money for a family

Often dismissed, but CFE represents the best value for money solution in the market for families in China. And they have improved a lot in terms of service.

Complete package and low price and the rest, thanks to its great stability, however, it is not sufficient to have a complete package. It is therefore important to choose a supplementary CFE that will accompany you in your installments.

The possibility of receiving a vital card for your care in France should not be overlooked either!

➜ Attention: Prefer that the complementary have a common counter with the CFE, and which will be able to manage the relationship with the CFE for you. More information here.

To summarize, there are many points you need to look at before buying or renewing your insurance. It is better to be well accompanied, is not an insurance professional who wants. I wish you a good end to 2022 and a good start to 2023.

Find out more here: expatmedicare.com

An article by Quentin Silva

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