If you’re planning on moving to China, one thing you may be considering is what you’ll have to do if you get sick. How to deal with recurring prescriptions or chronic illness? And what exactly you might get from the company or school you work for?
Health insurance in China for expats is a complicated topic. I hope to help you navigate and understand it, so you can feel comfortable keeping yourself healthy in China.
1. Ask your employer
The first and most important thing to do before signing a contract, is to inquire about their health insurance policies and benefits for expats.
In most cases, you will probably have an insurance policy through your employer. However, the actual coverage can vary widely. It can also be confusing to read and understand, especially since it was likely translated from Chinese, so it may have terms that just don’t translate well.
Ask if someone can explain questions you have about coverage, and point you in the right direction. In the time I spent in China, I had health insurance through my company, but personally wasn’t able to make much use of it, for reasons I will explain later.
2. Consider your “at home” insurance
Some health insurance policies may work internationally. If you will still have valid health insurance for your home country while you are in China, do some digging. In most cases it either won’t cover much, or will only cover in the form of reimbursements.
This means that anything you’d want to put through the insurance will have to first be paid out of pocket.
3. Private vs Public hospitals/ clinics
One of the biggest things you’ll actually deal with when trying to be treated for anything from the flu to a broken bone (and hopefully nothing worse), is that you have to choose between public and private hospitals and clinics.
From my experience, this is not as simple as a similar choice would be in the US. Most likely, your health insurance will cover public hospitals/clinics only. What this means in practice is that it only covers Chinese speaking healthcare.
This can become one of the frustrating ways in which expats feel like they are unable to take care of themselves in China. If you don’t speak Chinese, you may need to take a gracious friend or colleague along with you to translate your condition and help you communicate with your doctor. If you’re really sick or hurt, this is probably something you’ll want and need to do, so make sure to find someone you trust who you know you can ask in case anything happens. If you don’t, treating acute conditions in private, English speaking hospitals (or at least hospitals with some English speaking doctors) can be incredibly costly, and likely none of it will be covered by your insurance.
What does this mean for you, practically? It is another reason why you really should learn Chinese, but honestly medical Chinese is not something that you’ll learn quickly, so really, definitely, don’t forget to find a Chinese speaking friend to help out.
*Please make sure to check how this will work in your city. If you live in Shanghai or Beijing, you may have better luck finding staff at public hospitals or clinics that speak English. Save that money if you can!*
4. What isn’t covered
So, as you now know, cushy, English speaking healthcare will likely be an out of pocket expense, unless your company has great health insurance.
I also found personally that my health insurance didn’t cover many specialty doctors, including dentists, psychiatrists, and pretty much anything else you can think of besides a basic general practitioner. This might be true, and might not, but is something to keep in mind.
What I learned is that expats just kind of accept this, and for most things they pay out of pocket if it’s more of a routine check-up. This ended up being the easiest thing for me to do in most cases too, especially because paying a little extra, but having the independence of making appointments and going on my own was worth it.
This is reasonable for many health concerns, but if you’re dealing with more chronic illness or otherwise have reason to keep going back regularly – especially if it’s for something your work health plan doesn’t cover – you might want to consider getting your own, secondary insurance.
5. Getting your own
This is something that likely isn’t needed for most expats, but if you either don’t have any health plan at work, or your personal medical expenses are regularly high enough that it seems worth finding an alternative, you may want to consider getting health insurance independently.
While my company chose a healthcare plan for its employees, some may give a budget and allow you to even choose on your own! In this case, there are multiple companies that are either based in China or have China specific coverage plans you should check out including Ping An, Cigna, Aetna, Now Health, and AXA Tianping.
6. Hospital and Clinic standards
Public clinics and hospitals are categorized into three tiers. Tier three being the one with the lowest standards and tier one being the highest. As long as you find a tier one or tier two hospital, it’s going to be nice enough.
Think about these standards as having more to do with the facilities feel and warmth than anything. You will still get fairly good treatment at either one. The tier one hospitals may have some more resources though. If you’re okay with things being a bit cold and clinical, tier two or tier one should be fine, but if you want a softer, more comfortable experience, your best bet is still private. If you have the time, ask around to what your co-workers and friends trust most in your city!
Health insurance can be a complicated topic, but I hope this gives you a good basic insight into how the expats I know deal with healthcare in China. It may be confusing at first, but with time you can figure out how to make the most of the plan you have.