Health Insurance

Both Foreign and Local Companies with International links have generally provided their expatriate workforce, Chinese Management and family members with International standard insurance products. Such protection however, when looked at more closely, may be adequate in their home country, but maybe lacking the necessary benefits and support systems that are absolutely essential while living in China. In most cases, where the treatment may be minor, existing cover may be acceptable. However, in the event of a major problem requiring lengthy hospital stays and expensive medical procedures, costs can be enormous, putting at risk the very survival of a family and even a business.

Before choosing a medical insurance policy one should consider these and many other questions:

  • What does my insurance policy cover?
  • Is the product licensed and can I pay in Rmb?
  • Where can I use the Insurance – cashless clinic visits
  • How much are the premiums?
  • Am I covered if I travel outside my country of residence?
  • Will my cover be affected if I return home?
  • Do I have an annual deductible or a per claim excess?
  • What is coinsurance? Is there coinsurance?
  • Will the policy cover a pre-existing condition?
  • How about chronic conditions such as asthma or diabetes?
  • How long do I have to wait before maternity benefits become active?
  • Does the insurer have a direct billing network of health care providers in my area?
  • How do I pay my premiums?
  • How fast can claims be reimbursed?
  • What does prequalification mean?

The team at Healthline Asia* is here to answer any questions you might have and to help guide you through the process of choosing the right plan at the right price.

The plans we recommend to our clients are designed for individuals, families, groups, small businesses, and corporations. The policies are annual or shorter term travel insurance plans, that are guaranteed renewable and are suitable for all ages and occupations.

Plan premiums are calculated by taking into account your age, the area of cover you want, where you are from, where you are living, what you want covered and what level of benefits you want to receive. Annual deductibles or per claim excesses can also be chosen, resulting in discounts on your annual premiums.

In most cases plans are portable and can be taken with you when you move to a new country of residence. Some policies will even allow you to keep the policy when you go back to your home country and continue to renew the policy as long as you wish. Should you choose an area of cover that is worldwide including North American you would be covered everywhere in the world. North American cover however is usually more expensive.

You may already be familiar with many of the most common benefits offered by medical insurance policies. There are also add on benefits that you may not know of.

Add on benefits include things like:

  • income replacement in case of hospitalization.
  • maternity
  • dental plans
  • chronic conditions
  • personal accident and injury
  • psychiatric care
  • organ transplantation
  • preventative medicine & wellness
  • a daily cash payment while staying in hospital
  • and even low amounts of term life insurance

Sometimes it can be difficult to find a provider that will cover certain pre-existing conditions. If you have a pre-existing medical condition our experts can help you select the best insurer that can extend coverage to this condition.

The following are examples of the most common kinds of benefits covered by an International Medical Insurance Policy:

Inpatient and Hospitalization:

This gives you the flexibility to choose to visit any hospital or clinic, doctor or surgeon you want according to our needs in your area of cover.

Basic areas of cover for inpatient and outpatient policies:

  • Accommodation in a hospital (private room or semi-private room)
  • Surgeons’ and anaesthetists’ fees
  • Physiotherapy
  • Diagnostics tests, MRI and CT scans
  • Psychiatric treatment
  • Oncology
  • Reconstructive surgery
  • Parent accommodation in hospital
  • Local ambulance charges

Outpatient and clinics:

These kinds of policies give you the flexibility to choose to visit any doctor, clinic, or specialist in your area of cover.

Examples of cover for outpatient and clinics:

  • Initial Consultation and specialists’ consultations fees
  • Complementary medicine: chiropractors, osteopaths, acupuncturists, homeopaths
  • Psychiatric consultations
  • Home nursing

Wellness benefits e.g. an annual mammogram test for women or an annual prostate test for men

Your plan can be extended to the following coverage:

Maternity

Maternity is usually covered at a slightly higher premium and may have up to a 12 month waiting period of continuous cover under your policy before your benefits kick in. It is important to understand the potential cost of maternity in your area and to plan ahead. Make sure you are covered with maternity benefits before you start planning a family.

Maternity cover includes:

  • Normal delivery
  • Pre and post natal consultations
  • New born coverage
  • Complications during pregnancy
  • Routine maternity care

The benefits and amount of cover depend of course on the premiums you pay. So let us help you find the best balance for your unique needs.

Dental

Many plans offer different levels of dental cover. The two main types are:

  • Routine dental treatment (these benefits may have a waiting period before you can claim of up 12 months continuous cover under your policy)
  • Emergency dental treatment following an accident

Evacuation

In the case of death, a terrible accident, or disease requiring prolonged hospitalization and treatment, most of us would want our remains to be repatriated or to be at home with our friends and family until we have fully recovered.

Repatriation usually covers:

  • Emergency medical evacuation
  • Return airfare following an emergency evacuation
  • Travelling and accommodation expenses of a companion
  • Compassionate home travel
  • Repatriation or burial of mortal remains

When selecting the type of cover you need there are some important points you should keep in mind.

Chronic conditions coverage

Chronic conditions are generally defined as medical conditions which you do not fully recover from, but only manage and maintain. For example: diabetes, asthma, arthritis or HIV.

It is important to understand that on going treatment of these kinds of conditions can be very expensive and therefore policies that cover chronic conditions are generally quite a bit more expensive. Currently, half of the international medical insurance companies have some form of chronic condition cover.

Geographical coverage

Basically, there are two main geographic areas cover:

  • Worldwide including North America
  • Worldwide excluding North America

Worldwide including North America would allow you to choose any doctor, clinic or hospital anywhere in the world including the USA and Canada. Worldwide excluding North America would obviously cover you anywhere in the world except the USA and Canada.

Policies that include North America are generally more expensive. Unless you are US citizen, or a non-US citizen planning to spend a lot of time in the USA, you would probably not need to pay the higher premiums. Most policies that exclude North America will give you 30 to 45 days emergency cover while visiting the USA and Canada.

Excess, Deductibles and Coinsurance

Many companies offer a discount on premium based on a deductible or excess. With a deductible or excess the insured would pay a certain amount of the bill according and the insurance company would pay the rest. For example with an annual deductible of $500, if you had an accident that required surgery, you would be required to pay the first $500 of medical bills and anything over that amount would be fully paid or reimbursed by the insurance company. If the bill were $1,000, you would pay $500 and the insurance company would pay $500. Since this is an annual deductible after you had paid out $500 during that particular episode, you would then be 100% covered for the remainder of the life of the policy.

Typically, an excess would be a per claim and/or per condition amount that the insured would have to pay before the insurance companies benefits started to pay out. You might have a $50, one time, per claim / per condition excess. An example of how this would work is: let us say you got food poisoning requiring hospitalization for a night, the insured would have to pay the first $50 of the bill and the insurance company would pay the rest. Two months later, if you had the same problem – food poisoning – you wouldn’t have to pay the $50 excess.

Coinsurance is a percentage of the bill that you would pay every time you have treatment. If you have 20% coinsurance on your policy then you would always pay 20% of the bill and the insurance company would cover the other 80%.

There are actually many ways insurance companies configure and deploy various kinds of deductibles or excess. Pay attention to these and understand the impact they have on your finances. Also you might want to try to understand the impact this has on the insurance company’s finances and therefore the amounts of premiums they charge.

If you have any questions about these kinds of seemingly complex issues please contact someone at Healthline Asia*. They would be more than happy to help you.

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