Last updated on Feb 28, 2012

Guide to Health Insurance For Expats

Let’s hope this never happens, but imagine the following scenario: you’ve just met up with your best friend after his month-long retreat at the Shaolin Monestary. He’s showing you all the sweet kung fu he’s just learned and, in his inept zeal, he breaks your shinbone clean in two.  Which hospital would you go to? Could you afford it? Would you be able to fly home to have your shin screwed back together? If you’re answering no or “I don’t know,” perhaps it’s time to consider health insurance targeted for expatriates.

This can all be a bit tricky, especially if you’re not familiar with what to look for so first let’s go over the important terms and then we’ll offer recommendations for choosing a plan.

Important Terms

Premium:  The cost of an annual insurance plan.  The premium will vary widely according to your age bracket, gender, other risk factors such as your medical history, coverage area, and what benefits you choose.

Deductible: The deductible is the amount you have to pay ‘out of pocket’ before the insurance company contributes to your health care costs.  A lower deductible means a higher premium.  So you should balance your choice of deductible according to your tolerance for risk and your budget.

Direct Billing: Direct billing means that the medical facility you visit will directly invoice your insurance company for your treatment. Otherwise, you must pay  own and claim after by sending all your invoices, receipts and related medical reports to the insurer.
Coverage Area: Typically, international insurance plans offer two options: worldwide including US and worldwide excluding US (a few insurers will also exclude Canada). The plan which includes US cover is more expensive due to the extremely high health care costs there.  However, if you are a resident of these countries you will likely want coverage for back home, although most insurers will offer some form of cover for emergency treatment in the States. There are also several insurers which can offer China only plans if you already have healthcare back in your home country.

Choosing a Plan

As health insurance is a major decision and a major expense, it’s important to choose wisely!  Typically you must first choose a broker and then choose among the various insurance companies whose plans they offer.  For the broker, it is important to choose someone who works with a wide range of insurers and has good experience with the market. Brokers with an office in China will have in-depth knowledge of the healthcare providers here and their costs. A good broker will help you choose the plan that best fits your needs and will support you throughout your coverage period.  Even after you are enrolled onto a plan they will be able to help with all queries and claim issues for the lifetime of your policy. For the insurance plan, there are a number of things to check for:

Direct Billing: We really recommend direct billing.  It makes it much easier to go to the doctor as you would simply show your policy card instead of going through the hassle of paperwork and waiting several weeks to get reimbursed.  Medical treatment at international hospitals in China can be very expensive and so you could be left with large out-of-pocket expenses. Be sure to check that direct billing is offered in the cities where you expect to be and that it covers the facilities you would expect to go – most insurers have their own hospital network so get this list before choosing your plan.  Also, be sure to check that direct billing is offered on all ranges of your health insurance plan. If the service you choose does not offer direct billing, check that you can submit copies of the documents electronically (nobody likes faxes or China post!) and that they will reimburse you by wire transfer and not courier pigeon.

Help Line: Before you choose an insurance company, call them! Check that they are open when you need them and that you can talk to a real person quickly to get questions answered. 

Dental: Many insurance plans only offer ‘emergency’ dental coverage.  You then must purchase a supplemental plan to cover regular dental care such as 6 month cleanings and checkups. 

Pregnancy: This is an important one to check for if you are planning on baby making.  Many insurance plans require an extra plan for maternity benefits or do not cover pregnancy-related expenses during an initial period. Typically insurers will have a 10-12 month waiting period after joining a plan before you can begin to claim for any maternity expenses.

Prescriptions and Medical Equipment: For some insurance plans, prescription medication and medical equipment are an optional extra.  As this can be a major portion of your medical expenses, you should look for insurance plans which include this or purchase the optional coverage.

Other Benefits: Many plans offer emergency evacuation, which means that they will cover airfare and travel related to getting you to a hospital.  Other plans will fly you home in case of family emergencies, which is also a nice peace of mind.  

Ultimately, you’ll have to settle on a plan that offers the best balance of benefits, coverage area, and deductible with a premium that is in your or your employer’s price range. Finding this is not easy work but the knowing in advance that you’re properly covered should you be in an accident is priceless. 

The introduction is contributed by Pacific Prime, an expatriate health insurance broker – or 021 6445 4592 – they have an office in Shanghai.

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