FEATURES
FACTORS TO CONSIDER Michael Ray from Pacific Prime considers emergency coverage – including inpatient and emergency evacuation – to be the most important benefit for families. Other considerations include vaccination coverage, outpatient coverage, annual health check coverage, and the hospitals covered by the plan. Here’s a quick rundown:
Outpatient Treatment Consider how often you or your dependents are likely to visit the doctor in a given year. Policies with high deductibles to minimize the cost of monthly premiums may not be the most cost-effective if you’re only planning to see doctor twice a year.
Annual Limit An annual limit is the cap on benefits that your insurer will pay in a year. If the dollar amount of covered hospitalizations, treatments, and prescriptions exceeds the annual limit, you’ll need to pay all healthcare costs for the rest of the year. Annual limits range from USD 100,000 to several million per year depending on the plan. The higher the limit, the more expensive the premium.
Pre-Existing Conditions Some insurers will cover certain pre-existing medical conditions, but the trade-off is a higher premium. Coverage for high blood pressure or cholesterol may seem expensive, but keep in mind you’d also be covered for heart attacks.
Annual Rate Increases Smaller and mid-range insurers with less financial stability usually have more erratic rate increases. Some even increase the premium in response to claims. Larger, more reputable insurers have more gradual increases, both annually and with age. “Watch out for age brackets,” says Ray. “You may find a large increase when you turn 50 if the insurer’s age brackets are 45-49, 50-54, etc.” Child Coverage Medical care for children (including checkups and immunizations) is often included, but confirm this with your insurer. Families with older children who may or may not live at home as dependents may be included, but check if there are any age caps and details of the “global” part of “global insurance coverage” if your kids don’t live in China. Discounts Some insurers offer a family discount, which can be especially cost-effective for large families. No-claims discounts or first-year discounts are sometimes also offered, but keep in mind that a 10 percent first-year discount carries a 10 percent plus age plus annual increase at renewal. Maternity Coverage Couples planning to conceive should note that most insurers require a waiting period of 10-12 months of paid maternity insurance before pregnancy, birth, and/or newborn coverage kick in. Medical Evacuation Evacuation is an essential consideration. Take a moment to think about the cost of out-of-pocket repatriation in case of an emergency. Evacuation would cover transport for essential surgery, medical treatments unavailable here, or a health epidemic. Check whether the plan covers return transportation to Beijing. Insurance for evacuation can be overkill if your primary policy covers most or all possibilities, so make sure it complements rather than overlaps existing coverage. Note that medical evacuation doesn’t necessarily cover treatment in your home country or third location like Hong Kong.
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Travel Insurance International travel goes hand-in-hand with living in Beijing; getting travel insurance is important as a backup on your rider. This is often available as a small package when you have visitors, either through your current insurance plan or through an international hospital or clinic membership. US citizens should note that many global policies don’t cover treatment in the US or only for a limited number of days (usually 30-45). See US Coverage for more info. US Coverage Ask yourself if you need coverage for elective treatment or only emergency treatment. “If the client wants the option to travel to the US for planned surgery, then the cost can be 1.5 times – or more – the cost of a ‘worldwide excluding the USA’ plan,” says Ray. Many such plans offer emergency inpatient treatment in the US. For expats who already have medical insurance through their company and don’t have to join the existing policy, options for US coverage usually come down to budget. If you can afford it, it’s best to have a plan that covers elective treatment in the US. Otherwise, having a “worldwide excluding US” plan with emergency US inpatient coverage is the next best thing; however, this won’t cover emergency outpatient treatment, which can be very expensive. “Another option for coverage would be an annual travel policy that will cover trips to the US,” says Ray. For instance, Pacific Prime offers a comprehensive option from an international insurer that offers unlimited inpatient, outpatient and evacuation coverage anywhere in the US for around USD 130 per child, USD 200 for adults, and USD 267 for medical and evacuation coverage. The disadvantage that it doesn’t offer the fapiao that most companies require for reimbursement in China, so may need to pay out-of-pocket. For families currently without medical insurance, there are many aspects to consider that will affect the premium. Age is the biggest factor; rates for younger clients will be much lower than for older clients. Premiums range from a few thousand RMB per person to tens of thousands for full coverage. “Generally the cost will be between RMB 10,000 and RMB 60,000 depending on age and options chosen,” says Ray.