When you are living in China, there are times when you don’t mind Zhang Li from the office translating.
Explaining the exact nature of your well-imagined food allergy to a long-suffering waiter. Telling a tailor how you want your coat adjusted for the several kilograms of dim-sim weight you have put on in the last four months. Negotiating with an over-eager internet supplier who is billing you as though you have a side-gig in streaming pirated GoT episodes from your Chaoyang apartment.
What you may not want translating is your neonatal doctor during a 17 hour labour.
To avoid this scenario, or a possible $70,000 US in debt, maternity insurance in China can be a great idea.
It’s not for the loosey-goosey, whoops-I-got-pregnant of us, but then neither is insurance generally. If you are the ‘I’ll wing it’ sort, then take that no-helmet Vespa ride through urban Vietnam without a licence when the closest comparable experience you have had was on your ten-speed when you were seven. Live your life, Steve.
However, for the ‘maybe I’ll just hang out here at the beach, possibly with a cocktail’ types amongst us, if you are about to move to China, or are an ex-pat who is living in China, with even the vague possibility of starting or extending your family, investing in maternity insurance, or pregnancy insurance, can save you a lot of money and even more in sleepless nights. You can only buy maternity insurance as a ‘bolt-on’ to your regular health insurance, but because you are not Steve and you are not in Westbury anymore, you are probably thinking about this anyway.
Maternity insurance is especially key if your conversational Chinese is limited to having awkward conversations with people who are politely insisting that your Putonghua skills are “excellent”, when in fact they are “very average”. The truth of this statement will kick in around hour three of the labour.
In China, you generally buy a maternal birth package instead of paying piecemeal per procedure. This covers various types of births, and includes different levels of checks depending on the type of hospital and how much you pay. A maternal birth package that includes an English speaking doctor, high-quality care, a hospital environment that is familiar to one you would see at home, and a natural birth, will cost from CNY 60,000 to over 100,000.
Maternity insurance, for a natural birth that does not cover congenital conditions (basically any baby health problems at birth, like, for example, a heart issue or a cleft palate) typically costs around CNY 15,000 on top of your regular health insurance annually.
A quality health insurance plan that includes a maternity plan covering a natural birth, or a planned or emergency C-section starts at around CNY 35,000.
In an international hospital, a planned C-section costs between CNY 100,000 to 150,000.
C-sections make up around 32% of births in the US. Chinese rates of C-sections were some of the highest in the world, and in 2008, 46% of babies were born via this way. This has decreased to around 35%, but this is still much higher than world health organisation recommended rate of 10-15%. There are several reasons for this trend, but with some hospitals charging 300% more for a C-section than a natural birth, these financial incentives have meant some less respectable providers are often eager to urge this surgery on women.
An emergency C-section – quite a common medical treatment at 22% of births in the US is – or the one-in-ten births that are premature, and the issues that arise from both of these births, such as NICU stays, costs can be more than CNY 500,000.
Huge costs like these can have a long-term impact on your family’s future, and are worth considering when you are thinking about your birth and insurance options.
Hospital maternal packages in China generally include pre-natal exams, birth, post-natal care post-natal examinations, baby care and standard examinations and vaccinations needed within the first few days. Not included are pre-natal treatment, post-natal treatment and examinations, complications during delivery, and paediatric medical problems.
Health insurance, that include maternity plans, can cover these and other medical interventions you might need, in any hospital you wish to attend.
The Chinese Health System
The Chinese health system is generally a good one, but some hospitals are much, much better than others. There is a wild variance in price, reflecting the quality of care, the birth experience you want, the environment, and the capacity to have English spoken easily. The best pregnancy package and maternity hospital for you may not be right for somebody else.
There are the very expensive *cough* outrageous *cough* hospitals, which cost from ‘eye-bleedingly’, to ‘still incredibly expensive if you are used to quality, free, universal healthcare’.
Firstly, international maternity hospitals. These offer a high-end, western-style birth and medical culture, where they are used to an expat pregnancy, English is spoken fluently by all doctors and nurses, and (at least a little uncomfortably, although low-key cool at the time) you will receive a gift-basket after birth. “Delicious 2000 yuan chocolate” you will say to your significant other while dressed in the robes of relief and comfort in your lovely hotel-like hospital. The real reason expats choose to forego good restaurant dinners for a year and go here instead, are for reasons other than well-wrapped candy though. They don’t want to spend several hours waiting to be seen for every medical appointment, and they would like a doctor who can spend more than two minutes with them, that they can completely understand, will listen to their choices about the birth they would like and answer their questions and concerns with attentiveness and real answers. You pay for an international hospital to not have to second guess your doctor, to be able to see your baby when you like, and for your idea of a good birth to be respected.
Next are the VIP Wings of public hospitals. These sound cheap but are actually a similar price to an international hospital. They have famous doctors, like Dr Oz, but medically competent. Here you need at least some guanxi to get you in (although as the administration often think that the odd laowai adds a certain cachet to a waiting room, you have a reasonable chance of being admitted). Here your life is really much better if you speak Chinese beyond the usual expat level of competent bargaining, dinner ordering, and directions. These have an extremely good reputation and English-speaking staff, but how fluent they are can be a matter of luck, and you should ensure you are taking a local translator, or more likely, Zhang Li from the office if she is happy to spend hours every other week in a waiting room. The rock-star doctors are incredibly talented professionals, but they are also in huge demand. This is where Ruyi’s Royal Love in the Palace stars have their babies. Because of this, and because you are not Ruyi, you will spend a fair amount of time holding a ticket in a medical centre. When you see your maternity doctor this will be an, ahem, efficient process. Your two to five minutes with your doctor may also have a Chinese cultural flavour; your ideas about birth may be secondary to their own.
Lastly, the least expensive of the insanely-expensive: private, local hospitals, where you can expect to pay around CNY 40,000 for a natural birth. These are very similar to the VIP wings, except without the celebrity doctors. There is strong demand for these hospitals, so it can be difficult to get admitted. If you are not concerned with a Chinese cultural experience of birth, and either your language skills are good, or you don’t mind sharing (what is for many people an intensely private experience) with an acquaintance who is translating, or having the non-Chinese native speaker of the couple less involved in the birth experience, then this can be a good option.
Of course, health care in China does come a lot cheaper than this, but you may have a fun story to tell your friends in ten years’ time, although maybe it won’t be so funny before then. These are the lower-end, local private hospitals, and public hospitals, which range in quality (again, wildly) depending on the area they are in.
Chinese public hospitals are all extremely reasonable priced, and a birth can cost as little as CNY 5,500, but besides all of your treatment (understandably) being in Chinese, you can also expect some negative, or just ‘weird’ experiences. A foreigner pregnancy, depending on the city you are in, may not be an everyday occurrence for the hospital, and because of this you may experience culture shock. Every antenatal check-up will mean half a day in a waiting room, and you need to get there very early unless you want to be waiting a lot longer than that. In the last trimester, you can expect to spend a significant amount of time sitting on a plastic chair looking dully at numbers on a screen. Hygiene is often not exactly tippy-top; no soap available in the toilets, and seeing blood stained cotton wool that has been casually flicked into the corners of rooms is not unusual. To the average Westerner who has grown up on a diet of 1990s antibacterial soap ads on television, this is quietly horrifying. Until recently, men were not welcome in the delivery room, but now, at least in Shanghai, this has changed somewhat and fathers can pay an additional fee to spend some time (but not all of the time) with the mother giving birth. From a Western perspective, this is often not ideal. Once the baby is delivered they will be taken away for checks that could take around five hours, which again is not a Western idea of a normal birth experience. There are also many reports of parents being barred from entering neonatal units holding their premature or unwell babies, which can be traumatic everybody involved.
Horror stories from untrustworthy doctors and providers within the public system, and less respected private institutions can be alarming. There are stories of women being charged per stitch to close C-section wounds, using the slower to heal, but faster to make, horizontal openings, and disturbing accounts of a harsh user-pays. As recounted to the New York Times, Felicity Miller, a British woman living in China, said that a Shanghai hospital refused to give her premature daughter an injection to prevent her lungs from collapsing because it had not received a deposit from her insurance company. “They said, ‘If we don’t get the money, we would stop the treatment’, and if she stopped the treatment, she would die.” Heart-breaking stories like these, make researching quality healthcare providers, and reliable insurers vitally important.
For maternity prices and options on some international and private hospitals we recommend click here
Maternity Insurance Options
Quality maternity insurance means that you can select the hospital that is right for you, without having to sell your older children to pay for it. It also means that in the awful situation that your baby has a health problem, you can concentrate on getting them better, not how you can pay enormous bills for their continued treatment. Having your baby born into a plan also means they can be enrolled into your insurance. If a baby is born outside a maternity plan, they could be denied medical insurance if they are deemed too great a risk.
Even in your hometown, one of the most stressful times for a young family can be pregnancy; China as the location for your birth can make this even more difficult. Maternity insurance is peace of mind for parents, but policies can vary wildly in what they offer, in price, and in service. In addition to this, maternity insurance is a very individual decision, and what is right for your family may not be right for someone else’s. Factors such as your finances, your language and level of ease in a Chinese environment, your expectations for what giving birth should be like, and your level of risk in pregnancy and labour should all be taken into account when deciding what is right for you.
Most maternity insurance policies require a 12 month waiting period, so it requires planning. When you are considering maternity in China, we can offer you advice on when to sign up to avoid needless overpayments.
The Bupa Elite Plan is one that we recommend for those considering the higher end of the market. It is the only plan which covers any kind of hospital for any kind of maternity package, no matter how expensive. It covers you globally and also includes your first child under ten-years-old in the plan.
MSH Premier Plan is another plan that China Expat Health recommends, which covers all hospital types. If you are looking to lower costs and do not mind that congenital conditions are not covered, this is exceptionally good value for money.
For an overview of what these plans, and others, cover click here
At China Expat Health we offer free, unbiased advice tailored to your specific situation. We are a boutique agency and have fifteen years of experience in healthcare insurance, so we have strong relationships with both insurance and medical providers and can use this for your advantage. We are all expats living in Mainland China, and many of the team have had our children here. We know what you are going through, and we partner with you to tailor the right policy for your family depending on your individual situation. We have in-depth knowledge of the hospitals here on the mainland, and have a wealth of information that you can rely on; giving you advice on the best maternity package for you.
Giving birth is often described as an exciting time. It is. So is living in China. But, these two exciting things together can equal a pulsating whisper of, ‘What have I done?’ at 4am on a Tuesday. Give us a call, we will talk through your situation, give you some options, and prevent some unnecessary anxiety attacks when you or your partner are giving birth in China eighteen months from now.
Pregnancy insurance is officially known as maternity insurance. If you are planning on having a baby in China it is important that you are covered for birth, prenatal, postnatal and emergency neonatal medical care. In addition you need access to great medical care in a clean environment and doctors who speak your language. The problem is this can be expensive in China.
What Is Included Within a Hospital Maternity Package?
Included within maternity package: Pre-natal examinations, natural delivery, post-natal examinations, baby care and standard examinations and vaccinations needed within the first few days.
Not included within maternity package: Pre-natal treatment, post-natal treatment and examinations, complications during delivery and baby medical problems
Make sure you have adequate insurance to cover additional and unforeseen costs which aren’t covered in a standard maternity package.
What Does a Maternity Package Cost in China?
There are a number of maternity clinics expats may have heard of or be familiar with. The below table contains the cost of maternity packages including pre-natal, child birth and cesarean section at various popular international facilities in China.
|United Family Healthcare Shanghai||High-cost provider||CNY 79,000||CNY 119,000|
|Shanghai Redleaf International Women’s Hospital||Private hospital||CNY 98,000||CNY 150,000|
|Shanghai American-Sino Ob/Gyn/Pediatrics Services||Private hospital||CNY 70,000||CNY 95,000|
|Worldpath Clinic International||Private hospital||CNY 70,000||CNY 95,000|
|Shanghai East International Medical Center||High-cost provider||CNY 74,800||CNY 94,800|
|Shanghai Inpatient Department (Huashan)||Private hospital||CNY 55,000||CNY 65,000|
|Beijing United Family Healthcare||High-cost provider||CNY 86,800||CNY 108,800|
|OASIS International||Private hospital||CNY 60,600||CNY 86,600|
|New Century Healthcare||Private hospital||CNY 41,616||CNY 52,416|
|AMCARE Beijing||Private hospital||CNY 60,782||CNY 77,792|
|AMCARE Shenzhen||Private hospital||CNY 69,070||CNY 88,400|
|Elizabeth Women’s Hospital||Private hospital||CNY 85,000||CNY 95,000|
Discounts: Sometimes clinics will offer discounts on the above prices which range from 12% to 5%.
*The above costs are estimates based on information available on hospital websites, enquiries made and costs our client’s have experienced.
Which Are the Best Maternity Insurance Plans?
Most insurers have a maternity option. However not all maternity plans were born equal. We’ve only listed the plans we ourselves would buy and the reasons below are clear.
|Bupa Elite Plan||NOW Health Apex Plan||Allianz with Maternity||MSH Premier Plan|
|Cover Limit||CNY 94,000||CNY 110,250||CNY 63,000||CNY 68,000 / 40,000|
|Pregnancy complications||Fully Covered||Fully Covered||CNY 126,000||Fully Covered|
|Waiting period||12 months||12 months||12 months||12 months|
|Is a medical questionnaire required to add a newborn?||Not Required||Not Required||Not Required||Not Required|
|Cover Congenital Conditions?||Yes||Yes||Yes||No|
|Other relevant information?||One child 10y/o and under free.||None||Both parents must be on the|
plan to choose maternity cover
|Relative Value for Money||Good||Excellent||Poor||Excellent|
The Bupa Elite Plan is one of the most comprehensive in terms of overall cover. It’s expensive initially however when you factor in that your first child under 10 y/o is added for free (or two if both parents are on the plan) and that both parents don’t necessarily need to be covered under the plan, this offers exceptional value for people planning to start or expand their family and who want worldwide cover. In addition it’s the only plan that covers pre-natal costs within their outpatient plan meaning it’s the only insurer which can cover the costs of the most expensive maternity packages.
Now Health offers great value maternity plans by allowing you to reduce costs by adding inpatient and outpatient deductibles and other restrictions onto the plan. If you want a plan primarily to cover maternity in private hospitals and wish to lower costs, then this plan is offers the best value for money.
Maternity insurance is expensive, and for those of you who are willing to work a little harder to find a lower cost maternity package and don’t mind the lack of cover for congenital conditions, the most reasonable lowest cost option is the MSH Premier Plan.
Disclaimer: the figures and views are subjective and based on our research, experience and client feedback.
What Type of Hospital Is Best For Maternity in China?
Check out our hospital types page which goes into details for the pros and cons and prices at different types of hospitals and clinics in China.
Coverage for Your Newborn
Most plans designed to cover maternity healthcare will ensure that there is at least some coverage for the newborn baby, if only for a short period of time. This length of time will be different for every policy as it depends upon the insurer and the plan, so you need to be aware of the limitations on this. There are some policies that offer full coverage, but these will bring with them high premiums. There are policies that have financial caps on the benefits for newborns. There may also be time limits for post natal care. You do need to be prepared in case your newborn needs some medical care after the birth. Expenses such as vaccinations are standard but you should also be prepared in case there are unexpected complications, which can incur very high bills.
There are many maternity insurance policies that offer cover with stipulations for assisted pregnancies, including those that have occurred as a result of IVF treatment. There may also be considerations for second and third pregnancies, particularly if the first child was delivered by C-Section. If any of these apply to you then you need to be aware that the cost of your pregnancy healthcare can rise dramatically. Make sure you make us aware of all the relevant details so that a member of our team can advise you accordingly.
How to Get Started
When you are considering maternity insurance you need to plan as early as possible. Most insurers will put a waiting period into place on a maternity policy so that you will only be able to claim on them after you have had the policy in place for a minimum of 12 months, so planning ahead will be to your advantage.
Fill out the form or chat to one of our consultants today and we will ensure you have all the information you need to plan for pregnancy.