Updates

Do I Really Need Health Insurance in China?

Health insurance covers your medical treatment costs. Yet among the thousands of expats we help, we often hear “I don’t think I need medical insurance at the moment.” This is indeed true for some people, such as if you have a company sponsored plan in place, but let’s have a look if this is really necessary for you.

Isn’t Medical Treatment Really Cheap in Public Hospitals?

The cost of basic medical treatment in public hospitals is cheap. But surgical and other major treatments can still cost well over US$ 10,000. If you don’t have at least US$ 10,000 down the back of the sofa you need medical insurance cover. Also check out this article on the cost of medical treatment in China at different types of hospitals and international clinics.

Social medical insurance doesn’t cover all the costs and only covers you in certain public hospitals. Advanced treatment like keyhole surgery, cost of blood transfusions and imported medication are usually not covered. Some people also find not knowing the language and the hygiene standards in public hospitals to be a big worry and barrier for effective medical treatment.

Whilst I was working for a Chinese insurance company I had the unfortunate situation of handling the case of a young North American. He was driving his scooter when a serious accident occurred. A car collided into him and he was rushed by ambulance to a public hospital in Suzhou for emergency treatment. Due to infection, he required two successive amputations on the same leg and at one point his physician gave him a less than 50% chance of survival. Fortunately the infection reduced and he recovered enough to fly back to Canada for rehabilitation. The total cost of treatment at the public hospital was over CNY 350,000 and was covered by his health insurance plan. A harrowing account but serves as an important reminder.

If Anything Goes Really Wrong I’ll Just Go Back to My Home Country Anyway?

I don’t think you’ve thought this through! This might work if you’re diagnosed with cancer or a non-urgent medical condition. But if you’re hit by a car crossing the road or slip on a step and severely injure yourself, exactly how do you intend to get home? Roll yourself on a hospital bed to the airport? Have a mate carry you whilst you’re suffering serious medical issues. If this is your plan B think again, it wouldn’t even make my plan Z.

And if you think the chances of getting injured in China are low, they are, but they aren’t low enough to ignore. According to this WHO article mortality rates from accidents are significantly higher than they are in developed countries. I’m from the UK and even back home if I didn’t have access to free healthcare I’d purchase a medical insurance plan.

I’m Covered Under the Chinese Social Medical Insurance, Do I Really Need Extra Cover?

You might already have extra cover beyond the standard social insurance we all have through our work. A lot of companies provide an employee benefits top-up plan which aims to cover some of the co-payment parts of the social medical insurance program, or might also include an accidental death and dismemberment plan.

But don’t take this at face value, dig in to the details, and in most cases you’ll find that you still don’t have adequate cover. Let’s take the example of my Chinese mother in-law. In 2016 she needed to undergo a heart valve repair surgery. She went to ZhongShan hospital which is covered under her social medical insurance plan. We expected pretty much everything to be covered under the insurance, however in reality we were left with CNY 100,000 in medical costs not covered under the social insurance…I was as shocked to say the least. This also meant I needed to skip my trip home that year to replenish my savings.

So despite having social medical insurance why was so much not covered? The imported medicine which was integral to the treatment isn’t covered, the keyhole surgery wasn’t covered and even the necessary blood transfusion cost over CNY 10,000 and isn’t covered.

It wasn’t all bad, my mother in-law recovered well and luckily I’d donated blood in the past as a student here and had my little red blood donation book, this got us a CNY 5,000 discount on the blood, small mercies.

I’m young and healthy and haven’t been to the doctor in years, so I’ll risk it.

Okay so you’re young and healthy…nice for some.

Being young and healthy isn’t a reason not to buy medical insurance, it’s actually the perfect reason to buy medical insurance. We come across plenty of expats who say to us, “I need medical insurance, recently I was diagnosed with an illness.” or “I need medical insurance, I recently had an accident and now have back problems.” When I hear this my heart sinks a little. Often when this happens you are no longer eligible to buy any private medical insurance or it’s very difficult and more costly. Sometimes you can get medical insurance but the ongoing costs or future relapse of your existing condition will not be covered. Once this is explained we often hear people say ‘I should have looked at this earlier.” or “I’ve been meaning to buy insurance, but just didn’t get around to it, is there anything we can do?”

Getting a long-term health insurance plan when you’re young and healthy is always a smart move.