Chinas insurance market is still at fairly immature when compared with developed countries. Domestic insurance companies dominant, but a few foreign insurers are now there. Many facilities will not take foreign insurance. The China Insurance Regulatory Commission (CIRC) is an agency of China authorized by the State Council to regulate the Chinese insurance products and services market and maintain legal and stable operations of insurance industry.
The basic medical insurance program covers all employers and employees in urban areas, including employees and retirees of all government agencies, public institutions, enterprises, mass organizations and private non-enterprise units. This has recently been an issue with little coverage in rural areas, but they are working to change that.
Both employees and employers are required to make contributions to this fund. The premium paid by the employer is about six percent of the total wage bill, while that paid by the employee is two percent of his or her wage. Retirees are exempted from paying the premiums. The individuals' premiums and 30 percent of the premiums paid by the employers go to the personal accounts, and the remaining 70 percent of the premiums paid by the employers goes to the social pool program funds.
Insurance companies in China require patients to first pay for treatment, and then send all claims and receipts to the insurance company. Some of the best hospitals in China have direct billing arrangements with certain international health insurance companies. Outpatient treatment fees charge smaller amounts and are mainly paid from the personal account. Hospitalization expenses and larger amounts are paid mainly from the social pool fund.
The minimum and maximum payments from the social pool fund are clearly established.
The minimum payment is about 10 percent of the average annual wage of local employees.
The maximum payment is about four times the average annual wage of local employees.
If the hospital is based in the city in which the medical insurance premiums are being contributed this is very straight-forward, but if care is given outside of that area reimbursement can be difficult to receive.
Health insurance policies can be fully customized to meet individual needs and requirements. Understanding the definitions and key terms of a policy means that you know what to expect from your plan.
Individual Insurance: A policy that you purchase from an insurance company on your own and not through an employer to cover your health. You can choose coverage either for your own or including your family. Even if you have pre-existing conditions, some insurance companies still provide coverage for you. Since this policy is covering you alone or just including your family members, the premium is usually higher and more expensive compared with the group plan.
Group Plans: Purchased by the employer to cover their employees. Basically, the premium is relatively lower than an individual policy because it is based on a group of people who have the similar job base. An important note, there is no assurance that the employees are covered by the policy once they are retrenched by the employers or they have resigned from the company.
With so much to deal with before leaving your home country, (taxes, moving house, paperwork etc.) the careful planning of your expatriation to Beijing is an essential step. As far as healthcare is concerned, your local social security scheme won’t be accompanying you to your host country and, once abroad, you might be surprised by the care system you find in China. So, before leaving, make sure you have appropriate cover!
EasyExpat.com works in partnership with APRIL International to provide specific insurance solutions for travelling or staying outside your country of nationality.
Designed for either short or long stays, APRIL International’s insurance policies offer protection against any problems that might arise before departure or during your time in China: cancelling your trip, medical expenses following an illness or accident, needing to be repatriated, causing damage to a third party or losing your luggage.
For more information on expat health insurance in China, visit our partner APRIL International