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.

Insurance Options in China:
• Insurance at an international company located in China (AXA Minmetals Interglobal, MSH)
• Insurance via your home insurance
• Insure at a Chinese company (IMG Ping’An, Goodhealth Chinalife, Taiping)

Public Care

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.

Private Care

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.

Basic Plans:
• Individual plans
• Family plans
• Group plans
• Travel plans
• Teacher plans

The main coverage options to consider before purchasing a plan:
• Chronic & Pre-Existing Conditions - These can potentially affect the insurer's decision to provide cover. For group insurance, according to the number of employees and the gravity of the conditions, the insurer will still consider to cover it.
• Dental
• Emergency Assistance and Evacuation
• In-Patient: Treatment at any medical facility or hospital where an overnight stay is deemed medically necessary. Coverage typically include: organ transplants, x-rays, pathology, ambulance transportation, MRI-scans, PET-scans, CT-scans etc.
• Traditional Chinese Medicine
• Out-Patient: The procedure does not require hospital admission and may also be performed outside the premises of a hospital
• Maternity
• Deductibles: The amount of expenses that must be paid out of pocket before an insurer will cover any expenses. It is normally quoted as a fixed quantity and is a part of most policies covering losses to the policy holder. The higher the deductible, the lower the premium, and vice versa.
• Geographic Coverage: Do you need mainland China only, worldwide, etc.
• Waiting periods
• Payment options: The major players on the insurance market have a wide network of medical facilities where you don't need to pay in advance. It is recommended to use these hospitals within the insurers network.

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.

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