Header graphic for print
China Law Blog China Law for Business

Expat Health Insurance In China. Part II.

Posted in China Business

Earlier this year, I did a really short piece on “Expat Health Insurance in China.” Based on the comments and emails, that post was helpful to a number of people, and yet a number of additional people were requesting an update and more information.

When I came across Tony Noto’s recent article on expat health insurance, entitled, “Health Insurance for ‘Halfpats,‘” I contacted him to ask if we might run it here with a supplement listing specific sources of health insurance for China’s expats. Tony is a a Shanghai based financial planner serving expatriates in China and since financial planning includes health insurance….

Tony’s article starts out noting how the “increasing number of expats signing up for local or ‘halfpat’ packages that do not include international health insurance” means more people who need to get that insurance on their own. He goes on to note that because Chinese hospitals typically require payment for treatment, “adequate health insurance is a must.”

Tony talks of how travel insurance is not a good substitute for real health insurance because travel insurance “usually carries lower benefit limits, and/or restricts how long you can maintain coverage. Time restriction are particularly dangerous, as the insurance company effectively pushes the risk of paying for any long term medical care back to you.”

Tony gives three money saving tips to consider when buying health insurance: tips to consider:

In-patient only – This is the type of coverage everyone needs at a minimum. In-patient generally refers to coverage for emergency hospitalization, but does not cover out-patient care (for example visits to a doctor’s office or clinic for a checkup).

Geographical Restrictions – Due to the high cost of healthcare in the US, health plans that exclude coverage in the US can offer significant savings. This type of plan could be risky, however, if you have plans to move to the US since any conditions you develop could cause problems when trying to switch to a US health plan. Another issue is that some of these plans will not cover emergency care in the US while visiting, which means you would need travel insurance if you go.

Increase your deductible – A higher deductible plan could significantly decrease your premiums compared to a low or no deductible policy. This means that you pay less on monthly premiums, but more out of your own pocket if you need medical care. Limit your maximum out-of-pocket to something you can afford, and have the insurance company cover everything beyond that amount.

Tony says that Pacific Prime and Shanghai SP Insurance Brokers are two China-based brokers he knows to have experience selling expat/half-pat policies. You can also contact insurance companies directly, such as the following: 

The above lists are not complete and you can find more insurance companies and brokers selling health insurance to expats in China at NextStepDirectory.com. According to Tony, “prices are typically the same whether you obtain coverage directly from the insurer or go through an insurance broker.”

Who do you use? 

  • Twofish

    One note is that Hong Kong has a great public health system so that if you are in HK on an employment visa, there is no need at all to get expat insurance.

  • Terry

    We use http://www.abacaregroup.com/ as a broker and have been happy with their services for our mainland China halfpats!

  • Toto

    Dan/Tony,
    Thanks for running this. I know this is not the most exciting thing you could be writing about, but it’s really helpful and I don’t know where else to get it.

  • Chris

    Agree that expat/halfpat health insurance a critical issue. The potential liability from a company perspective if a staff member becomes ill or is injured while working / on the road in China is enormous. In general offshore workers compensation does not apply, nor do the domestic schemes for PRC nationals. General travel insurance schemes purchased by companies to cover staff worldwide have huge gaps in coverage that could leave staff and the company exposed to very large costs.
    Full offshore expat health insurance purchased outside China are becoming less and less viable. China is becoming very strict on insurance agents selling offshore insurance (ie. no taxes paid in China).
    The expat/half-pat schemes offered locally are becoming increasingly competitive and sophisticated. Group schemes, whereby the company purchases insurances for all expats/halfpats, are actually quite cost effective and flexible with all the features offerd by off-shore schemes and offer direct billing at major Shanghai/Beijing hospitals and clinics or are reimbursable in RMB.
    We use a group scheme from AXA-Minmetals and overall coverage and service quite good and cost effective. Cost per staff member RMB8000-14000 (depending on age) for quite good coverage.
    Keep in mind that private health insurance is not an allowable tax deduction for expats (or local staff), so income tax will need to be deducted from the staff member’s salary.

  • http://pibb.com.cn Chris Hughes

    Dear Dan,
    To follow up on all the above comments i would like to add that there are approx 20 Companies in Shanghai alone whom deal with Expatriate Medical Insurance with approx 5 whom are fully licensed Nationwide to assist all those living in China on whatever basis. There are many legal issues in China that mirror those of any developed Countries i i noticed that you mention two International Medical Insurance providers above that at present do not have a licensed Individual Medical insurance Plan in China as we speak although there are plans to change this. Also there is no mention of Insurance Companies with Medical insurance plans to suit Expatriates such as Generali, CIGNA, PICC, Ping An, whom are some of the largest Insurers Globally. To gain a full option of all the available policies in China that are fully licensed protecting the policy holder then your readers and contact need to gain expert advice from a fully licensed Broker in China whom has market experience and there are a few to choose from. PIBB is a fully licensed Nationwide Insurance Brokerage since 2006 specialising in Medical Insurance and Employee Benefits.

  • Kevin

    This story didn’t make sense to me until I followed the links and saw that the definition of “halfpat” was exactly the opposite of what I’ve been assuming for the last few months. I previously thought it must mean “someone who spends half their time abroad”, not “locally-hired foreigner who was already living in China”.
    But now I know this, I’ve got to say I don’t agree with the article at all, especially its focus on international insurance. If you were hired in China and only work in China, rather than being regularly sent to different countries, surely it’s not a problem if your employer gives you China-only coverage. Even if it’s talking about employers who don’t give any health insurance at all, why go for an expensive international plan instead of domestic coverage topped up by travel insurance when you go abroad?

  • http://www.notofp.com Tony Noto

    Hi Chris, Thanks for your feedback. The focus of the piece and reason I wrote it was because I have run into a lot of expats that don’t own insurance, or try to save money in ways that take on too much risk for the individual.
    I mentioned a few companies in this space. If you would like to provide a complete list of insurers and insurance brokers for people to choose from – that would be very helpful.

  • http://www.notofp.com Tony Noto

    Hi Kevin, I’m sorry about the confusion, I was referring more to quality of coverage than geography (I reworded the reference to make it less confusing – thank you for pointing it out).
    For your plan – find out whether your policy could cover fees at high quality medical facilities (for example – Parkway and Family United in Shanghai… there are more). If your plan has relatively low limits – understand what that means in regards to the quality of care you must accept when the stakes are high.
    Insurance isn’t really needed to protect you from a bill for a few thousand dollars, you need it for bills multiple times greater (which can happen in an emergency if you want the best quality care). Low coverage limits leave your savings vulnerable, or limit your options in getting quality care.

  • Michiel V

    I went through Pacific Prime to get my insurance and I think they were fabulous, even spoke my native language, not that that matters. I got good advice and a wide choice of providers and policies, and enough plain-language help to allow me to make an informed decision. I ended up with AXA-minmetals with coverage that suits me, although I luckily cannot tell whether they are any good, since I’ve not needed to see a quack since I got insurance. In contrast to Pacific Prime, all my attempts to get ‘local Chinese’ advice on health insurance ranged from complete ignorance to outright attempts to swindle. In any case, it pays to shop around. Knock on wood I (or anyone else) won’t actually need to use the insurance, but hey….

  • Jack

    Expat insurance is expensive. Usually around $3,000 USD a year if you live in Asia. (1 person)
    In my home country, the cost would $250 USD a year for full worldwide coverage. Get the picture?
    You want reasonable priced insurance, visit your home country!

  • Dr. Keith

    Thanks for running this. Great information both from Mr. Noto and the comments, even the guy who got all testy!

  • http://www.cigna.co.uk/ Earnest

    Thanks for the informative article, and the interesting responses above. From my experience I would recommend CIGNA health insurance. As I moving to Columbia from the UK in two months I have been researching into the different type of international health insurance providers. Many of my friends who are British Expats have recommended CIGNA Health Insurance, and have spoken of their excellent servicve. With CIGNA because of their international presence and size they can reimburse you within five working days of receiving the completed paperwork (plus you avoid having to struggle with the language of your adopted country throughout – a massive plus!) As this article mentions, choosing a provider for medical care whilst living abroad can be a difficult task given the number of options available.

  • http://www.cignaglobal.com/ Earnest

    I should add that CIGNA Global differentiates itself, from CIGNA UK, the link I accidently posted, as it is caters solely for those seeking international health insurance, such as expats working abroad.

  • James Trent

    Expat health insurance can be a bit of a worry, especially with all the other things that you have to sort out before leaving your home country. It’s an absolute must though, I can’t believe how many people don’t get it sorted and then have to re-mortgage their house etc. to pay for the results of a their new lifestyle!

  • http://www.pibb.com.cn Chris Hughes

    With regards to Kevin’s comments about non Chinese employed while already living here should only be covered with a China Only Plan, i would totally agree in principle. However please note that China Only Plans will only cover you in the State Hospitals and unless you now the system well and also have a good Broker / Insurer to Case Manage your situation then you can have some serious issues.
    1. Hospitals in China will generally not refer you to best of practice Doctor or Facility if they are not the best to deal with your problem.
    2. After Care and other issues do sometimes still exist out side of the top few Tier 3 local hospitals.
    3. If it is a serious case with need for long term reabilatation then the policies sometimes can leave you short of cover and also the person would prefer to be treated close to home and family which the insurance would not cover.
    I do believe the policies and the facilities for China Only Care will greatly improve in the next few years however today they do have limitations