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Health insurance for expats in China

This guide aims to give an (impartial) overview of some international insurance plans on offer in in China. When I first came to China in 2005, I just used a Dutch insurance (Joho – Special Isis). Because that one expired after 4 years, I was forced to take a new insurance. I wrote this guide, because apparently there are no good guides to picking an insurance for expats in China. I only found some incomplete posts on several forums.

update February 2010: I've collected lots of information from various insurance companies. I aim for a budget of around 2000 USD per year including outpatient benefits without dental benefits. For each insurance company I list down the most important considerations. It has been quite a lot of work and I'm sure there are some mistakes in the table, but I hope it's useful advice for anyone who is looking for an expat insurance in China. I provide links to each insurer so you can evaluate each plan yourself in detail.

update 2: Added more information from MSH China
update 3: december 2010, attached a document from IMG ProtExPlan.
update 4: december 2010, updated Chartis insurance: full coverage emergency evacuations


note to insurance companies or expats: if you find any errors on my page, please let me know .

Some common tips:

  • Since I live in China and rarely go abroad, I don’t really need an international insurance. I definitely don’t need an insurance that covers North-America (which is always much more expensive)
  • Health-care in China is quite cheap, so it doesn’t make sense to have a large ‘excess’ or ‘deductible’ in your plan. An excess of ’50 euro’ for example would mean that you always need to pay the first 50 euro for each event, and the insurance company only pays over that amount. In China this doesn’t make much sense, unless you really want to go cheap. I prefer 0 excess.
  • Chinese insurers such as Ping An, China Life don’t have good information for foreigners. They should theoretically be cheaper and it's possible to buy those insurances, but who wants to deal with all the Chinese paperwork?
  • Chinese insurances are quite different: they offer long-term health and serious-disease insurances. For serious-disease insurances you pay for example 20 years long a yearly fee. If you happen to get one of the covered illnesses, you will get paid immediately. If not, then you can withdraw your money after X years. The serious diseases are really only the very worst, where you either die or get permanently handicapped, so it's not something for normal surgeries.
  • Some companies only offer insurances to companies or groups or to specific nationalities.
  • Pay special attention to things like renewal of the insurance after each year; can they deny you or is extending your insurance guaranteed?
  • Dental insurance is generally expensive, and in China the dentist is really cheap. Think carefully if you want to spend 400 US$/year on a service that might only cost 200US$ in the worst case in China.
  • Most foreign clinics and hospitals are located in Beijing, Shanghai and Hong Kong. Guangzhou, Shenzhen and other Chinese cities have much less especially for foreigners. Direct Billing is usually only available in BJ/SH/HK.
  • Consider if you need health insurance at all, I know several people who just save some money in their bank account. If you get some very serious illness, this is not a good option, but since normally medical bills are quite affordable in China, it's definitely something to consider. Even if you stay a few days in a hospital, you probably don't pay more than a few thousand RMB anyway. I recommend always getting an insurance, but if you are on a tight budget, it's a valid option. Otherwise try to get at least a local Chinese insurance.
  • money saving tip: you can get discounts on your insurance! Those insurance sales people get quite a hefty bonus on each insurance they sell. You can ask for a discount and they will probably give you one. For an insurance of about 2000 dollar, it should be possible to get a discount of 500+ yuan!



All prices in the overview below are in US dollars:


Company Aetna AXA AIG/Chartis Allianz Bupa William Russell IMG/Ping An MSH DKV Globality Vanbreda Nordic Healthcare
Plan name Foundation Comprehensive GHSH 150 (with OP) Essential + Crystal Worldwide + Plus+ Wellbeing
Elite Silver Standard Greater China Plus Plan Plus Globe Gold
Annual limit 1,600,000 1,700,000 2,000,000 (250,000 per disability) 710,000 2,550,000 1,800,000 2,700,000 Lifetime 300,000 Unlimited 1,250,000 2,000,000
Geographical Coverage Worldwide excl. USA Worldwide excl. USA Worldwide incl USA Worldwide excl. USA Worldwide excl USA Worldwide excl. USA World ex US/CAN Greater China
Worldwide excl. USA World ex US/CAN World ex US/CAN
InPatient (Hospitalisation) Yes Yes Yes Yes (semi-private) Yes Yes Yes Yes (pre-auth required)
Yes Yes Yes
OutPatient (GP, Clinic, Specialists, Drugs) Yes 8,500 General and Specialists Up to 5,000 Up to 3,550 Up to 42,500 with sub-limits Yes Up to 10,000 Yes Yes Yes, mostly 20% Coinsurance Yes
Excess / Deductible per person 100 per condition
inside DSN
10% Outpatient Coinsurance 0 0 425 Inpatient / 170 Outpatient 0 (was 20% loading) 100 per condition 40% copayment depending on provider
350 per year 0 600 per year
Dental o Up to 850 with 25% co-insurance Optional No Yes, part of wellbeing
No NA Emergency 1,100
Routine 70
Yes
No No
Dental Waiting Period NA 6 months after enrollment
NA No NA NA NA Yes
8 months for major
No NA
Chronic Conditions Acute phases only Palliative 85,000 lt, Acute full
Not mentioned Yes Yes with waiting period Acute full cover, Palliative 1,000 Acute full cover, Palliative up 38k (lt) Yes Yes Yes Yes
Emergency Evacuation Covered in full Covered in full Covered in full
Covered in full No (Optional)
Covered in full  Covered in full Yes Covered in full Covered in full Yes
Coverage out of Geographical Area - Unscheduled Treatment Unscheduled Treatment Up to 51,000 Worldwide coverage 42 days, max 14,000 No None Up to 38,000 and 45 days Yes Up to 6 weeks 90 days per year Unscheduled Treatment
Renewability Lifetime Lifetime Conditionally up to age 75 Lifetime Lifetime Lifetime Up to 74 Enroll 65, renew 70
Lifetime Yes up to age 80 Lifetime
Claims Handling (China) Direct Billing *  Direct Billing* Direct Billing* Direct Billing*  IP - Direct Billing   
OP - Reimbursed
Direct Billing*  Direct Billing* Direct Billing*  IP - Direct Billing / OP -Reimbursed IP - Direct Billing    OP-Reimbursement IP - Direct Billing    OP - Reimbursed
Underwriter Aetna Interglobal AIG Allianz    Bupa Allianz China Ping An MSH DKV Munich Allianz Allianz
Established 1980 1987 1992 1980 1947 1992 1999 2000 2007 1959 1927
Out Patient Chiropractor 10 visits Up to 1,700 Not covered 710 Up to 30 visits 10 visits 0 Up to 500 Up to 700 Up to 1,250 Up to 1,500
Annual Medical / Well Being No Up to 680 No No No Up to 240 after 1 year Up to 280 after 1 year No Up to 350 Up to 750 Up to 300 after 6 months
Vaccinations No Incl. Wellness benefit No No No No 0 No
Up to 350 Under Well Being Benefit Yes incl. in Wellbeing
Coverage of Pre-existing Medical Conditions 2 Year Moratorium 2 Year Moratorium No Possible coverage with loading No Exclusion After 2 years up to 38k (lt) Possible after waiting period Possible coverage with loading Possible coverage with loading Possible coverage with loading
Annual Premium USD-Age 29 1,793 1,705 1,989 2,278 2,981 2,319 1,815 2,490 2,608 1,770 2,777
Impression website Bad, USA only Bad global, good overview plans Great Good Good
Good Bad, Chinese only Good Reasonable Good Good
Website www.aetna.com  www.axappphealthcare.co.uk  www.aiggeneral.com.cn allianzworldwidecare.com  www.bupa-intl.com  www.william-russell.com  insurance.pingan.com  www.mshchina.com  dkv-globality.com www.expatplus.com  www.nhcglobal.com 
Online quote only Americans using Internet Explorer After providing all personal data Freely available Customized free quotes Simple form, immediate quote
Yes, limited personal data No, contact sales people No, form + email Doesn't work Yes, simple form No quotes for China

* Direct billing: most international insurances only have a direct billing network in Shanghai and Beijing. Some have it in Guangzhou, Tianjin and Hong Kong as well, but Shenzhen is not included in most plans, so it's of little benefit to me. If you live in Shanghai or Beijing, it's definitely something to take into consideration. 


My insurance:

I have decided to buy Chartis GHSH 150 with Outpatient insurance (about 1989 USD / year). I like the fact that Chartis has quite a clear policy and doesn't seem to require upfront approval of almost all treatments. Just hand it in after your treatment is done. Outpatient has a limit of 5000 USD which is not a lot, but probably more than enough in China where most treatments are very cheap. Since my employer pays for the insurance, I also wanted to pick a low deductible; Lots of insurers have deductibles that are global, for example 100 USD. That makes little sense in China, because most of the time the costs will be well below 100USD. I will consider several of the other insurance options next year again though, because I don't like worldwide coverage (I only need China) and some other companies seem to offer better coverage.

I also bought an AIA serious disease insurance (7780 yuan per year) because you can get money back, and that it offers more continuity over all the yearly insurances. You still need to pay per year and you can stop each year, but the longer you continue, the more money you collect in your account. If you ever happen to get (very) sick, then at least you have some money to take care of it. I treat this insurance more as a life-insurance than a health-insurance, because it only covers the worst possible diseases where you either die or permanently get handicapped. Some more details about how this works: you need to pay for X years (in my case 20) and if you get one of the few covered illnesses during this period, they will pay you a fixed amount of money. If you don't get sick, you can get part of your money back at the end. It's a bit like saving money in the bank, but you also get the benefit of insurance in the meantime. As long as you didn't get your money out, you are still insured. Many other Chinese insurance companies offer similar schemes (Ping An for example). The benefits are : cheap and you can get some money back if you stay healthy. Disadvantages: no substitute for a real health insurance and if you get sick, they don't pay much either.


Other impressions insurances:


+ AIA - Chinese insurance 

My girlfriend made an appointment with a salesperson from AIA, Chinese branch. They don't offer any policies on their website, so you really need to talk to them individually. We asked about this, and the guy said all Chinese insurance companies work like this. I guess they want to get your contact information and they expect better conversion rates like this. Anyway, what we found out was the following: they don't offer out-patient insurances, only in-patient and a separate serious-diseases insurance.

The normal health-insurance is paid just on a yearly basis and is quite cheap: about 1200 yuan per year for the most expensive offer for people aged 18-29. This insurance is non-refundable and they pay quite little as far as I am concerned: only about 10K rmb/event. Apparently this is enough for an appendix surgery (the sales-guy said about 5K rmb). You can pay also several times the rate and then you get several times the coverage as well.

This is for the normal health insurance, scanned for your information :


thumb_aia_insurance_startinchina
click for full-size version

   

++ AIG Global Health / Chartis - http://www.chartisinsurance.com.cn/en/en_index.html

Great website, clear information, immediate access to quotations (Expatriate Medical Insurance, pdf at the bottom) without filling out details. Reasonable prices as well and three different packages (GHSH 150, 350 and 400). It would be nice if they offered to exclude North America for GHSH 150 or to include out-patient into 350, but all packages are quite reasonable. Has offices in Beijing, Shanghai, Guangdong and Shenzhen. Insurance is targeted at the Chinese market.  I have bought this insurance myself (GHSH 150).

Contact information (English speaking) - printed with permission :

Lucie Lu (Support department of Shenzhen Chartis insurance)
11 Floor, Diwang Commercial Center,5002 Shennan Road | Shenzhen| 518008
Phone: +86 755 3685 6162
Email: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 


++ Allianz Worldwide Carehttp://www.allianzworldwidecare.com/
One of the biggest insurers worldwide I guess and although their website is a bit overwhelming, they have a good quotations page (http://www.allianzworldwidecare.com/individual-international-health-insurance-cover-quote ). I got a quote for about 1800 euro for a classic individual plan + crystal individual out-patient plan.
Great overviews:
http://www.allianzworldwidecare.com/compare-our-out-patient-plans-for-individuals
http://www.allianzworldwidecare.com/compare-our-core-plans-for-individuals


+ Bupa International - https://www.bupainternational.com/
Impression: looks professional, backed by Allianz. Bit too expensive, nice to have option to exclude North-America.  Can get quotations online (after fill out some data). Price for all-in-coverage: about 3289 euro (inpatient+outpatent+preventative checkups, ex-USA). Too expensive for me.

 

+ IMG ProtExPlan - http://www.protexplan.com/

Impression: this insurance was mentioned to me by another expat living in Shenzhen. I like the fact they give a clear overview of their insurance on their website and you can immediately see the costs.

Costs for someone aged 30 without cover for USA range from 2704 US$ (gold cover) to 1784 US$ (silver cover) to 917 US$ (bronze) and this is with nil deductable.


  + MSH China  (also GBG) - http://www.mshchina.com/
Chinese insurance company that offers a decent website and online apply for quotations and they have some plans especially for Greater China. MSH China is the brand new joint venture established by Shanghai Tai Kai Business Management Co., Ltd (STK) and Mobility Saint Honoré (MSH) in June, 2009. MSH has three ISO certified claim centers located in Paris, Calgary, Dubai, and soon Shanghai, which proves our commitment to continuous pursuits for service excellence.

Greater China Plus Plan
  • Routine and Emergency coverage in Mainland China, Taiwan, Macao and Hong Kong.
  • Other areas are deemed restricted areas, where only Emergency coverage is covered.
  • Emergency coverage must be approved by our Care Coordination Company.

I think this insurance is too expensive for the levels they offer. Sure, it includes some dental insurance (but low limits) and outpatient, but the cost is too high compared to other insurances, especially considering the 2M RMB annual limit.

 ~ Ping An - http://insurance.pingan.com
One of the major Chinese insurance companies, unfortunately their entire website is in Chinese and you can really only get information about their products if someone who reads Chinese can help you. They have some English material about their products, but it is hidden behind many pages of Chinese.


+ William Rusell - http://www.william-russell.com
Website looks professional, won an award previously for service. Online comparison of plans and easy access to quotations: http://www.william-russell.com/benefits/compare/ Global Health Elite Silver (with outpatient) looks good. Price for Silver (no access) + travel + accident (no USA cover) was about 2500USD/year. Their guide mentions something about renewal of the insurance each year after their approval. Not sure what to make about that.

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henrique   |116.76.209.xxx |2009-12-27 00:10:44
Ik had in mijn eerste jaar ook ISIS maar betaalde 400-500? euro maar met een eigen risico van 50 euro, nou hier in China kan je daar best veel voor doen dus heb het na 1 jaar opgezegd, had alleen een tandarts rekening van 65 euro ( bij westerse tandarts in Diwang, 3 xrays, consult en nieuwe vulling) dus kreeg 15 euro terug woohoo!Nu stort ik gewoon jaarlijks 300 euro - 3000 rmb op mijn Chinese rekening en mocht ik onverhoopt hier in het ziekenhuis komen betaal ik het daar wel van.
Mijn vrouw heeft wel voor 100rmb per jaar bij PING An voor mij een of andere Accident verzekering afgesloten mocht ik een ongeluk krijgen in een auto, bus, vliegtuig dan krijg ik wat ziekenhuis kosten vergoed (en een uitkering mocht ik het loodje leggen tijdens dat ongeluk), het fijne weet ik ook niet precies hiervan maar ach voor die 100 rmb
Thijs     |219.134.27.xxx |2009-12-27 00:22:05
Precies, ik ben het helemaal met je eens. Alleen zit ik in de luxe positie dat mijn werkgever een aardig bedrag beschikbaar stelt om een verzekering te kopen. Dan kan ik dus maar beter het geld uitgeven, aangezien het mij toch geen cent kost
Henrique   |116.76.209.xxx |2009-12-27 09:41:17
Oh ok dat is mooi meegenomen, en ook nog feestjes van QQ, trips etc ik heb toch echt een verkeerd beroep gekozen
Laat het ons weten welke je uiteindelijk heb genomen.
James   |210.72.234.xxx |2010-01-21 11:14:43
Actually, Ping An does provide information in English and they are easy to deal with. I phoned them last October and they emailed me their policy information in English. Afterwards I visited their office in Beijing and spoke to a salesman. Ping An provides various levels of insurance for individuals for in-patient care. The rates depend on your age and the level of hospital care you want to insure for. In my case (age 36) the basic rate was about RMB 3500 per year, covering a list of possible medical procedures, a certain maximum number of days etc. with a discount for renewing the policy the following year). If you want to insure a higher medical event cost / have a higher level of care while you are in hospital the rate will be higher. A number of hospitals direct-bill to Ping An including BUFH and Amcare.
Thijs  - Ping An     |219.133.154.xxx |2010-02-15 00:54:22
Thanks for the tip James! I have found a Ping An insurance on the website (hidden behind many Chinese pages) and added it to the overview above. They work together with IMG to offer an expat insurance. The insurance I found is different from the one you mention though; 3500RMB is quite cheap (which makes it a great buy if you are on a budget) but probably comes with many limitations. The insurances I list above have much higher insurance limits and fewer limitations.
Paul  - health insurance   |59.61.3.xxx |2010-02-15 18:07:49
Very interesting study. Wished I had noticed it earlier, since my wife just bought an insurance in China. But with your study we would have had a good way to compare.
For myself (Dutch origin) I have already for years an insurance at a Dutch company "Oom verzekeringen" who are specialized in insurances for expats. https://www.oomverzekeringen.nl/nl.aspx (Also in English)
I pay a lot more than the table above, but I have extra insurances in the package such as travel, liability, Legal aid, molest, accident. And my age also makes the costs higher. But I will study above more severe, maybe I switch ?
Thijs  - thanks     |61.141.157.xxx |2010-02-15 20:31:46
Thanks Paul! I know "Oom verzekeringen" (I considered that one as well before I moved to China). There are indeed lots of options available from the various insurance companies; the ones I listed are mainly for health-insurance only. Several companies offer additional travel insurances which cover luggage etc.
I still hope to add some more plans to the list, especially Chinese insurance companies / at the cheaper end, but it's hard to collect the information from them.
Paul  - Health insurance   |59.61.71.xxx |2010-02-15 21:47:28
Oom doesn't have a time limit anymore. It became lifetime.
Paul  - Chinese health   |59.61.71.xxx |2010-02-15 21:57:04
I watched closely my (Chinese) wife looking for the insurance. Stroke me that they consider it like an investment. Calculate how much can earn back after 'x' years. Don't care what's insured and what not. On my advise she pushed to get more info what really is insured instead the A4 what they give you. Still not very clear. Terrible desease, rather vague I think. Anyway, the costs are very much less than I pay with Oom. But what is really insured ? guess we find out when something happens (hope not of course)
Thijs  - Chinese serious disease insurance     |61.141.157.xxx |2010-02-15 23:52:49
I also did one of those I never heard of this kind of scheme before I went to China. Mine (from AIA) is very similar to yours: it only covers the worst-of-the-worst diseases, so I see it more as a kind of life-insurance than a health-insurance. I'll update the page to point this special kind of insurance out!
Hildebrand, The Insurance Ward     |66.205.157.xxx |2010-03-02 03:19:23
No Chinese insurance companies offer policies over their website? If it were so here in the States, I'd guess it owed to an imbroglio of legislation, but over there, I can only imagine it represents a significant gap for marketers to fill.
Thijs (Shenzhen)  - yes, very strange     |61.141.242.xxx |2010-03-03 21:05:18
I agree; it's very strange they don't offer online information. Perhaps things will change when the market becomes more mature? Most Chinese don't have any choice for health insurance, they just get one via their employer (if they have insurance at all).
Hans  - mr   |116.24.226.xxx |2011-01-31 20:03:47
Dag allemaal,

Wij gaan waarschijnlijk in China onze oude dag doorbrengen. Echtgenote is Chinese. Ik ben 67. Hartpatient. Mogelijk gaan we in LonKao wonen.
Ik ben al enige tijd bezig met de ziektekostenverzekering voor mijzelf.
Kom er niet uit. Veel van dit soort verzekeringen zijn voor jongere mensen/leeftijden.
Heeft iemand een goede/briljante gedachte/voorstel?
Thijs     |116.24.226.xxx |2011-01-31 20:03:18
Hallo Hans, inderdaad zijn expat verzekeringen duur, daar is gewoon geen oplossing voor. Aangezien je al 67 bent, wil je waarschijnlijk gebruik blijven maken van je Nederlandse uitkeringen? In dat geval moet je dus officieel in Nederland blijven wonen. Je kan wel grotendeels doorbrengen in China, maar je moet ervoor zorgen dat je ook regelmatig terug bent in Nederland. Als dat niet uitmaakt, kan je eventueel voor Chinese verzekeringen gaan, die zijn goedkoop maar verzekeren je niet zo goed. Als je iets ernstigs krijgt moet je veel bijbetalen.

Ik las ook dat je hart-patient bent? Ik zou er zeker sterk over nadenken om je Nederlandse verzekering aan te houden. Ik ben al een aantal jaar weg uit Nederland, dus ik weet niet hoe de verzekeringen nu zijn in Nederland, maar het is iets om te overwegen.
Hans  - verzekeringen   |82.156.65.xxx |2011-02-01 04:24:16
Dag allemaal,

Thijs, natuurlijk heb ik er over gedacht om de Nederlandse verzekeringen aan te houden.
Daarbij komt dan het probleem dat je ook een adres in Nederland moet aanhouden, of je moet je verzekeren en als je boven de 60 bent is dat haast niet betaalbaar.
Dank voor je reactie overigens.
De vraag blijft dus, wat is wijsheid en dan wel zonder postadres.

Dutch1
health insurance   |219.133.62.xxx |2011-02-28 18:27:12
Different health insurance plans, different benefits. For instance, the insurance you have mentioned; the benefits are : cheap and you can get some money back if you stay healthy. Disadvantages: no substitute for a real health insurance and if you get sick, they don't pay much either.
doron shorr   |221.220.191.xxx |2011-04-13 18:58:08
James,
Any chance for contact # so can check out what is available at Ping An. Thanks in advance
Abacare     |88.191.96.xxx |2011-04-21 12:49:01
Hello Everobody!

Our company specializes in Medical insurance for expats in China. We've been working in China for several years already. We offer different types of insurance packages.If you have any questions, please feel free to contact us.
eric  - Mr   |122.62.126.xxx |2011-06-03 19:39:13
hello
i came across your information regarding health insurance

I am looking for a total cover for outpatient /inpatient /and serious illness /disabilities

I intend to travel and stay in Shenzhen for a few years and would like to know a reasonably priced insurance company who will front up in case of being approached when in actual need
If there is anyone who a=could help me find such an insurance company please reply to me
Thijs     |121.34.21.xxx |2011-06-03 22:03:13
The overview I wrote is about the best you can find for free. Otherwise you will get advice from insurance brokers and though they might claim to be impartial, it's hard to be sure of this since they earn a commission. My advice: just use 1 weekend to look at all the options and then make your own overview.
James A  - Question   |66.82.9.xxx |2012-01-10 09:43:17
Abacare, who are you and do you have a website. Considering moving to China to be with wife but health insurance is a major concern. This site at least if offering some very good insight to what is available. Thanks StartInChina!!

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