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March 2023

What is preventative care and how to cover it with health insurance?

What is preventative care and how to cover it with health insurance? 150 150 China Access Team

What is preventative care?

The purpose of preventative care is to help a person deduct any potential abnormalities in their health at early stages, in many cases, before symptoms actually develop. This article will guide you through the preventative care raider on health insurance plans, how to check if you have these benefits already and if in general it worth to include it.

First of all let’s figure out what is preventative care. Most insurance companies will already have wellness raider “built into” the plan. Others will have it as elective, meaning you can pay extra and get it into your policy. Preventative care refers to something that you can use without necessarily being sick.

The following treatments are usually classified as preventative care under insurance policy. Routine health checks, preventative immunizations and eye checks. Insured member can decide to do an annual health check without having initial symptoms to consult on. If you have certain symptoms or discomfort, such consultations usually go as part of general outpatient benefit.

How can you check if your plan includes preventative care?

For that you will need to refer to your wellness raider. This is a general rule of how insurance companies list preventative care under policy structure. Number one step is to check your actual table of benefits. Entire policy structure with limits is on it. Example below.

Health Check Ups for Health Insurance

This will clearly state what the benefit can be used for as well as what limit do you have. Most insurance companies in China have limits that apply per policy year. So when you renew your plan next year, limit will be renewed as well. Example above lists that only check ups and vaccinations are covered under this raider. So if you do decide to go for a check up with ophthalmologist, this will be billed separately. There are insurance companies that can have vaccination benefits as a separate limit. Particularly for plans designed for kids. In some cases all of preventative care can be under the same limit as example below.

Health Check up in China

Does it worth to include preventative care?

If your health insurance doesn’t include wellness raider, there is a chance it goes as an optional add on. Surprisingly, extra costs for those is higher for adults than for kids. This is a case of most insurance plans in China. So does it worth including preventive care in your China expatriate health insurance?

In general, adding these benefits in terms of “value for money” is not great. Companies follow a rule where benefits vs extra costs ratio is 1:0.8. For instance, if you add RMB 2,000 wellness benefits, you should expect to pay around RMB 1,600 on your insurance premium. Reason for this is because insurance companies consider preventative care as claims that will definitely occur under each policy. You don’t have to be sick to use it, so why not use all of it, right?

Doest preventative care in insurance worth to include?

In conclusion, if your insurance plan already has wellness benefits then it is no subject to any extra costs. You are good to use them every year as limits will be renewed on each subsequent renewal of your insurance. On the other hand, it does look like adding these benefits as extra will not be a good option. But hey, we all need annual medical. And if we all do it every year for RMB 3,000, why not pay RMB 2,600 for it. Saving RMB 400 has not hurt anyone yet.

Are you looking for the best foreign and English speaking doctors in China? Read our ultimate guide on this here. 

We also discuss here importance of expatriate health insurance in China and how to get the most out of it. 

Our Editorial Team

Expatriate Healthcare in Chongqing

Expatriate Healthcare in Chongqing 150 150 China Access Team

Chongqing – Expatriate Healthcare

As per recent China census in the last years, Chongqing is ranked #1 most populous municipality in Mainland. It is also directly controlled municipality alongside as Beijing, Shanghai and Tianjin. Location of the city is in-between two major rivers, which led Chongqing to establish itself as a major transportation hub within the country. As a result, it became a very attractive destination for expatriates for relocation. All because more and more multinational companies open branch offices there. So where to get good expatriate healthcare in Chongqing?

Home to several major international and bilingual schools in China, Chongqing offers quality international healthcare to foreigners. Choices vary primarily with some large government run public medical facilities with International Departments. There are however also several foreign international hospitals and clinics.

Chongqing Expat Health Insurance

Below is the list of some of the most popular medical facilities with English speaking doctors. Foreigners and expatriates can get good quality care in Chongqing in those. Most of them have direct billing services with major insurance companies in China. This means you can go directly to obtain outpatient care without any extra steps. Always make sure to bring your medical card as proof of your cover. In that case medical facility can verify right away what benefits and policy structure you have as well as help you to arrange bills to be sent to your insurance providers. There might be some situations when you will need to take some extra steps beforehand. Such things might include pre-authorization or even applying for GOP (Guarantee of Payment Letter) for the elective medical treatment.

Raffles Hospital Chongqing 慎安(重庆)医院(RAFFLES 重庆渝北店)
Global Doctor – Chongqing Clinic 重庆环球医生诊所
Chongqing Wuzhou Women’s&Children’s Hospital 重庆五洲妇儿医院
Chongqing Hoeye Hospital 重庆何氏眼科医院
Chongqing Life Infinity Clinic 重庆聚美力诊所(重庆生命汇)
Songshan General Hospital 重庆松山医院

How to receive a treatment in hospital in Chongqing

Most of the time you can enjoy direct billing or guarantee of payment for outpatient care, if your insurance provider has such services. Inpatient care or hospitalization is very different. In many public hospitals they will require you pay deposit upfront before you can access any long term care.

Hospital will return you deposit once they received payment from insurance company. How much of deposit are we talking about, this largely depends on the treatment you are about to receive and is usually somewhere in the range 10-25% of the total costs of it. It is your duty then to notify insurance provider as fast as you can so they can start processing payment to medical facility. Notification can come pretty much from anyone, even a nurse at a hospital if she is willing to help you with that. In private facilities such as Raffles they have experience with that and will do everything for you. In government run hospitals it is quite often you will need to help insurance company and chase hospital representatives for extra documents before they can approve payment, such as detailed treatment plan, costs estimations and so on.

If you are already in Chongqing and looking for health insurance to give you great services and access to expatriate level of medical care – get in touch so we can help.

For more details about English speaking doctors in China visit our another article

Our Editorial Team

How smoking and alcohol affects health insurance in China?

How smoking and alcohol affects health insurance in China? 150 150 China Access Team

What qualifies as a smoker for health insurance in China?

As an expat in China, for an individual or family health insurance policy you will need to fill out application form to get the plan. Complexity of enrollment form depends on marketing team of insurance company. However there are a lot of similarities between questions that are asked on it between companies. Apart from regular height and weight figure, almost all companies these days ask if insured person smokes. This article will guide you how smoking and alcohol affects your health insurance in China.

General rule for insurance providers to qualify if someone is a smoker is if they consume more than 14 cigarettes. In that case form will go for further review with underwriting team. It is hard to predict the outcome of such. More conservative companies might require you to provide a recent check up report. In our experience this is largely a case if a person states they smoke more than 30 cigarettes a day. There is also a chance insurance company might apply special loading on you medical insurance in China. Loading refers to a certain % that you will be required to pay on top of a standard premium. Given the fact of course that you still want to continue with coverage.

According to World Health Organization, more than 22% of world population use tobacco on a daily basis. This results in severe chronic medical conditions over the long term. This, in particular, a major aspect why insurance companies carefully assess such situations.

Do I need to notify insurance company if I started smoking?

Situation is very different if you are already insured for some time and decided to consume tobacco. There is no specific rule that you need to notify insurance company about that as there is a continuation of cover. This means you are covered as per terms given on the initial start day of insurance contract. This is also known as a first day of the policy.

Typical results are facing special terms on your insurance coverage. Additionally, medical team might ask you further questions before they finalize the enrollment. It is important to remember that smoking habit overall brings negative impact on your health over a long-term. A person who is keen to smoke is more likely to suffer from common cough or cold than a person who isn’t. List of potential future medical conditions that can develop because of smoking is endless.

How will insurance companies treat tobacco and alcohol related treatment?

With most insurance providers in China there is a very clear exclusion in terms of what cover is available on this matter. It is common to explicitly state that they won’t cover anything related to drug addiction or alcoholism. Same goes if a person injures himself in let’s say an accident when under influence of smoking or alcohol. These exclusions may also include detoxification programs and other similar sort of treatments. Some may just state alcohol or tobacco, while there are companies that will not cover any medical treatments if a person is being under influence of “any other intoxicating substance”. This gives insurance company the ultimate role to decide if they are going to process your claim or no.

When it comes to alcohol, there is also a very similar approach for health insurance in China. Foreigners and expats shall be prepared to be asked if they drink more than 20 units per week or no. Unit refers to 250ml of beer or 1 glass of wine. Same applies for stronger spirits. Numbers higher than industry norm of 20 a week will more likely cause extra investigation. Meaning more questions from insurance company’s underwriting team to finish the enrollment. If insured person however developed a habit of drinking while being insured by the policy, there is typically no need to notify insurance company on this.

What if I quit smoking while under cover from insurance company in China?

Good news are, if your policy has been subject to special terms because of tobacco use – those can be removed on renewal date. So how can quit smoking affect health insurance in China? In many cases insurance company might also want to ask for a recent check up report. Requirements are different by each company but usually include lung CT or X-Ray. Based on this they will determine how much loading on the premium shall be removed. We have had clients who faced 20% increase in price from a particular insurance provider due to their heavy smoking habit. This has been reduced to 10% once they stopped smoking.

To summarize, if your insurance plan previous had special terms with regards to excessive use of tobacco, we can help you change it. In this case, quitting smoking can actually positively impact your health insurance in China. Our consultants also got a proven record that insurance company will be willing to re-assess the situation again in 2 years. Keep in mind that such review quite often requires recent check up report as a back up.

We will help you find the best expatriate health insurance in China at affordable costs. Get in touch for a consultation. 

Our Editorial Team