How much does expat health insurance in China cost?
Average costs for a medical insurance in China for foreigners covering both in&outpatient benefits will be RMB 37,219 per year*.
- the above is average costs for a plan covering Worldwide excluding USA for a 40 years old person
Premium range in the country is devastating, as an expat living in China you can get a health insurance plan with low limits for less than RMB 2,000, while more premium insurance companies like Bupa can easily charge you over RMB 100,000. Lower premium always refers to less coverage, in many cases copayments from your side as well as a large list of exclusions*.
There are other factors that determine the costs as well. Your age, access to foreign and international doctors throughout the country, deductibles (if any), and in rare occasions the city where you live in China. In addition to these factors, pre existing medical conditions are also reviewed on a case by case basis, and may or may not be covered under the plan depending on the insurance company and their standards of underwriting. Let’s dive into the details.
*No matter how expensive your policy is, every insurance company has its own exclusion list, things they won’t cover under any circumstances. While most things are common among all companies, some for instance will not cover sleep treatments related to apnea, or durable medical equipment such as crunches or wheelchairs. Always refer to the policy wording for the exact list of exclusions.
Inpatient – Core cover
The base package for any medical insurance plan is inpatient cover, sometimes referred to as core benefits. The core plan is designed to cover the cost of an emergency or planned stay in a hospital where a person is hospitalized and spends at least one night. For example planned medically necessary surgery, or a large accident or medical emergency which requires hospitalization. The average cost for a 40 years old person looking to get this type of health insurance plan in China is around RMB 13,287 per annum.
About half of insurance companies in China offer deductibles* only for inpatient care, which helps to reduce the costs of the core plan by 30-50%. In our experience, the most suitable option is to have a deductible of around RMB 10,000-15,000 which will save you roughly 25-30%* Any deductible above this amount will not reduce the premium by the same percentage, meaning there is diminishing returns on paying more out of pocket relative to the lower premium you pay for the plan
*Deductibles, sometimes also referred as excess, is a fixed amount that the policyholder must pay out of pocket first, before the insurance company begins covering any bills. For example, a RMB 10,000 deductible means the policyholder must pay 10,000 RMB out of pocket before the insurance company begins covering treatment. The deductible is set per year, meaning that each year the deductible will return to the selected amount.
Outpatient is the second kind of package for a medical insurance plan. Adding outpatient benefits such as clinical doctor visits, prescriptions and therapies will increase the costs by RMB 13,432 for a 40 years old person. For example coughs and colds, minor scrapes, broken limbs, orthopaedic consultations and literally anything that doesn’t require a person to spend a night in the hospital (be hospitalized).
Outpatient is where insurance companies reimburse the most. A person can be insured for 5 years and never be admitted to a hospital (inpatient care) and thus not have a single inpatient bill under the plan, but can easily have 3-4 outpatient doctor visits each year. This is related to lower back pain, skin rash, or a simple cold during the winter season.
Most expats in China, over 76% based on our research, have a medical plan that covers both in&outpatient benefits.
Having deductibles for outpatient care is much less of an attractive solution in our experience. People who tend to visit doctors more than 2-3 times throughout the year in the vast majority of cases prefer plans that are fully covering this part. The discount on adding deductibles to the outpatient part of a package can be anywhere from 1%-4%, which pales in comparison to the cost of a single outpatient visit.
Not all companies offer a dental package, and it cannot be purchased separately. As a foreigner in China you have the option to add dental coverage to your plan. A dental plan that covers RMB 6,000 in benefits will increase your premium by approximately RMB 3,000 to 3,500. This is enough for an annual teeth cleaning and maybe one or two other visits if you live in a Tier 1 city in China. For kids, the premium surcharge on dental benefits is often lower. Several insurance companies also do not provide preventative dental benefits for minors. Please get in touch with us here for more information about which companies offer which dental benefits.
For those looking to cover braces, implants and orthodontic treatment, there are only a few companies that offer high enough limits to cover these kinds of treatment. Allianz, Now Health and Bupa each provide more than RMB 15,000 dental benefits per year. Adding a dental package to their plan will increase the premium by approximately RMB 6,000-7,000
Wellness covers annual medical checkups, vaccines or tests which are not medically necessary. To make it simple, wellness covers preventative tests and treatment, which are otherwise not covered under any plan. For example if you need a COVID test for travel, or a flu shot during winter season for your kids.
Most insurance companies in China view wellness benefits as a strict liability which is why costs to cover Wellness are quite high. Some companies will allow you to add RMB 3,000 of Wellness coverage to their plan, but will charge RMB 2,600-2,700 for this benefit. Some companies like Aenta and ICBC AXA will add wellness into their plans at no extra costs to be more competitive on price. Please speak with us here so we can share with you the companies that offer the best wellness packages.
How can plans be tailored to reduce the costs?
Some policies will allow you to remove dental and wellness benefits to lower the price of the plan. You can also restrict coverage at luxury hospitals (often referred as high cost providers) and clinics, or reduce the geographic area of cover of your plan (for example, changing the area of cover from Worldwide Excluding US to Mainland China). Quite often plans covering China only can still cover you overseas for emergency & inpatient situations, very similar to travel insurance.
- excluding high cost providers (luxury hospitals and clinic) from cover typically reduces premium by 25-30%
- reducing the area of coverage to China only compared to Worldwide excluding the US in most cases will save you 5-8% of the premium. However, certain companies such as ICBC AXA and Aetna will provide a greater discount of around 18-20%
Does it matter where I live in China?
Only a few companies factor in the primary city of residence into the cost of your plan. Recently there has been a launch of a few plans offering around 10% discount for members who live outside of Tier 1 cities (Shanghai, Beijing, Guangzhou and Shenzhen). That usually means that 80% or more of the medical expenses under the plan should come from places other than Tier 1 cities. If you live in Ningbo but travel to Shanghai for your medical care, this kind of discount is not an option.