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Great information, however there needs to be more clarification about actual coverage and allowances.
I once had an international medical insurance policy from the States.
Became injured on a remote jobsite ouside a third tier city.
This required xrays, bloodwork and stitches at the local hospital, paid cash.
Never received a reimbursement check.
So, will all hospitals/clinics here in China accept and provide treatment without payment?
Is it required to first get approval/pay bill – then submit any fapiaos to the respective insurance firms?
It would be helpful to all here if you could attach a PDF file or provide a company website which shows what is covered and/or the limits of standard procedures/fees.
What are the pre-existing condition terms, catastrophic coverage or disease restrictions?
Kindly identify the specific coverage if there are different plans, annual costs, deductables, co-pays, etc.
Obviously I can only speak on behalf of my company so provided you except that all company terms and conditions can be different I’m happy to provide you with the benefit of my experience here.
NO is the answer to your first question. Many hospitals outside of the Tier 1 cities and indeed, many public hospitals within Tier 1 cities will not except direct billing arrangements for the simple reason they don’t need to. They don’t need the extra customers and they don’t want the extra work of providing credit to insurance companies that are often offshore and may or may not pay for the treatment provided – cash is king. A number of insurance companies and third party networks have had some success in penetrating the Chinese hospital system but the coverage is by no means complete. In our case, for outpatient treatment, we have the client pay and claim but for an inpatient case where the hospital will not except credit, we have a network of agents nationwide that run along to the hospital hauling a bag of cash! I have no idea why you weren’t reimbursed by your original insurer.
With reference to pre-authorisation, in our case this is only necessary if the member needs to be admitted into the hospital. In the case of an emergency the hospital will have an additional 12 hours to contact us to ensure that treatment isn’t delayed whilst trying to obtain pre-authorisation. Outside of our outpatient cashless network all outpatient treatment is pay and claim.
With reference to pre-existing conditions, again, all the companies are different. In our case, for individual plans, we impose a 2 year waiting period for all conditions that occurred in the 2 years before the plan started. We are not considering coughs, colds and other common ailments but we focus on those clients that have serious ongoing conditions that purchase insurance with the full intention of making claims significantly above their premium contribution. These clients prejudice our results and also impact the other members who through subsequent premium increases are subsiding their treatment. Once 2 clear years have passed without treatment those conditions considered pre-existing are once again covered.
With reference to available plans and premiums etc., I don’t want to turn this post into a sales pitch for our product as I believe that by providing honest opinions we are already marketing our services however if you do want more information about out products either contact me on my email.
Attention, I am going to make some salient points about medical care in Shanghai. Let me give some perspective. I have lived in greater China for 17 years, the last 10 in Shanghai. I work in the legal profession and I am an expat. Primarily I practice corporate law however on too many occasions I am approached to assist expats who have had unsatisfactory experiences with medical treatment in Shanghai from the foreign medical clinics.
It is disconcerting to me that these complaints are varied and all too common.
Let me point out some facts about the foreign clinics in Shanghai.
a. Staffed by foreign medical practitioners who have either failed in their home jurisdiction or been held too incompetent to practice medicine in their home jurisdiction. However, they are cheap for the international clinics to employ as they are desperate for employment and because they are cheap to employ, they maximise the profits of the international clinics which are run essentially for profit.
b. I have been approached in respect of misdiagnoses of heart conditions, paediatric issues, dermatological conditions etc etc.
c. Those local Chinese medical practitioners that are hired by the foreign clinics are usually the incompetent ones that the local Chinese hospitals are happy to be rid off. I have personally heard on several occasion of paediatricians, anti hesiologists who were dismissed as incompetent by the local leading hospitals, Ruijin, Huashan etc, ending up working for the clinics and foreign inpatient clinics, who are not concerned about incompetence provided the price is right.
d. It is a travesty that these clinics’s abilities are limited to treating mundane problems such as coughs and colds but have little or no competence with medical complications that go behind this. Meanwhile, one pays RM B 2000-4000 at such clinics to be referred to a Chinese medical specialist who five minutes before is treating a local patient for the same condition and charging 200 RMB for the same consultation. By and large, one is therefore paying RMB 3000 for an English interpreter to receive the identical treatment.
The purpose of this post is to advise you that by and large the more competent treatment is to be found in the Shanghai hospitals. For those, who still remain sceptical, ask yourself, when you are next seeing the dermatologist, cardiologist, paediatrician, gynaecologist, ask yourself this, is it better to see the specialist who sees the medical conditions and problems 50 times a day as opposed to the foreign medical practitioner who in his career, and in his or her short time in China, has much less exposure to the medical condition or problem which confronts him or her.
All the above is sad but true.
/profile/92-dextrum/?do=hovercard” data-mentionid=”92″ href=”<___base_url___>/profile/92-dextrum/” rel=””>>@Dextrum Not too long ago i had gallstones, and was rushed to Hua Shan Hospital. It was weekend, and late at night, and for this reason, i could only get help at the Chinese department.
It was, as to be expected, packed and after a long wait i got to see a doctor, who was not patient at all and told me to do MRI and blood exam.
They told me to wait one hour for the result, which i reply i couldn’t because i was experiencing acute pain. He said there was nothing he could do. I then decided to transfer myself to Parkway, which i knew was going to be much more expensive, but when you feel your life is in danger, money is the last thing you think about.
As i was rushing out of Hua Shan, i got my blood report, which i brought with me to Parkway.
When i got there, the doctors reviewed the blood exam from Hua Shan Hospital, which said i was perfectly fine. I knew i wasn’t, because i was in serious pain. Later reports stated “patient pain, grade 10/10”. Gallstones are no joke.
Anyways, they told me i was having gallstones, and since this is can be a very annoying and painful chronic condition, i was suggested to remove my gallbladder, which is a very common surgery.
I was treated very well, and the doctors seemed to be professional.
The point i am trying to make is, i have had bad experiences in Chinese hospitals before, and only go to International Hospitals when is something serious, since my insurance policy has a big deductible. Chinese hospitals sometimes may have better doctors, i can’t argue with that because i dont know. However, they are often crowded, many of these doctors have no manners and they often prescribe you expensive medicines because they get commission on it.
Sad but true.
If you have a good insurance that covers any hospital, i recommend Parkway “worldlink” and United Family. I might need to do some research, but i heard bad things about Ruijin Hospital and Hua Shan is a big No No for a lot of people.
Health insurance companies are profit-making entities which exist to help reduce the fear people may have at not being able to pay generally POTENTIAL medical bills that are out of one’s budget.
Agreed, it would be terrible to be in an accident or have a serious illness and incur high fees for the needed treatment (without adequate insurance) but if we are playing the odds, having such an accident is extremely unlikely, although it is possible.
I work for someone who holds a US passport who purchases an insurance plan for his foreign employees which is so pathetic I opted out straightaway as I did the math and saw how pointless it was to pay the premium. The problem with that plan without naming names is that if you have any serious illness or emergency it would not cover you! For example, cancer would not be covered if you got it. This boss, unfortunately, receives kickbacks from the insurance company so he pushes this onto the employees.
I agree with the idea that the foreign clinics are charging an arm and a leg for services which may be provided by medical staff that has been rejected in their home countries or here in China. I would definitely prefer to be seen by a doctor who exercises his/her area of expertise say 50 times a day vs a few times in a month or year! A girlfriend and I recently had health exams at a local regional hospital. I paid cash for everything up front and while the whole endeavour was quite different from what would happen in my home country, I felt it was overall a more thorough exam at about 10% of the price overseas. This is not, however, why we buy insurance.
We need insurance for major events, should they occur.
I seriously do not understand the thinking of insurance companies, usually making women pay a year premium before covering maternity. If a woman is happy with the company she will stay with it, and guess what – that baby and that baby’s family is very likely to be buying insurance one day as well. I guess insurance companies don’t value future investors enough to cover women who are pregnant or would like to have babies soon – which should not be such a major expense as it is a NORMAL part of human health and life and NOT an illness. In fact I believe it should be factored in to ALL insurance schemes as it is a NORMAL thing and not a pre-existing condition, not a disease and wow – could even make money in the future for the insurance company. Hmmmm just food for thought.
Best of luck to us all and may we not have to rush to an emergency room in the middle of the night!
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