Articles

Health Insurance - Living Shanghai

Questions commonly asked concerning international health cover in Shanghai:

Maternity insurance

How long must we wait?

• Waiting periods for individual policies are typically 10 or 12 months, after which time you can begin to claim prenatal and birth costs.
• Given a typical normal pregnancy and delivery cost of around US10,000-US 15000 in Shanghai (and Hong Kong for that matter), many people focus on this.
• Consider the possible lifetime costs, for example treatment of a child born with complications. Few basic plans will cover serious problems, and fewer still
• will guarantee cover for a child conceived by assisted reproduction (e.g., IVF).

Evacuation Insurance

• The UK firm Bupa International is one of the few to offer “Repatriation” cover, which gives you a choice to return to your home country for treatment.
• Most insures offer evacuation only on the basis of a life threatening condition, where suitable local facilities do not exist.
• Make sure your evacuation company knows and understands the local environment.

How much cover do I need?

Is just hospital cover enough?

• People often focus on hospital cover but ignore the fact that if we are hospitalized, we often need follow-up treatment with doctors and specialists. This is especially the case with something like kidney dialysis or chemotherapy, which may require outpatient treatments.
• We know of one case of a man who lapsed into a coma and was rushed to the Adventist hospital in Hong Kong. The cost of nearly 10 weeks in intensive care was around US 900,000. Beware of plans with a limit per condition and look for those without a lifetime maximum.

What about pre-existing conditions?

• Some of the American group plans are relaxed about pre-existing conditions and exclusions in general (even covering AIDS). For most of the rest of the world, the attitude toward pre-existing conditions will either be to exclude cover for any related issue or, less frequently, to charge a “loading fee” to cover the condition.
• Be careful to disclose fully your medical history. Time and again we have witnessed the results of what may have been an innocent oversight

Can I retain cover when I return “home” to settle?

Most commonly “No”, especially to North America, but there are exceptions.

What about taking a deductible to cut costs?

If your concern is more the bigger than the smaller bills, you will often do well to take a deductible. However, you will normally find that the premium will NOT be reduced by the amount of the deductible. So if the annual premium was US 3,000 say and you opted for a US 1,000 policy year deductible, the premium may only reduce to US 2,2500. But if find your self claiming beyond the deductible, you will find that instead of paying US 3,000 for medical expenses, you end up paying US 2,500 +US 1,000 = US 3,500.

Thank twice about the deductible you choose.

Some companies will not allow you to change your deductible and others will require you to complete a fresh application form and underwrite you. A high deductible when you are younger may not be so attractive when you are older and more likely to claim.