back to blog
28 May 2016
Insurance & Health - Crash Course China
On May 16th at 10:38am 2016 I officially became a father. Naturally this was a very exciting and emotional time for me. After I held my baby for the first time, the midwife came took him away to get cleaned up. I sat on a cold bench outside the delivery room and started thinking about all my new responsibilities and how I need to make sure if the worst happens too me, my new family are prepared.
I was thinking about health in China, this ranges from everything from health insurance, to getting prescriptions or even just visiting a doctor with a stomach flu. I decided to write this as a “Crash Course China” guide to help other expats in China understand what is needed to live in China knowing you are safe from any unforeseen “what if” situations. I will talk about what is given to you from the state, what you can do too protect your self financially and how to manage with Hospitals inside of China.
Social Benefits/Social insurance
In China every person who is working for an employer gets state social benefits which is broken into 5 sub categories;
Every company in China has to pay into your social benefits by law. Depending how much your salary is controls how much you and your company pays into it. In my city the highest bracket is 16,000rmb, this means you pay 10% of your gross income towards your pension and sickness. Your company will pay around 23% towards the rest
Please note that these numbers are controlled by the government and it changes year by year and differs city to city and even district to district inside a city, its recommended that you ask your companies HR department about this. This information will be available on your cities government website
Every paycheck you and your company are basically paying into a little bank account. You even get a social benefits card which you present at the hospital to pay for any treatments you need inside China. Obviously only hospitals or government departments can withdraw from your card.
If you are planning to leave China then you can take out part of your pension, ask your HR department about this and read more here
Your social benefits card is like a subway card. Money gets put on it every month and you can spend that money any state run hospital and most large private hospitals. You can check how much you have by going to a hospital and scanning your card at a dedicated machine or ask someone at the hospitals reception to scan for you. If you are in hospital for a prolonged amount of time then you can run out of money, if this happens you will have to pay out of your own pocket once your social benefits have dried up. If this is a fear of yours then I recommend you take out private health insurance as well. It’s also important too note that if you want fancy foreign perceptions or some non medically necessary surgery you have to pay out of your own pocket.
IMPORTANT: If you do not have a social benefits card and are working full time inside China then its strongly recommend you ask your employer about it. Some employers get around this through loopholes and some cities in China may not require foreigners to pay social benefits.
Private health insurance
If your company does not pay social benefits, you are self-employed or just worried that your social benefits isn’t enough, then it’s recommended you have some form of private insurance. I personally have private insurance as well, this is a landing cushion incase I am hospitalized for more then 3 days (my wife worked out that more then 3 days in hospital would empty my social benefits). I pay around 200 rmb per month for accident only insurance from PingAn insurance China. This is so if I get hit by an e-bike or crash my car and get hurt then they will pay (to a certain amount). Some companies inside China will take out private insurance for you and a spouse/dependent so ask your employer if they can set something up for you.
Hospitals in China
In China you goto a hospital for everything, from the sniffles to quadruple bypass surgery you goto a hospital. This can be weird to outsiders, you will first see a pay window before you see a doctor or nurse. Let’s say your sick with a stomach bug, you goto your nearest (public) hospital and goto the pay window and tell the person behind the pay window you want too see a doctor about your stomach. They will ask you to pay some money (normally 7 to 20RMB in public hospitals) and then you will go see a doctor who knows about stomachs.
The doctor will listen to your ailments and do some checks (heart beat, temperature etc..) then they will normally just prescribe you some medicine on a slip of paper. You take the prescription back to the pay window and pay for the prescriptions, than they will give you another piece of paper and you take that to the prescription window.
If you have a bigger problem then they will ask you to have some medical tests like a CT scan or a blood test (they like blood tests in China) once again they will ask you to first goto the pay window and pay, then take the proof of payment paper to a doctor who will preform the test on you.
A common treatment I have noticed in public hospitals is intravenous treatment (IV), in China some doctors prefer to give you medicine via IV instead of oral tablets or injection. This means that instead of giving you a prescription to take at home, they will ask you to sit in a large waiting room hooked up too an IV drip for 2 to 4 hours. I personally ask for an oral or injection option as I do not fancy sitting for 4 hours on my phone surrounded by other sick people.
Remember that this can be cash or your social benefit card. If you only have private insurance then you will pay cash first then claim it back later (however most private insurers will only pay out if you have a bill of over a certain amount).
Private Hospitals & Clinics
If your Chinese level is not good enough or you would rather speak English then visit large private hospitals, some private hospitals will accept social benefits and offer English doctors (normally costs over 200rmb for a consultation with a doctor and most tests will cost more, this is referred too as “VIP service”).
If you would like to be treated by a foreign doctor who went to medical school abroad then you can try a smaller private clinic. These work more like GPs where you will only see one doctor and that doctor will diagnose you and will prescribe you foreign imported medicine. These clinics are not covered by your social benefits and obviously cost more (around 350RMB for a consultation, personally have paid 530RMB for a stomach bug which I was prescribed 2 weeks of antibiotics)
These are a nice alternative if you want a more pleasant experience, however be aware that private hospitals may try to up sell you treatments and procedures that may not be covered by your benefits.
Another thing to watch out for in both private and public institutions is what they prescribe you. I noticed that when they prescribe you medicine, they bundle in nutrition supplements, the Chinese try to cure the cause of your illness not the illness itself. So say you go in for a headache, the doctor will prescribe you prescription strength paracetamol, however they will also bundle in some nutrition supplements that you could buy at any pharmacy (normally in the form of small bottled drinks or dried powered you add hot water too). Try to ask about what your doctor is prescribing and if it is medicine or a supplement, you can say no to these if you don’t want them.
Hopefully this little guide was useful for anyone living in China! Remember to take care of yourself and anyone you love. China is great however being caught out with large medical bills is not!
back to blog