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  1. I am constantly flying in and out of China - I rarely if ever stay in the country for more than a few weeks at a stretch. As a result, I can be covered by travel insurance, as long as I purchase it in my home country and link it to an outbound flight. I've combed the fine print and can't see anything in there which would exclude me, unless my medical mishap were to commence more than 90 days after arriving in China - which would never happen in my case. The cover basically includes local stabilisation then medivac to another country for definitive treatment. @woshiweideren, your argument in favour of self-insurance makes some superficial sense but ignores two major considerations: (1) In the event of a real disaster, you may not be in a position to make your own decisions. What happens if one day you wake up in the ICU at United, to be informed that you have suffered a near-fatal heart attack (or whatever) and have already had a quadruple bypass? Got 1,000,000 RMB handy? (2) You decide to self-insure by laying aside (say) 1,000 RMB per month. One day after making this decision, you suffer said heart attack. At this point you've got 0.1% of your bill covered. Oops.
  2. 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.
  3. @victoria For an individual medical plan almost all insurance companies will require a waiting period for maternity as they wish to avoid clients paying for one years insurance, having a baby and then not renewing their policy - it becomes a very expensive exercise. We have a 12 month waiting period but our restriction is on paying the bills so provided the pregnancy occurs after the 4th month of the policy and lasts the normal duration we will cover the delivery provided the client has renewed the policy. I'm sorry I couldn't be more helpful.
  4. @Paullie Your implication however that health insurance companies prejudice the health of their clients to save a dollar is a general statement that can't be applied across the board. There are good and bad insurance companies and practices in every country as there are good and bad examples of medical facilites and assistance companies but I for one know that we would never risk the health of our clients by suggesting sub-par treatment. We are a for profit company and we therefore have an obligation to ensure that every dollar spent is spent in the most efficient manner to ensure the best possible outcome for the client. We also have to consider our other policy holders and ensure that the premiums we charge each year are within their expectations and not inflated by unnecesssary treatments that provide no benefit other than to inflate the bill. With reference to medical treatment in China, everyone has anecdotal evidence of medical treatment going wrong in every part of the world but I have factual evidence that in my three years in this business in Shanghai we have only been involved in three cases of alledged medical malpractice and ironically all three cases were at Western orientated facilities. Far from suggesting Chinese medical facilities are perfect, I am simply stating that they are not as bad as many scaremongers would have you think and evacuation is of course, no walk in the park. For a case to require air evacuation it is by implication extremely serious and will certainly not be improved by any additional delay in arriving at a medical facility and the additional trauma suffered through air travel and the logistics involved. If good quality and effective treatment is available locally it should always be considered first to maximise the chances of a complete recovery for the patient. Certain conditions such as transplants would automatically qualify for evacuation but other conditions should rely on the opinions of those qualified to make them such as the local attending physician, physicians working with the assistance company and those intending to receive the client in the offshore location. Efforts have to be focused on achieving the best overall outcome for the client.
  5. As an expatriate living abroad, it's both more important and more difficult to understand the details of your health insurance. Here are six points to consider when shopping for coverage. Buy it before you need it. At the very least you need a health insurance policy that includes inpatient services and emergency evacuation. Outpatient services aren’t that expensive to pay out-of-pocket but add a lot to your premium. Emergency evacuation coverage is key. You never know where you’ll be when you need it. So make sure you have adequate emergency evacuation cover. And by adequate it means the overall limit should be sufficient to provide evacuation to the nearest center of medical excellence. Know your healthcare options and preferences. You need to consider your healthcare options when deciding how much and what kind of coverage you need. Will you use western, local or overseas facilities? For example, are you just going to use western clinics and want to evacuate offshore if you have a serious emergency? Will you use a mix of local and western facilities? Or will you head for those nearby countries that have top international hospitals but at much lower cost such as Thailand, Singapore and the Philippines? Place your coverage locally. If you’re not covered under your company’s global policy, then it’s best to place your coverage locally through one of the legally registered local insurance providers (e.g. AXA-Minmetals, Goodhealth, Ping An, GBG/TieCare). Placing your coverage locally has several advantages. First of all, you have local staff that speak the language, can help you navigate the local system and can negotiate with local hospitals and doctors. Secondly, in cases where direct billing isn’t an option then a good local provider will send agents directly to your clinic to pay the claims directly (for inpatient cases). And finally, with an offshore product, you won’t have any consumer protection. In China the China Insurance Regulatory Commission (CIRC) regulates and maintains the legal and stable operation of the insurance industry. But if your provider isn’t here, they can’t help you. The devil is in the detail. Read your policy. Does it extend overseas? What does it cover? Where doesn’t it cover? For example, we offer worldwide coverage and then worldwide coverage excluding the U.S. The latter decreases your premium, but won’t cover your medical expenses if you want to go to the U.S. for treatment (with the exception of a small amount of emergency coverage). Sometimes people will bring domestic plans from Hong Kong and find out too late that these plans don’t actually cover everything they need. For example, there’s a higher probability of evacuation from mainland China and their Hong Kong-based policy won’t necessarily cover that. Insurance and the local healthcare system. Some local hospitals will handle direct billing (your insurance company will have a list), but most don’t. They have plenty of local paying business, so they don’t have a need to cater to foreigners. Even if you don’t use a local hospital it’s a good idea to find a Chinese doctor who speaks English. They’ll be able to navigate the local system and services for you should you need something a western clinic can’t provide.
  6. Health Insurance for Thailand Expats is often overlooked with most expats either having a insurance policy that simply doesn't really fit their lifestyle, doesn't provide the correct coverage or protection, or they are paying too much for health insurance coverage they don't need while living in Thailand. But unfortunately too many expats in Thailand fall into the category of being able to mumble some excuse for not having any health insurance all together. I never get sick, Im Healthy, I don't need it. Staying healthy and never getting sick is great, and its even better for keeping your health insurance premiums low, but its never a excuse for not having any health insurance. If you truly never get sick or make visits to the doctor you can opt for a inpatient only health insurance plan, which will be cheaper than full coverage and only cover you for those unexpected emergencies that could quite possibly be life threatening and require you to stay overnight in the hospital or even a medical evacuation. When you take a taxi or ride a motorcycle you are at risk, Remember Thailand has one of the highest road accident and traffic accident fatality rates in the world. In certain rural areas of Thailand you may also be exposed to mosquitos carrying dengue fever and Japanese encephalitis. Thailand is a beautiful country to explore but the risks of accidents happening or exposure to diseases and dangerous creature bites is something you should definitely be aware of. And although you may feel healthy, you never know when an unexpected condition or disease may occur. Im covered by my credit card or travel insurance policy. Credit card and travel insurance policies provide basic travel insurance for short-term trips If you have a minor accident in Thailand then you may have to get approval from the travel insurance company or even pay the bills yourself and then reclaim those costs from the travel insurance company. If you have a major life threatening accident in Thailand you still might need to get approval from the travel insurance company before any treatment is carried out or any medical evacuation is arranged, and the travel insurance will only cover the costs to get you stabilised and safely home and not any further ongoing treatment you may need. A good health insurance policy will ensure you are taken well care of by any hospitals in Thailand, they recognize international health insurance companies and will give you the best possible care knowing in fact that the medical bills are covered directly by the health insurance company. If you are involved in a life changing accident that results in you needing a lifetime of costly medical care, the health insurance company will be responsible for the required care while you continue to be insured by that insurer, unlike a travel insurance policy that is only valid for the short-term. It is possible in the short-term but if you’re away from your supposed home for an extended period of time you may find any claim on travel insurance is rendered invalid. A general rule of thumb for travel insurance is no more than 90 days in one country or one year away from the home country, although this can vary. Health insurance is too expensive, I cant afford it. Regardless of your age or income your health and wellbeing is your number 1 asset. Without your health and wellbeing you may be unable to work or live comfortably. There are many health insurance policies on the market available to expats living in Thailand some of which are very affordable that provide coverage that could possibly be life saving. Having a insurance policy that based on individual coverage only in Thailand can be significantly cheaper than a global coverage policy, but make sure you are covered where you need to be. If I get sick ill go back home. Commercial airlines do not allow anyone to board a flight if they are sick or seriously injured. If you are seriously injured your only option would be a Medevac emergency evacuation with a medical team and pressurized plane, these cost on average $100,000 - $250,000 per trip. I have savings to cover any medical bills. If you are unconscious or comatose, who has access to your money to pay the bills ? How can you be sure you have enough savings? Do you have proof that you an pay ? In a life or death situation you really don't want to be waiting on a international wire transfer before you receive needed medical treatment. I get health insurance from my employer. Your employer may provide you with health insurance or include you in their group insurance policy, but what happens when you leave your job or change employer ? If you have a medical emergency or a medical condition arise while you are in-between employers, you would not be covered and would have to cover those costs yourself. Also any health conditions that were covered by or occurred during your previous insurance policy may not be covered by your new employers insurance policy, whereas if you had your own insurance policy you could continue that policy regardless and ensure any health conditions continue to be covered without relying on a employers insurance policy. Finally when you retire from that company you might find it difficult to find a new insurer that will agree cover you, most insurers will not cover any pre-existing conditions and charge a higher premium for the same level of cover. If you had maintained your own personal policy your insurance you could avoid these pre-existing condition exclusions and higher premium worries.
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