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.

Steven Conway is the Head of Healthcare for AXA-Minmetals Assurance Co. Ltd. He has been in the health insurance business for 11 years – the last 3 of those years in Shanghai.