As an entrepreneur who is going through the process of being a good husband and dad, I have been doing a decent amount of research on healthcare and insurance in Hong Kong and China. The choices are overwhelming and I need a place to digest it all and write it out, so today’s post will be where I hash it out and hopefully get some feedback from you!
What is Healthcare?
When writing this article, I first made the assumption that we all know what healthcare is, and all have the same definition of what it should do. Instead, after talking to people and researching, there are a lot of different interpretations. Let me take the definition from good ol’ Wikipedia about healthcare:
Health care (or healthcare) is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in human beings. It refers to the work done in providing primary care, secondary care, and tertiary care, as well as in public health.
Healthcare Systems Vary Between Countries
The Wikipedia article is a great read, and it goes into the differences in healthcare on a country-to-country basis and the idea of each country having its own system:
Access to healthcare varies across countries, groups, and individuals, largely influenced by social and economic conditions as well as the health policies in place. Countries and jurisdictions have different policies and plans in relation to the personal and population-based health care goals within their societies. Healthcare systems are organizations established to meet the health needs of target populations.
I will stop quoting it, but it goes on to say how in the US healthcare was almost 10% of the GDP in 2011! So it is a big deal, and a big cost. We all want to be healthy and also have coverage if there is a medical emergency.
This Article Focuses on Foreigners in Hong Kong and China
For those traveling outside of your home country, your life is going to get a bit more complicated and it is hard to help everyone in all these countries and systems in one article. I will focus today’s article primarily on those in Hong Kong and China. Some of these solutions and definitions can help others. As with other articles I have been writing, I will try to continually add and edit these as time passes to keep relevant. And I welcome all feedback and insights readers have.
Is Healthcare the Same as Health Insurance?
I have heard the word healthcare used together with health insurance and always wondered. From my research for this article it seems the two words are interchangeable, healthcare being the same as health insurance.
Health Insurance Plans and Options
Now for the fun part, let’s go through some plans that I have been collecting from referrals and research. Disclaimer: I am simply doing the research; I am not an expert, these are not endorsements, and please do your own due diligence. I would love your feedback in the comments section below.
This is the one I ended up choosing, and have coverage for Miles and myself under it, the CEO plan. They said it is tricky to do as an American citizen this year as the healthcare policies in the USA have been going through big changes over the past few years. But I think my application is going through OK. The cost will be about 1,000 USD for each of us per year.
I went with this one because the price was reasonable and their rep is my wife’s good friend and we can call on her if we need. If you want me to introduce you to her, she is a very nice lady – a Mainland Chinese woman who has moved to Hong Kong for about eleven years now – just let me know.
One of the first people I went to referred me to Now Health, and I pulled up the quote for me with Miles and Wendy – $4,500 US dollars. And me with just Miles would be 2,826 US dollars.
Another friend talked to me about one he has, which is Aetna International. The only quote for just putting Miles on the insurance worked out to be $1,929 USD/year.
Doing online research, I found Healthcare International, but didn’t get too far on the digging here.
Cigna is a brand I have heard of a lot since I was young – think I was on that under my dad’s plan when I was growing up.
A lot of blog posts talk about Expat Financial, which had a lot of experts answering questions online. May be worth taking a look at them.
If you have heard anything on Infinity Solutions, let me know and I can add it here. They came up too while doing research.
The last one I’ll add on this list is Pacific Prime, which has a .hk domain and, therefore, I feel must be pretty focused on the Hong Kong market. I’d love feedback and experiences from people.
Other Sources I have Found
This Expat Woman list of health insurance providers in Hong Kong is also worth reading. What other sources are people using? I have a hunch that most of this is from word of mouth and referral, as healthcare is a complicated thing and people don’t have time or interest to search on Google for the answers.
Question: Are You an Employee or a Business Owner?
You need to first ask yourself, are you an employee or a business owner? This will make a difference in the choices you have and what you need to take into consideration.
As an employee, your company should have a healthcare plan to offer you.
Are you in Hong Kong or Mainland China? This will also make a difference on the plans and options.
For the most part, you can’t choose things outside of what is offered from your employer. This is why companies that want to attract talent will get good healthcare plans to offer their team so that they are attracted to work there and want to stay there long term. If there are plans that you want that aren’t available, ask your HR department or the CEO – maybe they just don’t know there are other options out there. If that doesn’t work, and you really want your preferred level of coverage, you can purchase private insurance.
If you are a business owner, you have more options but also more complexity. You can basically pick your own insurance company and policy; if you have staff they can also get coverage under the company going forward.
I’m going through the process now (scared to admit I haven’t had health insurance since I quit my job at Deutsche Bank in March 2007!) and there are a ton of forms to fill out, but once it’s done you will feel much better.
Insurance Is a Lot Different if You Prove You Will Be Outside of Your Home Country
The whole idea of expat health insurance is that you’re an expat, which is defined as staying out of your own country the majority of the time. If you aren’t outside of your home country the majority of the time, you may not be able to qualify for expat insurance. It may also make more sense to get your domestic country’s insurance anyway as there may be more perks and benefits in your home base.
American Expats, Do You Need Coverage When Traveling in the USA?
I remember hearing a story from Canadian friends who said they went to Hawaii on a trip and got sick. They didn’t have coverage in the USA and the prices were sky high. I remember them complaining on and on about how they are terrified to visit America as the healthcare costs are through the roof.
I don’t even want to get political, but I think the fact is, healthcare costs in America are extremely high. As a person living overseas, almost all of the healthcare options will say global coverage EXCLUDING USA. If you need coverage in the USA, your rates will be much higher to reflect that. We can get angry and emotional, but that is the fact, so we just need to deal with it.
Do You Have Dependents to Claim?
Do you have a wife (or husband) and children to claim? Maybe your spouse has his or her own plan already, but will you claim your children on your plan or the spouse’s plan? This will affect the cost of the insurance, obviously, and you should compare rates of various healthcare options with these dependents, and also consider adding or removing your spouse from your plan. Another idea is maybe your child should be added to your spouse’s plan instead of yours. You need to be creative here and figure out where you fit in the matrix.
Healthcare in Hong Kong
Once you have coverage, or even if you don’t, let’s look at some of the options of what you can get in Hong Kong.
Going to a Public Hospital in Hong Kong
You need to get a HKID (Hong Kong ID), and then you can visit the hospitals for free. If you don’t have a local ID card, then you would pay market rates, which is said to be about the same costs as a private hospital in Hong Kong. Of course, a public hospital may have longer wait times and you may not get the best level as service or see the same doctor each time. But again, it is pretty amazing that there are free public hospitals for all legal residents of Hong Kong. But if you want higher-level service, you’ll need a private hospital, which is pretty expensive! My friends have also been to some of the public hospitals and sometimes you will have some trouble if you don’t speak Cantonese; it can be pretty local. Surely there are some hospital workers who will speak English, but you may not have 100% of the staff speaking English.
If you have the HKID card and qualify for this local Hong Kong healthcare, you will not be covered if you’re outside Hong Kong. Therefore, you need to either get travel insurance while outside of Hong Kong or get international healthcare coverage.
Private Hospitals in Hong Kong
The cost of private healthcare is second highest in the world (according to a British Expats article on Hong Kong healthcare) after the United States, while some of my research puts it as third highest after top Chinese private hospitals.
List of Hospitals in Hong Kong
During my research, I found out there are 12 private hospitals in Hong Kong, and you can go to the official government website for that full list. There is also a good article on Expat Arrivals that helps you get the gist of what is going on with healthcare in Hong Kong.
Healthcare in Mainland China
Some of you may be cringing to read this headline, to think of going to a hospital in Mainland China. I have heard pretty strong words from expats who refuse to enter a Chinese hospital and would risk further complications just to get out of China and get checked in Hong Kong or another country. And there are entire businesses setup to help Mainland Chinese get medical attention and advice from overseas. I will leave it up to you to make your own decisions.
Going to a Public Hospital
I’m embarrassed to admit, but I have not had health insurance since quitting my day job at Deutsche Bank in early 2007. While in China, I have had some medical issues – nothing too serious – and I have simply gone to the general admission of the local public hospital. My Western friends were so afraid for me when they heard this, but I have gone quite a few times. It is a cash business, or at least you have to pay at each step in the checkup process. You pay to get a checkup, normally at the lobby of the hospital, and get a receipt to show the doctor that you’re paid up. If the doctor tells you to see a specialist or some other procedure, he or she will write up a ticket for you to go back to the cashier at the lobby and pay it and get another receipt. You may see the same doctor again, or you may have to go to a specialist to do the procedure.
If there is any medication to be prescribed, then you will get a receipt from the doctor and they have a full medical shop downstairs in the hospital where you can buy it. Other times you need to go to a medicine shop nearby.
Maybe I am just lucky, but I have not had any issues going to a public hospital in China (fingers crossed).
Going to a Private Hospital
Going to a private hospital in mainland China is almost as expensive as going to a Hong Kong private hospital. Again, the reason behind it is that it is a private company and does not involve government subsidies. Therefore, some would say the quality and attention you get will be much better.
In Summary: Talk to People
Having coverage for your health in case of emergencies is a big boost to your confidence in business. I haven’t had health insurance for so many years, but I have always been fearful of the “what if something happens” thought, and luckily the only medical issues I had I was able to solve quickly in a Chinese public hospital. But now with a family, I need to be a bit more security.
While we live in the time of everything being done online, I felt a lot better meeting an insurance agent and talking to a person face to face. I met a few different agents and they were more than happy to make proposals for me and explain what they meant. To save time, I did tell them my expectations and requirements – which is mostly to be protected if something serious happens and that I don’t need the most fancy medical rooms if I am hospitalized.
I’d love to hear your feedback and suggestions here. I will try to keep this article up to date as I get more experience and information on the complex world of insurance for expats in China and Asia.