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Old Apr 10, 11, 10:49 am   #1
 
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Medical Costs in China/Travel Insurance

New here. My husband, 9 y/o daughter, and I are traveling will be in China, June 22-July 10 with a group tour. (Beijing-Xian/Hu County-Chengdu-Guilin-Yangshou-Hefei-Shanghai). Nothing off the beaten path.

After research many travel insurance products, I've boiled it down to either TravelEx Lite or Travel Select. Both plans provide comprehensive travel insurance. http://www.travelexinsurance.com/ins...avelbasic.aspx

The primary difference between the 2 is that Lite covers $250,000 for medical evacuation and Select provides $500,000. Each plan provides $50K pp primary medical coverage (My BlueCross/Blue Shield plan also provides medical coverage outside U.S. and at facilities in each of our locations. It's outsourced to World Access Service Corp/Mondial Assisatance.)

Is $250K medical evacuation sufficient? It is per person. The State Dept Travel Assistance page for China only says that medical evacuation can cost more than $50,000. But I don't really know if that is typical, the low end, the high end. Any advice appreciated.

Select costs $594 for the three of us; i can upgrade to Cancel for Any Reason for a total of $843. Lite is $448; $670 for Cancel for Any Reason (offered through Squaremouth). I'm inclined to get the Lite with the Cancel for Any Reason upgrade.

Susan
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Old Apr 10, 11, 12:59 pm   #2
 
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Some may disagree with me, but my inclination is to say that you shouldn't blow $600 on insurance at all, especially not when your existing insurance will cover expenses incurred abroad. In travelling to ~60 countries, and many places far more dangerous and off the beaten path than anything you're doing, I've never once purchased (or wished I had purchased) any type of travel insurance.

In major cities in China, you can get perfectly adequate medical care for just about anything. For minor incidents (random infection, broken bones, etc.), you'd end up ahead just paying out of pocket every single time. And for something more significant, your insurance from home will reimburse expenses. The idea of needing an "evacuation" from Beijing or Shanghai strikes me as extremely far-fetched. The chances of you getting anything worse than a case of diarrhoea or common cold in China is extremely, extremely small.

And please take anything on the State Department website (or the UK Foreign Office etc.) with a grain of salt: it is almost always over-sensationalised nonsense that can be safely disregarded.
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Old Apr 10, 11, 2:32 pm   #3
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Agree, no need for additional insurance. Unless you're doing something crazy like some adventure sport, you'll be fine with regular insurance. You'll just have to pay out of pocket and reimburse later, but even most expat insurance is like that.
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Old Apr 10, 11, 2:43 pm   #4
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I know some citizens of some countries are scared to go to the US without some huge policy. I've traveled to 55 countries, any medical care I've ever needed, I've always just paid out of my own pocket. Most of the time it's way under $100, and usually $50.

I've been to China 8 or 9 times in the last 2 1/2 years, and always found the hotels quite helpful if I needed anything. I guess it really depends in you're staying in a good 4-5* hotel or not.

I've had elective surgery done in Thailand, dental work in Costa Rica, gone to hospitals in Argentina and Indonesia, and have always felt I got as good or better care than I would in the US.

I would never spend that much money on insurance, since I've often seen so many loopholes that means you were just blowing your money. Also, many foreign hospitals won't accept the insurance in the first place. So it's pay out of your own pocket, and then try to get the policy to pay.

Of course, if you need to pay out 2k for all of you for piece of mind, then you'll probably do it not matter what we say.
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Old Apr 10, 11, 3:25 pm   #5
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Add my vote to foregoing insurance. The OP is going to be, for the most part, in well-developed cities in China that compare to any major city in the west. Chinese health care is paid for out-of-pocket (the Chinese don't have health insurance), but costs when measured against the American dollar are quite low and affordable.

I also agree that the State Department webpage tends towards hysteria. I've been going to China once or twice a year for more than 12 years (my wife is Chinese and we visit friends and family there). I would not be worried, in the least, about seeking medical care there if I needed it. The doctors speak "medical English," (I know this because my father-in-law is a retired surgeon) and, I suspect, the OP's tour company can provide someone to assist with basic translation needs in the event of an emergency.

Go enjoy China and don't worry -- it's a wonderful country with wonderful people and a truly amazing place for Americans to visit.
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Old Apr 10, 11, 5:28 pm   #6
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Originally Posted by Jaimito Cartero View Post
and always found the hotels quite helpful if I needed anything.
A friend had a major cold and couldn't find any type of medication that looked familiar. So asked the desk at the Sheraton (now Pan Pacific) in Suzhou for
some assistance. They sent us down to their medical office, a nurse took his blood pressure, temperature and other various tests. Gave him some type of
pharamaceutical medication. The total bill was 20 rmb, which at the time was
2.43 USD.

Been to a couple Chinese hospitals. Not exactly your standard western
room, but works.

http://www.chinadaily.com.cn/china/2...7481076154.jpg
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Old Apr 10, 11, 5:45 pm   #7
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Originally Posted by PTravel View Post
Chinese health care is paid for out-of-pocket (the Chinese don't have health insurance),
Those that work/worked for the state get free medical and low cost for their families. Since hospitals are stated owned, they subsidize a bulk of the costs.
When Gates and Buffet went over there to explain their living pledge, they soon realized that education and medical is all provided by the state so what do they need the living pledge for?
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Old Apr 10, 11, 7:51 pm   #8
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This will be long response for the benefit not only of OP, but others looking into the same issue. I'm going to somewhat disagree with every single other poster above and say you need evac coverage. After living in Beijing for 10 years, I've seen what happens when a foreigner (child) is hit by a car in a Beijing street. And a friend with a bad fall in Guilin that broke a femur. Etc etc. It happens in all the "on the beaten track" places, believe me. For the average healthy traveler, accidents are generally more of a worry than illness in China. Don't listen to anybody who tells you the normal Chinese hospital system is good--it is not and just negotiating the system is a nightmare. I've had first-hand experience on more than one occasion and that includes the Emergency Room. The expat hospitals don't have a lot of depth in their physicians and facilities for many specialties, so for some types of injuries/conditions, you'd have to use Chinese facilities and doctors and hope for the best. There are some decent doctors sprinkled around major cities, but finding them is a needle in a haystack exercise not easily done on short notice and in an emergency. Infection control in Chinese medical facilities is a crapshoot at best.

Having said that, you don't need to succumb to panic or overreaction. I will also agree that the insurance you are looking at for med evac isn't what you should be buying. That TravelEx thing is a piece of crap in what it provides for the money. I don't know how you did your research process, but first of all, it seems very very expensive for such a short trip, and especially if you already have decent BC/BS coverage that will work for non-evac medical expenses overseas. Second, nearly all evac policies will not necessarily evac you to "home" or anywhere you want--read the fine print and you'll see the language probably states something like "nearest suitable facility." And that interpretation will be up to the insurance/evac company. Depending where you incur a problem, it could be a bigger city in China, could be Hong Kong or Bangkok. But not automatically the USA. Cost of an evac from Beijing or Shanghai to USA is probably between $40-70K depending on whether it can be done on multiple seats on a commercial airliner, or dedicated medical airplane. Add another $10-20K from Chengdu, Hefei, Guilin. So a per person evac coverage of $100K is more than adequate for this sort of trip that doesn't include the Himalayas or far West.

I suggest you try to get coverage for less. First of all, start by looking at www.medjetassist.com which is an evac membership program not an insurance plan. It's one of the only companies I know that will take you anywhere in the world you want to be evac'd, no questions asked--just need to require inpatient care. They have short term and annual single and family plans. Cheaper and better than what you are looking at now, and this company comes highly recommended. This will not overlap with your Blues coverage.

For more typical evac coverage that is bundled with travel medical and so will provide overlap that you personally don't seem to need, you might as well look for something either better or cheaper or both. If you only want coverage for this one trip for the next year, look at www.worldnomads.com at a family plan. If you will be going on multiple international trips (each trip less than one month), look at www.ihi.com look at "international-personal-travel" insurance, annual plan policy. Outstanding company and they set up coverages in the European mode by percentages not fixed $ limits. I'd choose them over any US-based insurance company for travel/evac. Of US-based companies, HTH Worldwide has one of the better reputations but I'm not familiar with the specifics of their travel insurance product.

I have found Squaremouth seems to leave out or not have in their database a lot of possible options, especially for international travel or expat medical types of insurances. Squaremouth is convenient but not the gospel. Also, one reason what you're looking at is so expensive is the trip cancellation part. If you can forgo the TC and related (baggage, etc.) fluffy stuff with its sundry loopholes, and rely on your regular homeowner's policy + common sense for property, you should find what you really need for cheaper.

Last edited by jiejie; Apr 10, 11 at 8:20 pm..
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Old Apr 10, 11, 8:00 pm   #9
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Originally Posted by anacapamalibu View Post
Those that work/worked for the state get free medical and low cost for their families. Since hospitals are stated owned, they subsidize a bulk of the costs.
When Gates and Buffet went over there to explain their living pledge, they soon realized that education and medical is all provided by the state so what do they need the living pledge for?
Hmm....the Chinese covered under these free plans know just how inadequate they currently are, the (lack of) quality of care provided due to hospitals' and doctors' mixed motives, not to mention the hoops needed to be jumped through to get into see the doctor. Free = You get what you pay for. Urban Chinese of any means, when possible, prefer to get coverage through their employer--if employer is private--or get supplemental private plans. This makes it easier to get into and pay for the VIP/ (texumenzhen) clinics and best doctors in the hospital. But cost prohibitive for the urban poor and nearly all rural residents. As of 2011, it's a spotty health care system at best, and neglected for many years by all levels of government.
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Old Apr 10, 11, 8:03 pm   #10
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Hmm....the Chinese covered under these free plans know just how inadequate they currently are, the (lack of) quality of care provided due to hospitals' and doctors' mixed motives, not to mention the hoops needed to be jumped through to get into see the doctor.
Its pretty much understood you better bring a red envelope.
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Old Apr 10, 11, 8:33 pm   #11
 
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This will be long response for the benefit not only of OP, but others looking into the same issue. I'm going to somewhat disagree with every single other poster above and say you need evac coverage. After living in Beijing for 10 years, I've seen what happens when a foreigner (child) is hit by a car in a Beijing street.
Could not agree with jiejie more.

Traffic rules in china are completely unfamiliar to most people, and to a child in particular (for example, green man at cross-walk does not mean cars will stop for you if you are crossing... for the most part pedestrians still GIVE WAY to cars).

Also most cars do not have seatbelts.

The initial cost of medical treatment in china may not be that high, but it will certainly be more than USD600 odd if you spend a week in hospital following a car accident (a friend of mine stayed in a hospital in shanghai for a week, for minor procedures (not in theatre) and the cost was rmb7000 for 6 days to cover the room and other minor stuff).

The emergency evacuation... Again, the cost may not be that high compared to the US, but what if the accident requires a stay in hospital of three or four weeks. Wouldn't you rather be evactuated to the states for this? The cost of a First class ticket would be a lot more than the USD600.

I cannot stress enough, for peace of mind alone, that travel insurance is essential.
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Old Apr 10, 11, 10:31 pm   #12
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Ok, response to jiejie's comments. If you're talking major emergency (hit by a car, need emergency surgery) then yes the Chinese medical system is not adequate. I fully agree with all of the comments on getting Chinese medical care and navigating the hospital system.

But, the point is additional insurance isn't going to help unless as jiejie points out you get the "evac" type of service that will cover major hospital fees to fly you back to the US. Otherwise, if you get any sort of care (sniffle to major ER stuff) your regular insurance should cover you, so additional insurance really won't do you any good.

If that is the case, then you need to assess your level of risk (as Jaimito points out). If you really are afraid of getting hit by a car and needing to be evac-ed back to the US, then go ahead and buy the insurance (but I remind you to read all of the fine print on such policies).

To me, the risk of getting hit by a car, in a plane crash, or something that catostrophic such that I need evac service back to the US is so low it would NEVER justify buying such insurance. But hey, that's me. If you have to buy it to sleep at night, go ahead, it's your money.

But I think the majority is with me, don't pay and don't buy.
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Old Apr 10, 11, 10:59 pm   #13
 
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OP:
Did you use www.insuremytrip.com to check travel insurance rates? You can see rates for multiple companies at one time and then you buy directly from the insurance company. never buy travel insurance from the tour company or a TA. They will charge twice as much to cove their commission.
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Old Apr 10, 11, 11:23 pm   #14
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But I think the majority is with me, don't pay and don't buy.
I'm in your camp.

I only know one person (appendicitis) who has been evacuated from China in the entire time I've been here, and the all in cost (to HK) was around $4,000. This happened nearly 16 years ago; I'm guessing that it is possible to to treat appendicitis in Beijing now.

Separately, I worked for a study abroad program in the late 90s and made frequent visits to the local hospital with my accident prone students. It was okay; while the doctor was younger than me at the time... and I was 22, he was was pretty good at fixing broken bones and the like.
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Old Apr 11, 11, 2:03 am   #15
 
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Can the OP speak Mandarin? Are they familiar enough with the Chinese medical system? This has to be a consideration to purchase or not purchase insurance.

I found in emergency rooms, the doctors treat you differently if you have travel insurance. They can charge for everything, all the imported medicine, ask for any tests, get full price for everything thus the care you get is better than without. There is no need for the doctors to come in and ask which do you want, since money is not a consideration they just give you the most expensive. (not necessarily the best)

Especially with serious illness or accident, the doctors, at least in the smaller cities, expect "Red Envelopes" for good care. I have had first had experience with this 3 months ago. They come to you and tell you prices, this is how much, this is what they have to do, the cost is.... The doctors not necessarily fluent in English albeit most can read it. Under that kind of duress, insurance is really big help.

After saying that, our travel insurance policy is about to end next month and we will not be renewing. We feel we can get by without insurance.

However as for the OP, going to China as a family, sounds like a once in a lifetime vacation, what is a few hundred extra bucks for peace of mind?
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