Shanghai’s Healthcare: Everything an Expat Needs to Know
Do you know what to do during an medical emergency? What are your options when delivering a baby in Shanghai? What happens should complications occur during birth? What to look out for when buying an international health insurance?
This is the first of a 12-part series that examines the healthcare facilities in Shanghai and what expats need to know about international health insurance.
Shanghai TALK is happy to partner with Expatmedicare on this series. Expatmedicare is a fully independent intermediary that specializes in International Health and Medical Insurance. Apart from providing free health and medical insurance advice, they also help clients with market research and claim management.
How does Shanghai’s Healthcare System compare to the rest of China
Shanghai attracts the most foreigners in Mainland China thus its healthcare infrastructure is better developed and well catered to the expat community. However, many expatriates still find the healthcare facilities and treatments in Shanghai to be limited. Many will consider returning home or going to Hong Kong or Singapore should they require serious treatment. Evacuation to Hong Kong is quite common considering the lack of facility and service that are on par with international standards. The good news is that the quality of service and availability of treatment are slowly improving.
What to do before moving to Shanghai
Before moving to Shanghai, ensure that you complete a routine medical check-up and make sure that all your vaccinations are up-to-date, including vision and dental. To enter China, no vaccinations are required but make sure that the standard vaccinations, like polio, diphtheria and tetanus, are up-to-date. Discuss with your doctor any additional vaccinations that may be advisable as some, like hepatitis B, may require several shots over a period of time. Bring copies of your medical and immunization record, prescriptions for medication and an extra pair of visual aid.
Healthcare services and costs in Shanghai
Pharmacies
Pharmacies require a prescription issued by a doctor in Shanghai to dispense non-OTC (over-the-counter) drugs as overseas prescriptions are not valid. Hospital pharmacies only accept prescriptions issued by their own doctors. If a patient already has a prescription from overseas, he/she needs to bring his/her overseas prescription and consult a doctor in Shanghai in order to obtain a local prescription. If the specific drug is unavailable, an alternative drug may be recommended. Due to China’s strict rules on importing medicine, pharmacies, even those in international hospitals, have limited range of Western medication and these can be very expensive. It's best to stock up on all your prescriptions before you leave.
Depending on what you need, standard OTC drugs are usually available at pharmacies. Be sure to go with a Chinese translation of the medicine as the brand name may differ. It is advisable to bring regular medications, especially those for cough, cold, sore throat and allergies, from your home country.
Local Hospitals
In Shanghai, primary healthcare is provided by the local hospitals. Should you decide to seek treatment at a local hospital, your level of Mandarin should be proficient otherwise, bring along a translator. Be sure to arrive early to obtain a registration number (queue ticket) which costs around RMB 14. Thereafter, doctor’s fee and medication are charged separately. These can be very inexpensive and you will be required to pay first. As with the low cost, the resources and level of service are extremely limited and basic.
Local VIP Hospitals/Clinics
Foreigner/VIP clinics in Shanghai are typically departments of large public hospitals that provide outpatient services at a higher price than the ordinary clinic where most local patients go. These departments are staffed with English-speaking personnel and some, like Guangci or Huashan Hospital, have doctors that can speak other foreign languages, such as French or Japanese.
Unlike the local hospitals, you can make appointments with your preferred doctor. Some clinics may only have certain doctors available at certain times, so always call before you go. Referrals are not necessary but it helps if you do get one from a Western clinic. In China, having an introduction to the right doctor will save you a lot of time and frustration.
Most expatriates who go to Guangci and Huashan Hospital find the level of English to be limited and a translator may be necessary. Also, the standard of treatment and service is reportedly very low in comparison to international hospitals. Some hospitals may refuse to give patient their completed medical records, tests, scans or other documents.
Cost
The average consultation fee of a General Practitioner is RMB 300. Other charges for medication or required tests are calculated separately.
Payment
Local and overseas credit cards are accepted. If you are insured by a local insurance company, you are required to pay first and file the claim later. Only top hospitals like Guangci and Huashan are recognised by some local and international insurance companies and direct billing is possible. Other hospitals only accept a limited number of insurance companies. Check with your insurance company and your local healthcare provider. For receiving inpatient treatment, a deposit of 80 to 100 per cent is usually required upfront upon admission.
International Clinics/Hospitals
In Shanghai, there are a number of international clinics located in each expat community. These facilities which are set up as joint-ventures, offer modern medical equipment, hygienic environment, well-trained English-speaking staff and outstanding Western and Chinese doctors who are sensitive to the cultural differences and have better bedside manners.
A wide range of general and specialty in and outpatient services are provided. If major surgery is required, these medical centers have links with major local hospitals that will provide full medical support whenever needed. In cases when the medical treatment is not available in Shanghai, patients will be evacuated to Hong Kong or back to their home country, depending on various situations.
Your embassy should be able to provide you with a list of medical practitioners from your home country who are practicing in Shanghai.
Cost
Most expatriates feel at home with these facilities and it comes with a price tag. The average consultation fee of a General Practitioner is RMB 700, which is more than double the Foreign/VIP clinics. Other charges for medication or required test are calculated separately.
Average starting price of consultation cost:
General Practitioner - RMB 700
Pediatrician - RMB 700
Specialist - RMB 1,000
Gynecologist - RMB 1,000
Dentist - RMB 500
Payment
All international hospitals and clinics accept local and overseas credit cards, and direct billing channels are set up with most insurers. Some facilities require a letter of guarantee from your insurer before direct billing is accepted for certain treatments such as TCM & acupuncture, physical therapy, nutrition, chiropractic, psychology, Pilates, occupational therapy, pediatric physical therapy and podiatry. Be sure to check the direct billing list with your insurance company and your local healthcare provider. If direct billing is not accepted, keep your receipts so that you can claim later. A deposit of 50 to 100 per cent is usually required upfront for receiving inpatient treatment.
Ensure that you and your family are properly insured
Regardless of whether you are moving to Shanghai on your own or with your company, ask yourself these questions:
1) What are my health insurance benefits?
2) Does it cover China?
3) Is medical evacuation and repatriation included?
Looking at the average consultation cost above, a visit to the doctor starts at between USD 105 to 151 without medicine, so this could add up to a sizable figure, especially when you have children. It is worth considering a comprehensive package that includes dental.
Save on premium with better geographic definition
Most insurers have two geographic categories: Worldwide and worldwide excluding USA. Some insurers have a more specific geographical breakdown. Premium increases with wider area of coverage. With better definition, in some cases, it could reduce your premium by 60 per cent.
What to do in an emergency
If you are insured, always keep your insurance card with you so you can call their emergency hotline for assistance and arrange for direct billing whenever possible or get evacuated to a better facility if needed.
Otherwise, you can also call the emergency line of Shanghai United Family Hospital at 2216 3999/5133 1999. If you need an interpreter over the phone, you can call the Shanghai Call Centre at 962288, which provides such service at no charge. If you choose to be admitted to the A&E department of local hospitals, make sure that you have at least RMB 10,000 to 20,000 cash on hand, as payment is expected upon admission.
Take note that none of the hospitals in Shanghai own ambulances. All ambulances are run by the Shanghai Ambulance Center. If you call 120 for an ambulance, it will be able to take you to your preferred hospital but it may take some time before it arrives. The service is 24-hour and upon arrival at the hospital, there will be a service charge. The operators have very limited command of English so you should learn to say at least your address and the name of your preferred hospital in Chinese.
If it is safe to move the sick or injured person, the fastest way to get to the hospital is by taxi or private car. Always have a card with the name, address and telephone number of your preferred hospital in English and Chinese. If you live in a managed compound, the management office or the security guards are usually very helpful.
