Chinese medical insurance for beginners

The state’s medical insurance programme is funded by individuals and employers. The patient has two accounts, termed personal and public. The former is funded by the individual who must make a payment equating to 2% of salary. After a visit to the doctor with a routine illness, the fee for the consultation is deducted from this account.

When the disease is more serious, the public account is debited. This is funded by employers, who pay in an equivalent of 9% of staff salary.

Drawing down on the funds works like this. If the cost of the treatment is more than Rmb2,000, the public account will pay 50% up to a maximum of Rmb20,000. When the patient has had to stay in hospital for an operation, the public account will pay for at least 50% of bills above Rmb1,300 to a maximum of Rmb70,000. But complicating matters is that the grade of the hospital also has an impact. If the operation takes place at the best hospitals (known as level 3), the public account contributes a greater proportion, on a sliding scale. Up to a cost of Rmb30,000 it will pay 85%, for example.

Perhaps it’s best to use a real life example WiC knows of. A retired teacher in Shandong was diagnosed earlier this year with throat cancer. He was treated with 35 hours of chemotherapy at his local hospital over seven weeks this summer. The total cost of the treatment was Rmb12,000 ($1,890) and so far looks to have been a success. The patient paid Rmb4,000. The rest was covered by the government scheme, i.e. 66% of the bill.

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