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*The main content of this article is based on publicly available information from various insurance companies. Please refer to the latest information released by the insurers.
Several major high-end medical insurance brands have exited the Chinese market;
Cigna & CMB have tightened their physical therapy benefits;
JD Allianz’s operational plan in China for international health insurance has been updated;
United Family Hospitals has been classified as a non-expensive hospital;
Peking Union Medical College Hospital, China-Japan Friendship Hospital, and New Century Hospital have been classified as expensive hospitals
……
Those who follow Pacific Prime's recent articles may have noticed significant changes in China's high-end medical market. Adjustments have been made to both insurance company operational plans and lists of expensive hospitals in response to market conditions. The aim is to control claims costs and maintain stable operation of products. Accordingly, benefit and rate adjustments are normal. For consumers, there’s no need to be concerned, all that we need to do is to choose the products that suit our needs.
Today, Pacific Prime will provide a quick review of the recent changes in the domestic high-end medical insurance (group insurance) market. Our aim is to help you or your team select the right products more efficiently, and clarify any confusion that may arise when using insurance benefits.
Due to the length of this article, it will be divided into two parts for sharing. The first part will primarily introduce the operational changes of insurance companies in recent years, while the second part will focus on updates to the list of expensive medical institutions. Without further ado, let’s get started!
Due to changes in market demand, rising medical costs, cost control, and strategic adjustments, etc., several established brands in high-end medical insurance like Aetna and Bupa, have implemented operational adjustments in recent years. Details are as follows:
In recent years, Aetna International has continuously scaled back its insurance business outside the Americas. Its operations outside of the Americas, Thailand, and India were taken over by Allianz Partners starting from June 2022. Aetna's policies in China will be underwritten by Allianz after 2024, and its service website in China was permanently closed in March 2024.
Due to adjustments in its global strategic direction, Bupa Global decided to exit the Chinese market in 2023 and terminated its partnership with Alltrust Insurance.
To maintain stable operations, many insurance companies have updated their products this year. Let’s look at the specific changes and how they will affect group clients who are insured or about to purchase products.
Physical therapy has become one of the key benefits that grab people’s attention in recent years. Cigna & CMB have clarified and further explained their physical therapy benefits, indicating that registration fees and other costs will also count towards the benefit limit. The specific details are shown in the figure below:
Traditional Chinese medicine/physical therapy is a general term that usually encompasses physical therapy, traditional Chinese medicine treatments (including acupuncture, Tui Na, cupping therapy, external herbal applications, small needle-knife therapy), chiropractic treatment, osteopathic therapy, and homeopathy.
Expenses arising from physical therapy, traditional Chinese medicine treatments (including including acupuncture, Tui Na, cupping therapy, external herbal applications, small needle-knife therapy), chiropractic treatment, osteopathic therapy, and homeopathy, as well as relevant general and specialist outpatient registration fees, and relevant diagnostic and treatment-related costs will all count towards the benefit’s limit for claims.
This clarification is also based on adjustments to the fee systems of some network hospitals, prompting Cigna & CMB to update their clarifications for physical therapy benefit terms. Frequent users of physical therapy benefits may find the limits insufficient. Therefore, Pacific Prime suggests contacting your account manager in advance to confirm the fee structure of the medical facility regarding physical therapy and check if your policy limit will be sufficient, so as to prevent your medical care from being affected.
Starting in August this year, JD Allianz has designated MSH China as its service provider. Following this service structure rearrangement, JD Allianz members can conveniently check policy information, submit claims online, apply for pre-authorization, as well as locate direct-billing network hospitals through the Chinese/English bilingual MSH service app, online service website, and WeChat app.
MSH China is a well-known third-party administrator (TPA) with extensive experience in the high-end medical insurance industry in China. With branches and service centers in major cities like Beijing, Shanghai, Guangzhou, and Shenzhen, it provides 24/7 service support to clients and covers over 70 cities in China with its medical network, allowing clients to enjoy direct billing services within the network.
Everyone's situation and needs are different, so products should be selected based on individual circumstances. If your selected product has been affected by recent changes, consider seeking a reliable and professional insurance intermediary to reassess your plan or compare products from various insurers to find a more suitable option.
Pacific Prime has been deeply engaged in the insurance field for many years, and works closely with multiple insurers, allowing for quicker understanding of changes in the high-end medical insurance market and operational adjustments of insurers. If you have any insurance-related questions or needs, You are welcome to enquire about our customer service, or click here to contact us to leave your message. Our professional team will contact you as soon as possible.
Disclaimer: The cover, illustrations and other materials of this article have been authorized for commercial use by 凡科快图
