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How is Shanghai’s Healthcare System compared to the rest of China


As one of the first tier cities, Shanghai’s healthcare infrastructure is better compared to the second and third tier cities. Having said that, many expatriates still find the healthcare facilities and treatments in Shanghai very limited. The good news is that the quality of service and availability of treatment are slowly improving.


What to do before leaving for Shanghai

Before leaving for Shanghai, ensure that your routine medical check-up and vaccination are up-to-date, including vision and dental. To enter China, no vaccinations are required but do ensure that the standard, like polio, diphtheria and tetanus, are up-to-date. Discuss with your doctor on any additional vaccinations that may be advisable as some, like for 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 your visual aid. Most importantly, ensure that your health insurance covers you and your family in Shanghai.


Healthcare services and costs in Shanghai

Pharmacies

To dispense non-OTC (over-the-counter) drugs, pharmacies require a prescription issued by a doctor in Shanghai 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, resulting in high prices. Thus, 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. Do go prepared with a Chinese translation of the medicine as the brand name may differ. It is advisable to bring your own regular medication especially those for cough, cold, sore throat, allergies, etc.


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 Rmb14. 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 is extremely limited and basic.


Foreigner/VIP 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 appointment with your preferred doctor. Some clinics may have certain doctors available only 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 poor thus a translator may still be required. 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, etc.


Cost

The average consultation fee of a General Practitioner is Rmb300. Other charges for medication or required test are calculated separately.


Payment

Local and overseas credit cards are accepted. If you are insured by a local Chinese health insurance company, you are required to pay first and claim later. Only top hospitals like Guangci and Huashan are recognized by some local and international health insurance companies thus 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 – 100% is usually required upfront upon admission.


International Hospitals

In Shanghai, there are a number of international hospitals and clinics located in each expat community. These facilities which are set up as joint-ventures, offer modern medical equipment, hygienic environment, well-trained western doctors and English speaking Chinese doctors and staff who are sensitive to the cultural differences thus having 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 the major local hospitals that will provide full medical support whenever needed. In the case when the medical treatment is not available in Shanghai, patients will be evacuated to Hong Kong or back home, 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 Rmb700, which is more than double compared to the Foreign/VIP clinics. Other charges for medication or required test are calculated separately.


Average starting price of consultation cost

General PractitionerPediatricianSpecialistGynecologistDentist
Rmb700Rmb700Rmb1,000Rmb1,000Rmb500
USD111USD111USD159USD159USD79
Note: Exchange rate @ USD1=Rmb6.3


Payment

All the international hospitals and clinics will accept local and overseas credit card and direct billing channels are set up with most international health insurance providers. 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, Podiatry, etc. Do 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. For receiving inpatient treatment, a deposit of 50 – 100% is usually required upfront upon admission.


Ensure that you and your family are properly insured

Regardless of whether you are moving to Shanghai on your own or by 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’s starts at between USD111-159 without medicine, so this could add up to a sizeable figure especially when you have children. Thus, it is worth considering a comprehensive coverage when purchasing an international health insurance.


Work with an independent intermediary

More often than not, it can be extremely confusing and time consuming when looking for the best solution as there are many options in the market. It would be wise to engage the service of an independent intermediary who is knowledgeable and experienced to guide you through your research and decision-making process. Ensure that the insurance advisor is truly independent and that they have professional liability.


Healthcare Shanghai Expat Guide


Moving to or living in Shanghai? What are the choices when it comes to healthcare? Does it offer the type of treatment I require? Will I be able to get the same medication back home? What kind of coverage do I need when purchasing an international health insurance?

Credit goes to ExpatMedicare