Case Study: American Expat Admitted to ICU Costing Over ¥700,000

Case Study: American Expat Admitted to ICU Costing Over ¥700,000

John, an American expat working in Shanghai, China, enjoyed his life in the bustling city. One evening, while commuting back home on his scooter, John was involved in a severe traffic accident. He was rushed to a local hospital where he was immediately admitted to the Intensive Care Unit (ICU) due to multiple fractures and internal injuries.

The initial medical expenses skyrocketed, covering emergency surgery, ICU stay, and subsequent treatments. The total cost of his medical care reached over $700,000. Unfortunately, John was uninsured at the time of the accident, leaving him with the daunting task of covering these substantial expenses out of pocket.


Below is a breakdown of John's overall medical bills:


1. Emergency Services:

  • Ambulance Fee: ¥3,600
  • Emergency Room Treatment: ¥14,000
  • Diagnostic Tests (X-rays, CT scans, MRI): ¥25,400


2. Surgery:

  • Surgeon Fees: ¥109,000
  • Anesthesia: ¥21,000
  • Operating Room Charges: ¥36,000
  • Surgical Supplies: ¥18,000


3. ICU Stay:

  • ICU Room Charges (10 days at $2,000/day): ¥145,000
  • ICU Nursing Care: ¥58,000
  • Medications and Intravenous Fluids: ¥36,000


4. Post-ICU Hospitalization:

  • Regular Room Charges (15 days at $1,000/day): ¥109,000
  • Daily Nursing Care: ¥54,500
  • Physical Therapy: ¥29,000
  • Follow-up Diagnostic Tests: ¥18,100
  • Medications: ¥21,800


5. Additional Services:

  • Consultation Fees (Specialists): ¥21,800
  • Medical Equipment (e.g., braces, crutches): ¥14,500
  • Miscellaneous Supplies: ¥18,100


Total Medical Expenses: ¥752,800


However, John's employer had recently introduced a comprehensive health insurance plan for their expat employees, which John had opted into just a month before his accident. This insurance plan included extensive coverage for emergency medical care, hospitalization, and repatriation.

Thanks to his health insurance, the insurer covered 90% of the total medical expenses, including the ICU stay and surgeries, which amounted to $90,000. John only had to pay the remaining $10,000, significantly reducing his financial burden. Additionally, the insurance plan provided John with access to a network of high-quality hospitals and specialists, ensuring he received the best possible care.


Here is a breakdown of John's insurance benefits:


1. Coverage:

  • Emergency Services: 90% covered
  • Surgery: 90% covered
  • ICU Stay: 90% covered
  • Post-ICU Hospitalization: 90% covered
  • Additional Services: 90% covered


2. Insurance Payment:

  • Emergency Services: 90% of ¥43,000 = ¥38,700
  • Surgery: 90% of ¥184,000 = ¥165,600
  • ICU Stay: 90% of ¥239,000 = ¥215,100
  • Post-ICU Hospitalization: 90% of ¥231,900 = ¥208,710
  • Additional Services: 90% of ¥54,400 = ¥48,960


Total Insurance Coverage: ¥677,070


John's Out-of-Pocket Expenses:

  • Total Medical Expenses: ¥752,800
  • Total Insurance Coverage: ¥677,070


John's Payment: ¥752,800 - ¥677,070 = ¥75,730


In this scenario, John's health insurance plan significantly alleviated the financial burden, covering ¥677,070 of the ¥752,800 total medical expenses. John was responsible for paying ¥75,730 out of pocket, a much more manageable amount compared to the full cost. This breakdown demonstrates how comprehensive health insurance can protect expats from severe financial loss during medical emergencies.

Without this insurance, John would have faced severe financial distress, possibly exhausting his savings and accruing debt. The experience underscored the importance of having comprehensive health insurance, especially for expats living abroad who might not be familiar with the local healthcare system and costs.

This scenario highlights the crucial role of health insurance for expats in China, demonstrating how it can mitigate financial risks associated with unexpected medical emergencies.


Note: the scenario was a hypothetical case study based on the overall experiences of expats in China, and no real private individual’s information is shared.



About the author


I'm an insurance broker at Mingya Insurance Brokers based in Beijing, and my company works with multiple insurance companies in China providing insurance plans eligible for expatriates in China. Our insurance partners include AXA, Allianz, AIG, Bupa, Cigna, GBG, MSH, Medilink, Ping An etc.


I specialise on insurance solution planning for expatriates in China, particularly health insurance. I have been assisting expatriates in China with their insurance solution planning since 2018, as well as group insurance planning for corporates and institutions' foreign employees. Currently our clientele includes international schools, foreign enterprises, embassies and so on.


I was born in Beijing, and am able to communicate in fluent English and Mandarin. I held a financial advisor's license issued by the Monetary Authority of Singapore (MAS) for 2 years, and I am currently holding an insurance broker's license issued by the China Banking and Insurance Regulatory Commission (CBIRC) since 2018.


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