In the event of a major illness, medical expenses in Hong Kong can be very costly. If you do not have sufficient medical protection, your savings may be depleted on treatments such as “balloon angioplasty”, kidney dialysis or cancer treatments. How do you choose a Voluntary Health Insurance Scheme (VHIS) that covers major medical expenses and is also tax deductible? Two major aspects of premiums and claims should be considered when comparing policies:
VHIS Covers Major Surgeries
Compare Premiums before Purchasing
The government requires that all VHIS plans must provide a minimum amount of benefit limit for severe illnesses. All standard plans provide benefit limit for prescribed ‘non-surgical cancer treatments’ and angioplasty, also known as ‘balloon angioplasty’.
According to the Manulife Shelter VHIS Standard Plan, the VHIS standard plan offered by Manulife, the annual premium for a 60-year-old male policyowner is $5,978, and this is one of the most inexpensive standard plans currently available in the market. In contrast, for the same 60-year-old male policyowner, the annual premium of AIA Voluntary Health Insurance Standard Scheme is $7,251.2, whilst that of the AXA WiseGuard Medical Insurance Plan, the AXA VHIS standard plan, is $7,511.
| Comparison of Annual Premiums of VHIS Standard Plans for a 60-year-old Policyowner |
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| Name of Insurer and the plan | Annual premium (Male) | Annual premium (Female) |
| Manulife Shelter VHIS Standard Plan | $5,978 | $5,823 |
| AIA Voluntary Health Insurance Standard Scheme |
$7,251.2 | $7,155.2 |
| AXA WiseGuard Medical Insurance Plan | $7,511 | $7,020 |
Non-surgical Cancer Treatments
Be Careful when Comparing Premiums
VHIS standard plans provide coverage for cancer, of which the annual benefit limit for ‘non-surgical cancer treatments’ per policy year is $80,000 , covering treatments such as radiotherapy, chemotherapy, targeted therapy, etc for current policy holder.
For flexi plans, the amount of benefit limit varies depending on the insurers, ward types and annual premiums. Take Manulife Shelter VHIS Standard Plan and the Manulife First VHIS Flexi Plan as examples, where the annual benefit limit ranges from $80,000 to $180,000.
In comparison, amongst the 6 different flexi plans offered by AXA, the benefit limit for non-surgical cancer treatment per policy year is $80,000 in each case. In view of the annual premium for a 60-year-old male policyowner, it is not considered inexpensive when compared with other insurers.
| Manulife First VHIS Flexi Plan | ||
| Name of plan | Annual premium* | Coverage for non-surgical cancer treatment |
| Ward | $7,842 | $80,000 per policy year |
| Ward with Major Medical |
$13,348 | |
| Ward with Major Medical Plus |
$15,771 | |
| Semi-private Room | $16,082 | $120,000 per policy year |
| Semi-private Room with Major Medical |
$22,404 | |
| Semi-private Room with Major Medical Plus |
$28,009 | |
| Private room | $31,186 | $180,000 per policy year |
| Private room with Major Medical |
$42,013 | |
| Private room with Major Medical Plus |
$50,435 | |
| *For a 60-year-old male policyowner | ||
| AXA VHIS Flexi Plan: Smart Medicare | ||
| Name of plan | Annual premium* | Coverage amount for non-surgical cancer treatment |
| Regular | $7,899 | $80,000 per policy year |
| Regular with Supplementary Major Medical |
$11,663 | |
| Superior | $16,445 | |
| Superior with Supplementary Major Medical |
$23,772 | |
| Premier | $31,340 | |
| Premier with Supplementary Major Medical |
$46,010 | |
| * For a 60-year-old male policyowner | ||
Significant Premium Differences in Dialysis Cover under Flexi Plans
| Manulife First VHIS Flexi Plan | |
| Types of plan | Coverage for kidney dialysis ／Outpatient kidney dialysis |
| Ward | $50,000 per policy year |
| Ward with Major Medical |
|
| Ward with Major Medical Plus |
|
| Semi-private Room | $75,000 per policy year |
| Semi-private Room with Major Medical |
|
| Semi-private Room with Major Medical Plus |
|
| Private Room | $100,000 per policy year |
| Private Room with Major Medical |
|
| Private Room with Major Medical Plus |
|
| China Life VHIS Flexi Plan Healthy Life Premier Medical Insurance Plan |
|
| Types of plan | Coverage for kidney dialysis ／Outpatient kidney dialysis |
| Semi-private | $50,000 per policy year Maximum 60 days per policy year |
| Semi-private with Supplementary Major Medical |
|
| Private | $75,000 per policy year Maximum 60 days per policy year |
| Private with Supplementary Major Medical |
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Amongst the VHIS coverage required by the government, kidney dialysis (outpatient kidney dialysis) is not mandatory. Therefore, consumers should shop around flexi plans provided by different insurers in order to purchase VHIS plans that provide benefit limit for kidney dialysis.
The Manulife First VHIS Flexi Plan offered by Manulife provides at least $50,000 of benefit limit for kidney dialysis per policy year. Depending on the choice of plan, the benefit limit can be as much as $100,000 per policy year.
At present, not all flexi plans offered by insurers provide coverage for kidney dialysis. Some insurers provide higher benefit limit for kidney dialysis but involves a higher premiums. In contrast, some insurers charge lower premiums but provide lower benefit limit for kidney dialysis. Consumers should carefully compare the premiums of plans which provide the same amount of benefit limit to find the VHIS plan which provides the highest ‘value for money’. For example, in the case of China Life, its 4 flexi plans also provide benefit limit for kidney dialysis, but the benefit limit amounts are only $50,000 or $75,000 per policy year.
Cardiac Surgery Coverage subject to the Type and Extent of Surgery
| Manulife Shelter VHIS Standard Plan Benefit Limit for Surgeon’s Fees |
|
| Standard Plan | Complex $50,000 Major $25,000 Intermediate $12,500 Minor $5,000 |
| Manulife First VHIS Flexi Plan Benefit Limit for Surgeon’s Fees |
|
| Ward Ward with Major Medical Ward with Major Medical Plus |
Complex $52,500 Major $26,250 Intermediate $13,125 Minor $5,250 |
| Semi-private Room Semi-private Room with Major Medical Semi-private Room with Major Medical Plus |
Complex $73,500 Major $36,750 Intermediate $18,375 Minor $7,350 |
| Private Room Private Room with Major Medical Private Room with Major Medical Plus |
Complex $105,000 Major $52,500 Intermediate $26,250 Minor $10,500 |
| AXA VHIS Flexi Plan: Smart Medicare Benefit Limit for Surgeon’s Fees |
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| Regular | Complex $50,000 Major $25,000 Intermediate $12,500 Minor $5,000 |
| Regular with Supplementary Major Medical | |
| Superior | Complex $80,000 Major $40,000 Intermediate $20,000 Minor $8,000 |
| Superior with Supplementary Major Medical | |
| Premier | Complex $160,000 Major $80,000 Intermediate $40,000 Minor $16,000 |
| Premier with Supplementary Major Medical | |
| FTLife’s Flexi Plan – ”BetterCare” Medical Insurance Plan Benefit Limit for Surgeon’s Fees |
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| Benefit Level 1 with Major Medical Benefits | Complex $50,000 Major $25,000 Intermediate $12,500 Minor $5,000 |
| Benefit Level 2 with Major Medical Benefits | Complex $63,000 Major $30,000 Intermediate $15,000 Minor $6,000 |
| Benefit Level 3 with Major Medical Benefits | Complex $84,000 Major $40,000 Intermediate $25,000 Minor $8,000 |
In the case of heart bypass or related angioplasty procedures, also known as ‘balloon angioplasty’, the benefit limit depends on the classification of the surgical procedures and the types of standard plans or flexi plans. At present, the government divides surgical procedures into 4 categories under VHIS, namely ‘minor’, ‘intermediate’, ‘major’ and ‘complex’. Heart-related surgeries are classified as ‘intermediate’ to ‘complex’.
Manulife’s VHIS plans provide benefit limit for heart-related surgeries such as ‘balloon angioplasty’. For example, ‘percutaneous transluminal coronary angioplasty’ is classified as ‘major’ surgery. According to the most basic standard plan, the benefit limit for surgeon’s fees is $25,000. If the insured wants higher benefit limit levels, they can consider flexi plans and the benefit limit for major surgery is from $26,250 upwards.
When it comes to the benefit limit for surgeon’s fees, consumers should also pay attention to the insurance premium. For example, although the Premier with Supplementary Major Medical plan of Smart Medicare, AXA’s VHIS Flexi Plan, offered higher amounts of benefit limit for surgeon’s fees, the annual premium is usually more than $10,000. At present, a 60-year–old policyowner has to pay an annual premium of $31,340. In the case of FTLife, another insurer, the highest category of flexi plan is Benefit Level 3 with Major Medical Benefits in which a 60-year-old policyowner has to pay an annual premium of $33,759.52.
To be hospitalised for important surgery, pay attention to benefit limit
Should you be hospitalised because of major surgery or cancer related treatment, the charges for hospitalisation are considered as part of the medical expenses. Therefore, when choosing VHIS, consumers should also note whether the benefit limit provided for hospitalisation is enough to cover related expenses.
Now, Manulife’s standard and flexi plans provide benefit limit for room and board. For ward, coverage will include semi-private room and private room, with amounts ranging from $750 to $4,000 per day.
Some Insurers Offer Flexi Plans that Provide 100% Coverage for Excess Expenses
What happens when the ‘benefit limit amount’ exceeds the limit because of major surgery or treatment? The insured should compare flexi plans offered by different insurers because certain flexi plans provide special benefit limit terms in such conditions. For example, the Manulife First VHIS Flexi Plan provides policyowners with ‘reimbursement of up to 100%’ of excess expenses and a free choice of doctors and hospitals after obtaining a preliminary assessment.
The ‘cashless arrangement for a hospital stay’ provided by the flexi plan of AIA is similar to Manulife’s. In the event that the policyowner is granted a preliminary assessment, AIA will pay the hospital invoice directly on the policyowner’s behalf. However, this plan does not guarantee to cover all cases of expenses exceeding limits. There is ‘a shortfall notification’ in the insurance contract terms. If the insured’s hospital bills exceed preliminary estimates, the shortfall is payable by the insured.
All in all, the Manulife First VHIS Flexi Plan offers more comprehensive coverage in areas such as cancer, balloon angioplasty and kidney dialysis, with benefit limit on surgeon’s fees, anaesthetist’s fees and room and board. Take the entry level of the Manulife First VHIS Flexi Plan as an example: a 60-year-old male policyowner will be entitled to the following benefit limit if he pays an annual premium of$7,842:
| Manulife First VHIS Flexi Plan (semi-private room) | |
| Non –surgical Cancer Treatment | $120,000 per policy year |
| Out-patient Kidney Dialysis | $75,000 per policy year |
| Surgeon’s fees | • Complex $73,500 • Major $36,750 • Intermediate $18,375 • Minor $7,350 |
| Anaesthetist’s fees | 35% of surgeon’s fees payable |
| Room and board | $2,300 per day Maximum 180 days per policy year |
| *Applicable only when receiving medical services in Hong Kong and Flexi Plan with Major Medical Benefits Reimburse up to 100% of the eligible excess expenses after obtaining a preliminary assessment. | |
Apply for Manulife designated plan(s) to enjoy premium discount*.
*Subject to terms and conditions. Please check for more product and offer details from the product/promotion leaflet on the website.
Want to learn more about the government’s VHIS? Read our VHIS Guide!
Chinese version
自願醫保計劃內容全面睇：癌症、通波仔、洗腎保唔保