Detailed Review of VHIS Plans: Coverage for Cancer, Balloon Angioplasty or Kidney Dialysis

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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
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 policyholder.

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 $7,398 $80,000
per policy year
Ward with
Major Medical
$12,592
Ward with
Major Medical Plus
$14,879
Semi-private Room $15,101 $120,000
per policy year
Semi-private Room with
Major Medical
$21,037
Semi-private Room with
Major Medical Plus
$26,300
Private room $29,283 $180,000
per policy year
Private room with
Major Medical
$39,451
Private room with
Major Medical Plus
$47,360
*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 $7,671 $80,000
per policy year
Regular with
Supplementary Major Medical
$11,326
Superior $15,968
Superior with
Supplementary Major Medical
$23,082
Premier $30,430
Premier with
Supplementary Major Medical
$44,672
* 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

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
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
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 $30,430. 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 $7,398:

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.

Want to learn more about the government’s VHIS? Read our VHIS Guide!

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