Insurance

Why You Need to Buy Critical Illness Insurance at 45

Author Bowtie Team

Updated on 2025-07-24

Disclaimer: This article is translated with the assistance of AI.

Critical illnesses are hitting younger ages – even at 45, you’re not immune! Ready to pick a plan? Let the Bowtie team break down why it’s crucial and what to think about before you buy.

Does Critical Illness Risk Increase at 45?

The risk of developing critical illnesses generally increases with age. This is because:

Physiological Changes and Declining Immune Function: Research from University College London (UCL) indicates that the biological age of organs, which differs from chronological age, affects disease risk. As we age, the immune system deteriorates, linking to higher risks of cardiovascular diseases, cancer, and dementia.
Accumulated Risk Factors and Lifestyle Habits: Studies from Harvard T.H. Chan School of Public Health confirm that maintaining healthy habits in midlife—like balanced diet, exercise, proper weight, no smoking, and moderate drinking—can significantly extend disease-free years, showing how poor habits accumulate to raise risks of chronic and major diseases.
Burden of Chronic Diseases: Research shows that middle-aged people commonly have chronic conditions like diabetes, hypertension, and chronic lung disease, which greatly increase the risk of severe issues like heart disease and stroke.
Genetics and Aging: Aging itself is a major risk factor for many serious diseases (cancer, cardiovascular disease, neurodegenerative disorders). Studies note that genetic factors combined with advancing age drive up incidence rates.

We’ll also break it down by the three major critical illnesses (cancer, heart disease, and stroke) to explain why risks seem to rise after 45:

Cancer

According to data from the Hong Kong Cancer Registry, in 2022, there were 12,841 new cancer cases in the 45–64 age group, about 5 times higher than the 2,583 cases in the 20–44 group.

Digging deeper into the data on the top five common cancers for men and women, incidence rates after age 45 are roughly 3 times higher than at 35 for both genders, highlighting how cancer risk climbs with age.

Age Group	Top 5 Cancer Incidence Rates (per 100,000)
Age Group	Male ¹	Female ²
20 – 24	2.6	13.3
25 – 29	4.8	30.2
30 – 34	12	62.8
35 – 39	29.9	103.7
40 – 44	46.5	173.1
45 – 49	89.4	322.2
50 – 54	163.7	382.8
55 – 59	294.4	464.2
60 – 64	524.4	492.1
65 – 69	806.8	573.9

Heart Disease

Based on the 2020–2022 Population Health Survey, only 1.6 per 100,000 Hongkongers aged 35–44 have coronary heart disease, but this rises to 6.2 in the 45–54 group. While the prevalence isn’t sky-high at 45, the figures show a 4-fold increase in risk over that decade.

Using the Framingham Risk Score for prediction, in the 30–44 age group, only 0.4% are at high risk of cardiovascular disease in the next 10 years. But at 45–54, that jumps to 4.9%, and soars to 19.6% for 55–64, underscoring how age amps up future heart risks.

Stroke

From the 2020–2022 Population Health Survey, stroke affects just 1.2 per 100,000 in Hongkongers aged 35–44 and 1.4 in 45–54. Compared to cancer and heart disease, stroke doesn’t seem like a big threat around 45. However, over the past 20+ years, strokes are striking younger.

A study by the Stroke Research Group at HKU’s LKS Faculty of Medicine shows that young strokes (ages 18–55) in Hong Kong rose significantly from 2001 to 2021. Cases increased from 1,531 in 2001 to 2,028 in 2021, with incidence climbing from 39.1 per 100,000 to 55.7—a nearly 30% jump in 20 years, signaling stroke as a growing threat to the young.

1 According to the Hong Kong Cancer Registry, the top five common cancers for males in 2022 were lung cancer, colorectal cancer, prostate cancer, liver cancer, and stomach cancer.
2 According to the Hong Kong Cancer Registry, the top five common cancers for females in 2022 were breast cancer, lung cancer, colorectal cancer, corpus uteri cancer, and thyroid cancer.

Are Cancer, Heart Disease, Stroke Main Causes of Death for Ages 45+?

According to data from the Centre for Health Protection , malignant neoplasms ( cancer ), heart disease , and cerebrovascular diseases (including stroke ) are the leading causes of death in Hong Kong, collectively known as the “three major critical illnesses.” Statistics from 2023 show that the total registered deaths for ages 45–64 were 8,146, with 5,172 deaths caused by these three major illnesses, accounting for 63.5% of the total. This means that in this age group, about 6.3 out of every 10 deaths are due to these critical illnesses.

The table below lists the proportion of registered deaths caused by the three major critical illnesses across age groups in 2023:

Age Group	Deaths Due to Three Major Critical Illnesses	Registered Deaths	Percentage Due to Three Major Critical Illnesses
15 – 44	572	1,408	40.6%
45 – 64	5,172	8,146	63.5%
65 and above	19,405	47,080	41.2%

From the data above, middle-aged individuals (45-64 years) have a higher proportion of deaths from the three major critical illnesses (cancer, heart disease, stroke) at 63.5%, compared to younger people (15-44 years, 40.6%) and the elderly (65 and above, 41.2%). Although the proportion is lower for those 65 and older, they have the highest number of deaths, reflecting that critical illness risks increase with age. Therefore, after middle age, it’s crucial to enhance prevention and early screening to minimize the impact of these illnesses.

Why Buy Critical Illness Insurance at 45?

People at 45 are often in the “sandwich generation,” meaning they bear the responsibility of caring for their children or elderly parents—or sometimes both at once. On top of that, they might be repaying mortgages or facing pressures from unemployment or health issues.

In such scenarios, if they unfortunately contract a critical illness, not only could they face hefty medical bills, but they might also be forced to stop working or even lose their ability to work. If they’re the sole breadwinner, this loss of income could plunge the family into financial stress. Below, we’ll analyze the expenses 45-year-olds face in life from various angles and explain why getting critical illness insurance can help them prepare for the unexpected:

Expenses for Childcare

According to Hang Seng Bank’s 2022 Retirement Planning Survey , raising one child to financial independence at 22 costs about HK$6 million, averaging HK$284,000 per year. Based on 2023 government statistics, the median age for women having their first child is 32.9. Using this, a 45-year-old with a 12-year-old child would still need around HK$3 million to support them until independence.

For a 45-year-old parent who is the main income earner, contracting a critical illness could lead to these issues:

Loss of Income : Critical illness treatment and recovery can take months or years, making work impossible. For a 45-year-old family pillar, this means the household’s primary income vanishes, leaving daily expenses and children’s education unprotected.
High Medical Costs : Take cancer—for self-funded targeted drugs, annual costs can reach hundreds of thousands or over a million HKD, plus surgery or hospitalization, quickly depleting savings and leading to debt.
Pressure from Child-Rearing Expenses : Tuition, tutoring, extracurriculars can’t pause due to a parent’s illness. Without enough savings, kids’ education and quality of life suffer, possibly forcing the use of retirement funds.
Increased Family Burden : If the main earner falls ill, others may take on extra caregiving, even quitting jobs or studies, worsening the family’s finances.

To avoid this, 45-year-olds should consider critical illness insurance. For childcare needs, a lump-sum payout can help in these ways:

Lump-Sum Payout Eases Financial Strain : Use it for medical bills, daily expenses, or child-rearing costs, cushioning the blow from lost income.
Protects Children’s Education and Growth : For parents at 45, the payout secures 5–10 years of child-rearing expenses, ensuring tuition, activities, and living costs continue unaffected.
Reduces Family’s Emotional Burden : With financial security, patients focus on recovery without money worries. Families avoid extra stress, maintaining normal life.

Expenses for Elderly Parents

For elderly parents, main expenses include living costs, medical fees, and caregiving. Some arrange private nursing homes or hire private carers; if parents have chronic illnesses, total annual costs with medical needs can reach hundreds of thousands.

For 45-year-olds supporting and caring for aging parents, these costs take a chunk of household spending. If they get a critical illness, it not only burdens the family financially but could also affect parents’ retirement years. Here are potential issues:

Loss of Income : Treatment and recovery may last months or years, halting work. As the family breadwinner, lost income directly impacts daily expenses and parents’ care, leaving their later years unsecured.
High Medical Costs : Critical illness treatments cost tens of thousands in HKD for surgery, hospitalization, and drugs. If parents need ongoing care, family finances double in strain, possibly requiring savings depletion, asset sales, or loans.
Pressure from Parental Support Expenses : Without steady income, affording private carers or nursing homes becomes impossible, affecting parents’ quality of life and dignity in old age.

To mitigate these risks, 45-year-olds should opt for lump-sum critical illness insurance. It effectively handles sudden financial challenges:

Stabilizes Family Finances : The payout acts as temporary income for mortgages, utilities, and parents’ daily needs, keeping life on track.
Covers Medical Expenses : Use it for costly treatments like surgery, drugs, or rehab, lightening the load.
Ensures Parents’ Care Needs : If you have VHIS, the payout can fund professional carers, equipment, or nursing home fees, maintaining parents’ quality of life.

Mortgage Repayment Expenses

On the other hand, many people buy property after starting a family and repay monthly mortgages until it’s paid off. But if a critical illness strikes during this period, forcing a work stoppage, lost income disrupts financial plans, making loan repayments tough and potentially leading to:

Mortgage Repayment Pressure : Interrupted income means missed payments, incurring late fees, damaging credit scores, and affecting future borrowing.
Risk of Property Repossession : Prolonged non-payment could lead to bank legal action, repossessing the property and losing your home and investment.
Family Financial Burden : Inability to cover essentials (like kids’ education or parents’ care) might force using retirement savings or high-interest loans, threatening long-term stability.
Emotional and Psychological Strain : The illness challenge, plus financial woes and fear of losing your home, can impose heavy stress on patients and families.

In such times, lump-sum critical illness insurance can effectively ease mortgage issues from a critical illness:

Eases Mortgage Repayment Pressure : The payout covers loan payments, ensuring timely repayments even without income, avoiding fees or credit damage.
Reduces Repossession Risk : Funds provide a buffer to maintain payments, minimizing bank actions and protecting your home and investment.
Supports Family Financial Stability : Use it for other expenses (like education or care), reducing the need for savings dips or loans, preserving long-term health.

According to market data, cancer, heart disease, and stroke generally account for about 90% of critical illness claims from insurance companies.

Critical Illness Coverage Comparison

Critical illness insurance products on the market vary significantly in coverage, so it’s wise to shop around and compare before choosing. Based on the comparison table below, Bowtie Term CI Early Stage and Multiple Cover stands out with several advantages:

Age: Issue age covers from 15 days to 65 years old, with maximum coverage up to 100 years old.
Provides multiple claims for cancer, heart disease, and stroke ¹

	Bowtie Term CI Early Stage and Multiple Cover	Company B	Company F
Issue Age	15 days to 65 years old	15 days to 60 years old	0 to 69 years old
Maximum Coverage Age	100 years old	100 years old	99 years old
Early Stage Critical Illness	✓	✓	✓
Second Cancer Protection	✓	❌	❌
Second Heart Disease Protection	✓	❌	❌
Second Stroke Protection	✓	❌	❌

^{Data as of: May 23, 2025}

1 For claims under multiple critical illness coverage, cancer (newly diagnosed, recurrent, metastatic or persistent cancer after the first cancer claim), stroke, heart disease and other heart-related diseases (including coronary artery bypass surgery or other serious coronary artery diseases) need to meet additional requirements. For details, please refer to the policy terms and conditions, as well as exclusions.

Critical Illness Insurance Premium Comparison

	Term CI Early Stage and Multiple Cover	Company B	Company F
45 years old	6,432	13,229	7,140
46 years old	7,080	14,885	7,750
47 years old	7,752	16,587	8,420
48 years old	8,448	17,795	9,140
49 years old	9,168	18,951	9,930
50 years old	9,864	20,216	10,720
51 years old	10,824	21,158	11,570
52 years old	11,784	21,983	12,480
53 years old	12,768	22,469	13,470
54 years old	13,776	22,838	14,540
10-Year Average Annual Premium	9,790	19,011	10,516

^{Data as of: May 23, 2025. Assuming the insured is a non-smoking male with a sum insured of HK$1,000,000. Premiums for Company B and Company F are calculated on an annual renewal basis.}

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Sources

Author

Bowtie Team

The Bowtie Life Insurance Company Limited is an authorized life insurance company and Hong Kong’s very first virtual insurer approved. Through the use of modern technology and medical expertise, Bowtie offers an agent-free, commission-free and more convenient online platform for customers to quote, apply and claim for Voluntary Health Insurance Scheme (VHIS) anytime anywhere. Bowtie is ranked first in the direct channel sales throughout 2021. Stay up to date at www.bowtie.com.hk