How to Claim from Two Medical Insurance Policies?


How to Claim from Two Medical Insurance Policies?

Many people in Hong Kong have more than one medical insurance policy, including group & personal medical insurance..So how exactly do you file claims for your two medical insurance policies?In this article, Bowtie will provide some advice to help you make smart claims and maximize your benefits in both policies.

When would someone have more than one medical/ health insurance policy?

You might have more than one medica or health insurance policy in the following situations:

Group Medical Insurance + Personal Medical Insurance

If you are a full time employee, your company may provide medical insurance as an employee benefit. However, many people also choose to purchase additional personal health insurance to enhance their coverage, which is a concept of what we call “Top Up Medical Insurance”.

Reasons for “Top Up Medical Insurance”:

  • Group Medical Insurance may not provide sufficient coverage; topping up can allow better coverage.
  • You could not control the benefits from group medical insurance as your employer is the policyholder. There may be a chance that coverage will be reduced in the future. Topping up allows you to control the policy, including the coverage.
  • When you leave the company or retire, you will lose group medical insurance coverage; topping up can back you up whenever you need.

Two Basic Personal Medical Insurance Policies

Some people choose to have two personal medical or health insurance policies to increase coverage. For example, they may have been insured by their family when they were young or purchased basic medical insurance when they first entered the workforce. 

Later, they might find that the coverage is not sufficient and then decide to purchase another policy with more comprehensive coverage and higher benefit limits.

However, the insurance industry generally does not recommend this arrangement, as the coverage of two basic health insurance policies is very likely overlapping, and hence, lowering the premium efficiency. 

With the same premium expenditure, other combinations can actually provide greater coverage, such as choosing a personal high-end health insurance policy with a deductible and full coverage  as the top up choice.

How to file claims if you have two medical insurance policies?

Group Medical Insurance + Personal Medical Insurance (high-end or basic) 

In this situation, you should first file claim with the group medical insurance or the basic medical insurance policies (referred to as the first policy), and then submit the original medical receipts (or verified copies), medical reports filled out by the doctor, and the claim report issued by the first insurer to the personal medical insurance policies – basic or high-end (referred to as the second policy).

If your second policy from Bowtie, you just need to upload the aforementioned documents to Bowtie’s online platform, and Bowtie will handle the other relevant claim procedures for you. Of course, if your group medical insurance is also from  Bowtie, you only need to apply once.

Having Two Personal Medical Insurance Policies

Since the coverage provided by the two medical insurance policies is similar, you can decide which insurance company to file your first claim. In addition to the basic documents, you only need to submit the claim report and original medical receipts (or verified copies) issued by the first insurance company to the second insurance company for approval.

If you have multiple medical or health insurance policies from Bowtie, you only need to submit the required documents to one single online claim application. Bowtie’s claims team will handle the claims for you.

Best Top Up Health Insurance Choices

If you already have one basic coverage policy, either from group or personal medical insurance, and would like to enhance your insurance coverage, a high-end medical insurance with a deductible is a cost-effective Top Up choice of yours

This type of insurance generally has a broader coverage scope, including full coverage for treatment worldwide. There is no benefit limit for individual items, only the annual benefit  and lifetime benefit limit.

For example, if you are an insured person of Bowtie Pink you could use the reimbursement from group or basic medical insurance (the first policy) to offset the deductible of Bowtie Pink (the second policy). In this way, you could get a full reimbursement of your treatment cost.

Note that Bowtie Pink is not only a high-end health insurance but also a “Voluntary Health Insurance Scheme (VHIS)” product, and the premiums paid can be used for tax deductions.

How to choose a deductible?

Based on the “room and board” benefit limit for each surgery under your group  or personal medical insurance.

Bowtie Pink is a VHIS (for semi-private or private rooms) with four options for deductible amounts: HK$0, HK$20,000, HK$50,000, and HK$80,000.

If you already have the first policy, you do not need to take the HK$0 deductible option into consideration. Since “Top Up” is the aim of applying for multiple medical insurance, you should choose the amount of deductible based on the coverage of your first policy, which we suggest looking into the coverage amount for “room and board”.

If you want to stay in a Semi-Private ward:
Room and board per surgery Choice of policy
>HK $1,800Bowtie Pink (Semi Private)

HK$80,000 Deductible

HK$1,500 – 1,800Bowtie Pink (Semi Private)

HK$50,000 Deductible

<HK$1,500Bowtie Pink (Semi Private)

HK$20,000 Deductible

If you want to stay in a Private room:
Room and board per surgery Choice of policy
>HK $5,300Bowtie Pink (Private)

HK$80,000 Deductible

HK$4,300 – 5,300Bowtie Pink (Private)

HK$50,000 Deductible

<HK$4,300Bowtie Pink (Private)

HK$20,000 Deductible

Let’s look into Bowtie’s claim data and case study!

You may calculate how much you can reimburse with Bowtie Pink with the below tool!

Next article - What is a Deductible in Insurance?
Not sure about the meaning for deductibles in insurance, and how it works? Let Bowtie guide you how to choose the best deductibles option for yourselve.
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