Best VHIS in 2026: Premiums, Coverage and Claim Rates
Comparing VHIS and Traditional Medical Insurance
Compared to traditional medical insurance, the Voluntary Health Insurance Scheme (VHIS) offers advantages in standardised terms and transparency. As VHIS plans must be approved by the Department of Health, insurers are required to adhere to government-mandated “minimum requirements”. This resolves the issue of inconsistent terms in traditional medical insurance, significantly enhancing consumer protection. It is worth noting that VHIS is the only medical insurance eligible for tax deduction. Each insured person may claim a maximum deduction of $8,000 annually.
VHIS Standard Plan vs Flexi Plan
The Standard Plan provides fundamental cover; the Flexi Plan builds upon this foundation by enhancing both the level and scope of protection.
| Standard Plan | Flexi Plan | |
| Assure | Meets minimum requirements | Relatively high |
| Compensation Model | Detailed restrictions | Detailed restrictions or full compensation |
| Annual limit | $420,000 | It can reach tens of millions |
| ward level | Only standard rooms are available. | In addition to standard rooms, it also includes semi-private and private rooms. |
| First year premium | Relatively low, as low as $1,760 | Relatively high, with the most expensive reaching $47,363. |
- NoteThe first-year premium assumes the insured is a 35-year-old non-smoker. Data as of 23 January 2026.
VHIS Coverage
Generally speaking, Voluntary Health Insurance schemes operate under two primary reimbursement models: “itemised limits” and “full reimbursement”. As shown in the table below, “full reimbursement” is only available under the Premium Flexi Plan, while the Standard Plan and Flexi Plan employ “itemised limits”. Furthermore, unlike the Standard Plan which provides only standard wards, the Flexi Plan additionally covers semi-private and private wards.
| Standard Plan | Flexi Planning | High-end Flexi Plan | |
| Example | Bowtie Standard Plan | Bowtie Flexi Planning | Bowtie Pink |
| Room type | Standard Room | Standard rooms and semi-private rooms | Standard Room
semi-private house private house |
| Compensation Model | Detailed restrictions | Detailed restrictions are set, but additional medical coverage (SMM) may be provided. | Full compensation^ |
| Features | There are caps or co-insurance provisions for certain medical procedures (such as hospitalization, surgery, and diagnostic tests). | Most medical expenses do not have itemized limits, but are only subject to annual and lifetime coverage limits. | |
- Note: Assumes the insured is a 35-year-old non-smoker. Data as of 23 January 2026.
Bowtie’s internal data indicates that approximately 65% of customers have opted for products featuring itemised claim limits among active policies.
| Product | Compensation Model | Percentage of effective policies |
| Bowtie Standard Plan | Detailed restrictions | 18% |
| Bowtie Flexi Planning | Detailed restrictions | 44% |
| Bowtie Pink | Full compensation^ | 38% |
- Data as of 22 January 2025; percentages are approximate figures.
Supplementary Medical Cover (SMM) Enhances Flexi Plan Reimbursement Rates
To address the shortfall in reimbursement rates for non-full-coverage Flexi Plans, certain Flexi Plans (such as Bowtie Flexi Plan) offer Supplementary Medical Cover (SMM) to enhance reimbursement rates. Supplementary Medical Cover refers to additional reimbursement provided by the insurer when actual expenses exceed the itemised reimbursement limits. The table below compares the Supplementary Medical Benefits (SMM) across four products. Among them, the Bowtie Flexi Plan (Standard) offers the highest SMM limit while maintaining the lowest premium.
Table Comparison of Supplementary Medical Benefits (SMM) Across Four Flexi Plans
| Bowtie Flexi Plan (Standard) | Company A | Company M | P Company | |
| Room type | Standard Room | Standard Room | Standard Room | Standard Room |
| Additional Medical Coverage (SMM) Cap
Each policy year |
120,000 | 120,000 | 100,000 | 100,000 |
| Additional medical insurance out-of-pocket expenses | 20% | 20% | 20% | 20% |
| premium | $3,336 | $4,923 | $5,421 | $4,270 |
| 10-year average annual premium | $3,983 | $6,001 | $6,232 | $4,985 |
- Assumes the insured is a 35-year-old non-smoker. Data as of 23 January 2026.
VHIS Long-Term Premiums
When selecting health insurance, one should not focus solely on the first-year discount but must also consider the long-term financial burden. The savings accumulated from lower premiums can add up significantly, potentially funding a family holiday. Premiums for Voluntary Health Insurance are transparent. Competition is particularly fierce among semi-private room products. Bowtie compares the long-term premiums of five popular products, providing you with a clear overview.
Comparing Monthly Premiums for 5 Popular High-End VHIS (Semi-Private Ward) with Full Coverage
| Age | Company A’s
premium |
Bowtie Pink
premium |
Company B’s
premium |
Company C’s
premium |
F Company’s
premium |
| 0 years old | $1,096 | $768 | $1,521 | $1,260 | $776 |
| 10 years old | $1,096 | $652 | $972 | $844 | $710 |
| 20 years old | $1,136 | $717 | $1,159 | $920 | $752 |
| 30 years old | $1,656 | $909 | $1,415 | $1,274 | $1,033 |
| 40 years old | $1,992 | $1,176 | $1,932 | $1,609 | $1,231 |
| 50 years old | $3,136 | $1,799 | $3,009 | $2,487 | $1,805 |
| 60 years old | $5,216 | $2,833 | $4,989 | $4,106 | $3,057 |
| 70 years old | $10,016 | $4,569 | $8,057 | $7,287 | $5,702 |
| 80 years old | $15,240 | $7,372 | $10,412 | $9,713 | $9,085 |
- NoteData current as of 29 December 2025. Assumes male non-smoker policyholder with $0 excess plan. Company F premiums shown as rounded whole figures.
Factor Affecting Premiums: Ward Category
Ward categories comprise Standard Rooms, Semi-Private Rooms, and Private Rooms. Generally, under the same plan, Standard Room costs are lower than Semi-Private Rooms, while Semi-Private Rooms are lower than Private Rooms. Differences between ward types lie in privacy and the level of luxury in facilities. The quality of treatment does not vary according to ward category.
Annual Premium Comparison for Different Ward Categories Under the Same Plan
| Bowtie Pink
premium |
Company A’s premium | Company B’s premium | |
| Standard Room | $8,424 | $9,357 | $9,072 |
| semi-private house | $10,908 | $13,783 | $16,980 |
| private house | $16,800 | $20,769 | $22,044 |
- NoteData updated on 23 January 2026; based on a 30-year-old non-smoking male insured person purchasing a $0 excess plan with annual or monthly premium payments. Amounts rounded to the nearest whole dollar.
Bowtie’s internal data indicates that Bowtie Pink customers predominantly select semi-private rooms (55%), followed by standard rooms (42%).
- Data as of 21 January 2026; percentages are approximate.
VHIS Claim Success Rate
According to Legislative Council documents, the claim success rate for Voluntary Health Insurance ranged between 92% and 96% from April 2019 to the end of 2023. For Bowtie Voluntary Health Insurance, the claim success rate reached 98.3%* as of February 2025.
Comparing Claim Success Rates Between Bowtie and Other VHIS on the Market
| Years | Market average claim success rate |
| 2019 (April to December) | 96% |
| 2020 | 94% |
| 2021 | 93% |
| 2022 | 92% |
| 2023 | 93% |
| Bowtie Voluntary Health Insurance
April 2019 to February 2025 |
98.3%* |
- The above represents the average ratio of approved claims for Bowtie Voluntary Health Insurance's "Standard Plan", "Flexi Plan - Standard", "Flexi Plan - Plus", and Bowtie Pink as of February 2025.
How do forum users compare VHIS?
Analyses from LINKG, Baby Kingdom, and Hong Kong Discussion forums reveal distinct user priorities:
LINKG users primarily scrutinise policy terms, such as comparing Bowtie’s “pre-existing conditions” clauses against competitors and discussing cancer-specific provisions.
Baby Kingdom parents prioritise children’s coverage, debating which VHI plan suits youngsters best and whether to purchase medical or critical illness insurance first.
Hong Kong Discussion forum members focus on claim rejection cases, including denied claims and personal experiences of rejected claims.
Despite differing entry points, netizens’ conclusions are remarkably consistent: they recommend selecting the “Flexi Plan”. Furthermore, with the proliferation of online insurance, online VHI products touting high value for money have also become a primary topic of discussion in recent years.
- Full indemnity refers to the absence of sub-limits on claims, and applies only to specified coverage items. Claims are subject to the excess (where applicable), annual coverage limits, lifetime coverage limits, and other restrictions including reasonable and customary charges, pre-existing conditions, the list of designated hospitals in Mainland China, and provisions regarding medical treatment in the United States. For detailed terms and conditions, product risks, and exclusions, please refer to the relevant product website and policy documents.
- Psychiatric treatment is restricted to Hong Kong; medical expenses incurred in hospitals outside the United States and those not included in the designated list of hospitals in Mainland China will be reimbursed according to the standard plan's compensation limits.
