Does VHIS cover "psychiatric treatment"?
VHIS provides coverage for the expenses of psychiatric treatment during hospitalization within Hong Kong, under the advice of a specialist.
According to the requirements of the Health Bureau, “psychiatric treatment” coverage must be at least HK$30,000 per year. This coverage has no age restrictions, which means that patients can receive relevant coverage even in their twilight years.
Coverage for psychiatric hospitalization treatment
According to the requirements of the Health Bureau, all VHIS policies will provide at least HK$30,000 of “psychiatric treatment” coverage per year. In fact, insurance companies can also set their own benefit amounts and provide insured individuals with coverage of no less than HK$30,000.
Taking Bowtie as an example, the benefit amounts for different VHIS are as follows:
| Psychiatric treatment annual benefit limit (only applicable to the hospitalization in HK) | |
| Bowtie VHIS Standard | HK$30,000 |
| Bowtie VHIS Flexi Regular | |
| Bowtie VHIS Flexi Plus | HK$37,500 |
| Bowtie Pink ( Ward/ Semi-Private/ Private) | Full Coverage 3 |
- 1The Company shall have the right to ask for proof of recommendation e.g. written referral or testifying statement on the claim form by the attending doctor or Registered Medical Practitioner.
- 2The coverage will compensate for qualified expenses incurred by the insured person for receiving psychiatric treatment under the advice of a specialist while hospitalized in Hong Kong.
- 3The Bowtie Pink Voluntary Health Insurance series fully covers eligible medical expenses such as diagnosis, hospitalisation, surgery, and prescribed non-surgical cancer treatments (except in the United States), and is subject to annual benefit limits and lifetime benefit limits. If the claim involves confinement in a Mainland China Hospital unlisted in / a High-end Mainland China Hospital listed in the "List of Designated Hospitals in Mainland China" / confinement in a room higher than the restricted ward class / a pre-existing condition, the relevant benefit payable may be adjusted.
Coverage for psychiatric outpatient treatment
Since VHIS only covers hospitalization treatment, outpatient treatment, or costs for a day case procedure clinic and outpatient psychological counseling are not covered.
Things to note when claiming psychiatric treatment:
According to the terms and conditions of VHIS, if a claim is made for psychiatric treatment, the following points should be noted:
- The insured person must be hospitalized in Hong Kong and receive qualified psychiatric treatment under the advice of a specialist to be eligible for compensation.
- All expenses arising from hospitalization for psychiatric treatment will be included in the annual benefit limit for “psychiatric treatment” (starting from HK$30,000, depending on the insurance plan).
- If the costs of hospitalization for treatment involve both psychiatric and non-psychiatric treatments and cannot be clearly allocated, the claim team will handle the claim in the following ways:
- If psychiatric treatment is the initial reason for hospitalization, the qualified expenses will be fully compensated under the “psychiatric treatment” coverage.
- If psychiatric treatment is not the initial reason for hospitalization, the qualified expenses will be fully compensated under the basic coverage, which covers general hospitalization treatment.
- ^The basic coverage includes room and board, miscellaneous expenses, attending doctor, specialist fees, intensive care, surgeon fees, anesthesiologist fees, operating theaters fees, Prescribed diagnostic imaging tests, non-surgical cancer treatments, and Pre- and post-confinement / Day case procedure outpatient care (where applicable).
How does VHIS cover psychiatric treatment to help Hong Kong people?
Before answering this question, we need to understand the number of people in Hong Kong who have mental illness and require hospitalization treatment, as well as the psychiatric facilities of the Hospital Authority.
According to Data by the Research Division of the Legislative Council Secretariat:
| Hospital Authority psychiatric services utilization | 2011 to 2012 | 2015 to 2016 |
| patients required hospitalization treatment | 14,300 | 14,700 (+2.8%) |
| Hospital Authority psychiatric resources | 2011 to 2012 | 2015 to 2016 |
| psychiatric hospital beds | 3,607 | 3,607 |
As of 2016, the number of psychiatric patients requiring hospitalization treatment is four times the number of psychiatric hospital beds, indicating that the public healthcare system cannot meet the demand for hospitalized psychiatric patients.
Having VHIS coverage allows patients to receive timely assistance by receiving psychiatric treatment in private hospitals.
Private hospital psychiatric hospitalization treatment
According to the information from the Hong Kong Mental Health Association, as long as it is referred by a private psychiatric specialist, some private hospitals (including Evangel Hospital, Baptist Hospital, and St. Teresa’s Hospital) can provide hospitalization treatment for psychiatric patients.
However, only Gleneagles Hospital has a psychiatric specialty ward named “Behavioral Health Division,” which provides psychological assessment, individual counseling, medication, and psychological behavior therapy.
Using the most basic “psychiatric treatment” benefit limit of HK$30,000 per year, staying in a semi-private room or higher at the following hospitals is enough to cover the room and board expenses for hospitalization of at least 10 days:
| Hospital | Semi-private room or higher (daily rate) |
| Gleneagles Hospital | HK$2,300 up |
| Evangel Hospital | HK$1,680 up |
| Baptist Hospital | HK$2,160 up |
| St. Teresa’s Hospital | HK$1,600 up |
