VHIS vs Traditional Medical Insurance: Coverage comparison + 6 key advantages

Bowtie’s insurance information team has searched the websites of Hong Kong’s five major insurance companies for their basic general medical insurance plans. These have been compared alongside Bowtie’s VHIS Standard Plan and Flexi Plan (Regular/Plus), aiming to help you find the most suitable hospitalisation cover for your needs:

1. Pre-existing conditions unknown at the time of taking out the policy

To manage risk, most insurers in the market exclude pre-existing conditions from coverage, regardless of whether they were diagnosed before taking out the policy. Voluntary Health Insurance, however, mandates coverage for conditions that were unknown but already present prior to application. It also introduces a waiting period, with compensation ranging from 25% to 100% depending on the stage of the condition. This approach similarly aims to extend healthcare protection to a broader population.

2. Diagnostic imaging examinations

You may also have heard that Voluntary Health Insurance covers “diagnostic imaging tests”, which essentially reimburses 70% of the costs for examinations such as CT scans, MRIs, and PET scans, with an annual limit of $20,000 under the Standard Plan. Under Bowtie’s Voluntary Health Insurance “Flexible Plan (Regular/Plus)”, the annual limit for “diagnostic imaging tests” is further increased to between $26,000 and $40,000.

This coverage is actually quite rare in traditional medical insurance products on the market. Many companies explicitly state in their terms that they do not provide this cover, or fail to clearly specify whether it is included. Naturally, a very small number of plans do state that they cover such examinations, but they impose restrictions, such as requiring the examination to be undertaken within 30 days prior to hospital admission or within 30 days following discharge.

3. Tax Deductions

Under the Inland Revenue Ordinance, taxpayers may claim tax deductions for premiums paid towards Voluntary Health Insurance Scheme-approved products purchased for themselves or specified dependents. The annual deduction limit per insured person is $8,000.

4. Guaranteed Renewal

Regardless of any changes in the insured person’s health condition after the policy takes effect, Voluntary Health Insurance guarantees renewal until at least the age of 100. Furthermore, insurers may not impose additional premium rates or introduce individual exclusions based on changes in the insured person’s health status.

5. Age of Entry

Most general medical insurance products on the market set an upper age limit of 70 for entry, with only a few accepting applicants under 75. However, Voluntary Health Insurance aims to provide coverage to a broader demographic, hence the entry age is set between 15 days and 80 years of age.

6. Standardised and Transparent Terms

Voluntary Health Insurance products must be approved by the Department of Health and regulated by the authorities, ensuring standardised and transparent terms.

1. Daily Doctor Visits Fee

Current basic medical insurance typically offers daily coverage of $550 to $768 for “daily doctor visits fees”. Voluntary Health Insurance, however, provides daily compensation of $750 or more for this benefit, aligning with market-leading basic plans.

2. Cancer Treatment/Dialysis

Cancer management requires not only surgery but also chemotherapy, radiotherapy, targeted drugs, etc. While “non-surgical cancer treatment” coverage exists in the market, its annual limit typically includes “dialysis” at $80,000 to $81,000. Voluntary Health Insurance, however, provides $80,000 or more annually for “non-surgical cancer treatment” alone.

3. Psychiatric Treatment

4. Congenital Conditions

Most insurers base coverage decisions for congenital conditions on age at onset. For instance, congenital conditions diagnosed or manifesting before age 16 or 17 are typically excluded. Voluntary Health Insurance adopts a more lenient approach, excluding only congenital conditions diagnosed or manifesting before age 8.

1. Private nursing fees

The vast majority of standard medical insurance plans provide coverage for private nursing fees, with daily compensation ranging from $300 to $370. The Voluntary Health Insurance Scheme’s “Standard Plan” does not include this benefit, but many “Flexible Plan” products incorporate it. Taking Bowtie’s Voluntary Health Insurance “Flexible Plan” as an example, daily compensation amounts reach as high as $500 to $800 (up to a maximum of 180 days per year).

2. Emergency Accident Outpatient Treatment

Regarding “Emergency Accident Outpatient Treatment” cover, most standard medical insurance plans provide annual coverage of approximately $6,400 to $6,500. The Voluntary Health Insurance Scheme’s “Standard Plan” does not include this cover. In contrast, the Flexible Plan – taking Bowtie’s Voluntary Health Insurance Flexible Plan (Regular) as an example – offers annual coverage of $8,000 for this item, approaching the maximum coverage standard of standard health insurance.

3. Additional Hospital Bed

The cost of additional hospital beds is another popular coverage option offered by major insurers. However, as it is not deemed “essential”, the Voluntary Health Insurance Scheme’s Standard Plan does not currently include this benefit. For Flexible Plans, taking Bowtie’s Voluntary Health Insurance Flexible Plan as an example, this coverage ranges from $350 to $800 per day.