Hospital Ward Level
Definition of Ward Class
Insurance companies generally provide multiple plan options to meet the needs of different individuals, mainly divided by “the level of wards that can be covered,” because this factor will affect the amount of reimbursement.
In other words, all plans are based on the charges of private hospitals, which are classified based on the fees for large wards, semi-private wards, and private wards.
|How to classify?
|Large Ward/General Ward
There are wards more supreme than private wards, like suites with larger spaces and more luxurious facilities, such as companion rooms, living rooms, dining rooms, refrigerators, and even massage chairs and jacuzzi.
- *The actual arrangements of each hospital may also be different.
Coverage of Semi-Private and Private Ward Insurance
Full coverage for medical expenses
Whether it is semi-private ward insurance or private ward insurance, most of them provide full coverage. In contrast, general medical insurance will set benefit limits for items such as surgeon fees, operating theatre fees, and miscellaneous expenses. It is worth noting that semi-private or private ward insurance is also subject to annual and lifetime benefit limits.
Does it provide cashless hospitalization?
General medical insurance requires patients to pay first and then claim from the insurance company, but many insurance companies also provide “cashless hospitalization” arrangements.
However, some companies limit the insured person to having treatment in designated hospitals, attending doctors, and pre-arranged services, meaning that non-network doctor services and emergency services could not enjoy the cashless hospitalization service.
Therefore, even if “cashless hospitalization” is provided, you are recommended to confirm the details before purchasing insurance or hospitalization.
Are the benefit amounts higher than general health insurance?
The benefit amounts of semi-private and private ward insurance are generally much higher than those of general medical insurance. The maximum annual benefit limit for general medical insurance is mostly in the hundreds of thousands to millions of Hong Kong dollars, while the maximum benefit limit for semi-private ward policies is often HK$10 million or more, and private ward insurance may have even higher coverage amounts.
Why is the benefit limit designed to be so high? Of course, it is because the related medical expenses are also more expensive!
The expenses for staying in a semi-private/private ward, such as deposits, daily room rates, and companion bed fees, are generally higher than those for general wards.
Other miscellaneous expenses are higher too, such as the cost of the same medicines and consumables, diet, examination fees, private nursing fees, etc.
For example, the daily room rate, companion bed fee, and surgery fee for a semi-private ward are 1.5 to 2 times more expensive than those for a general ward, while for a private ward, they are 2 to 3 times more expensive.
Are the premiums much more expensive than general medical insurance?
The benefit limit of semi-private/private ward insurance plans are higher than those of general ward plans, so the premiums are naturally more expensive.
Take a 35-year-old male as an example:
|General Ward Insurance Plan
|Around HK$3,000 – HK$10k
|Semi-Ward Insurance Plan
|Usually twice the cost of that of the general ward insurance plan.
Assuming the general ward insurance plan is HK$5,000 per year; the Semi-ward insurance plan cost around HK$10k per year.
|Private-Ward Insurance Plan
|Around HK$10k – HK$20k
The difference in premiums is based on different benefit items and limits for different plans (VHIS is also the same). However, the actual premium may be affected by the insured person’s lifestyle habits (e.g. smoking), health condition, required coverage, and insured amount.
It is recommended that individuals compare online according to their own circumstances or ask the insurance company to provide a policy recommendation and estimated premium.
It is worth mentioning that if the premium is considered too high, you can check whether the insurance company offers plans with a deductible^. The higher the deductible, the lower the premium expense.
- ^ A deductible, also known as a self-payment amount, is the amount that the insured person needs to pay out of pocket when claiming from the insurance company, and the insurance company will compensate for the remaining medical expenses according to the benefit limit of the insurance plan.
Bowtie Pink (semi-private/private) is a high-end medical insurance that provides coverage for semi-private or private wards, with full coverage1 for eligible medical expenses related to diagnosis, hospitalization, surgery and specified non-surgical cancer treatment in semi-private and private wards.
How much is the coverage?
|Bowtie Pink (Semi-Private)
|Annual Benefit Limit: HK$10m
Lifetime Benefit Limit: HK$50m
|Bowtie Pink (Private)
|Annual Benefit Limit: HK$20m
Lifetime Benefit Limit: HK$80m
- 1The Bowtie Pink Voluntary Health Insurance series fully covers eligible medical expenses such as diagnosis, hospitalization, 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.
- ^30-year-old male purchasing Bowtie Pink (Semr-Private) with HK$80k deductibles.