The Food and Health Bureau (“FHB”) has rolled out the Voluntary Health Insurance Scheme (“VHIS”).

Insurance companies participating in the VHIS (“VHIS Providers”) offer individual indemnity hospital insurance plans that are certified by FHB. It is a free choice of consumers whether to buy Certified Plans or not.

VHIS

VHIS – Standard

VHIS – FlexiProduct featuresFAQ
PremiumBenefit coverageTax deduction

Enrollment

The scheme comprises “Standard Plan” and “Flexi Plan”. Insurance companies are required to consider Hong Kong residents aged between 15 days and 80 years old for applications and guarantee to renew the insurance for policyholders up to age 100. As of 1st August 2019, 22 insurance companies have participated in the scheme and launched 172 products in total: 

Certified PlanNumber
Standard 24
Flexi*148

*Includes plans of different currencies and categories

Bowtie, the first authorized virtual insurance company in Hong Kong, offers “VHIS – Flexi” with monthly premium less than $200*. Successfully enrol with the promo code “BOWTIE” by 31st of August can get 1-month wavier of insurance premium and $2,000 BowtieCash^. Get your quote now!

*Monthly premium of Flexi Plan for non-smoking male aged 25 is $183. 

#Successfully enrol during the promotion period can get the premium waiver starting on the 4th month after the policy takes effect

^BowtieCash Rewards – can be used to cover any eligible medical expenses exceeding the benefit and coverage limit of Bowtie VHIS. Terms and conditions apply. Please refer to the Campaign Rules

There are only slight differences among different “Standard Plans”

Standard Plan is fixed in product design and adheres to the minimum complying requirements of VHIS. Except for some minor allowable variations, the Standard Plans offered by different VHIS providers should be largely the same in product design. All VHIS providers have to disclose the certification number of their certified plans. For example, the certification number of Bowtie’s Standard Plan is S00023-01-000-01. (as shown below) 

Coverage of different standard plans are largely the same, so insurance premiums become important when considering which plan to enrol. Consumers can get details and compare the premiums of all standard plans offered by different VHIS providers at FHB’s website.

It is important to compare the premiums!

For a non-smoking insured aged 20, the differences in premiums charged by different VHIS providers could be very large: 

GenderDifference between the highest and the lowest premiums
Male2.6 times
Female2.1 times 

Consumers should also consider other protections when enrolling for VHIS

Besides, VHIS providers are allowed to offer standard plans with minor variations. For example, some insurance companies provide:

  • Compassionate death benefit
  • Death benefit due to medical negligence
  • Total and permanent incapacity income benefit
  • Hospital income benefit
  • Accidental death benefit
  • Additional death allowance for organ donor
  • Day surgery cash allowance
  • Second claim incentive

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Flexi Plan offers more choices for consumers

Meanwhile, VHIS providers offer basic protection equivalent to Standard Plan coverage, plus top-up protection. What are those top-up protections?

VHIS providers can increase the benefit limit of individual benefit items or provides protection to additional benefit items.

Taking Bowtie “Flexi – Standard” as an example, coverage for prescribed diagnostic imaging tests and hospital room and board is increased:

VHIS Standard Maximum Benefits Limit 

Benefit itemBowtie “Standard” Bowtie “Flexi- Standard”
Prescribed diagnostic imaging tests$20,000$26,000
Hospital room and board$750/day

Up to 180 days/policy year

$880/day for unlimited number of days

Benefits coverage is also extended to emergency outpatient treatment, home nursing, rehabilitation, outpatient kidney dialysis, companion bed and $120,000 supplementary major medical (SMM) benefit:

Bowtie “Flexi – Standard”

Additional benefit coverageMaximum limit 
Emergency outpatient treatment$8,000
Home nursing $500/day
Rehabilitation (e.g. chiropractic, speech therapy, physiotherapy) $750/day
Kidney dialysis$50,000
Companion bed$350/day for unlimited number of days
Supplementary major medical (SMM)$120,000

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Flexi Plan offers more choices for consumers

 

From market data, and information from websites of “The Chin Family” and VHIS, non-VHIS medical insurance and VHIS are primarily different in the following 9 areas:

Non-VHISVHIS
Non tax-deductible Tax-deductible 
Insurance companies can design their own product Standard requirements of the scheme in product design
With “Lifetime benefit limit”No “Lifetime benefit limit”
Not necessarily cover unknown pre-existing conditions Covers unknown pre-existing conditions 
Not necessarily cover cancer treatmentCovers non-surgical cancer treatment 
Not necessarily cover psychiatric inpatient treatmentsCovers psychiatric inpatient treatments
Not necessarily cover prescribed diagnostic imaging tests such as Computed Tomography (CT scan), Magnetic Resonance Imaging (MRI scan) and Positron Emission Tomography (PET scan)Covers prescribed diagnostic imaging tests such as Computed Tomography (CT scan), Magnetic Resonance Imaging (MRI scan) and Positron Emission Tomography (PET scan)
Not necessarily cover the treatment of congenital conditionsCovers treatment of congenital conditions manifested or diagnosed since the age of 8 
Cooling-off period varies among different insurance companies Cooling-off period of 21 days

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Compare the premium of certified products

FHB announced on March 2019 that the average premium of VHIS products is $4,000, 20% lower than the estimate of HK$4,800 made by a consultancy report based on 2017 figure.

Bowtie, the first virtual insurer in Hong Kong, also offers “VHIS – Standard” with average premium $670 to $3,793 lower than the market average.

AgeAverage premium of “Standard Plans” in the market Average premium of Bowtie “Standard Plan”
0 – 4$2,600$1,657
20 – 24$2,000$1,330
40 – 44$3,900$2,734
60 – 64$9,800$6,007

Source: South China Morning Post, Food and Health Bureau

Last updated on 24 May 2019

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Benefit coverage and maximum limit have to meet the minimum requirements

Though the benefits of “Flexi Plans” offered by different insurance companies are very different, all “Standard Plan” and “Flexi Plan” have to meet the following minimum requirements:

Benefit coverageMaximum limit 
Hospital ward and board$750/day

Up to 180 days/policy year

Attending doctor’s visit fee$750/day

Up to 180 days/policy year

Miscellaneous charges$14,000/policy year
Specialist’s fee$4,300/policy year
ICU$3,500/day 

Up to 25 days/policy year

Surgeon’s fee$5,000 – $50,000
Anaesthetist’s fee / Operating theatre charges35% of surgeon’s fee payable
Prescribed diagnostic imaging tests$20,000/policy year 

Subject to 30% coinsurance 

Prescribed non-surgical cancer treatments$80,000/policy year
Psychiatric treatments$30,000/policy year
Pre- and post-confinement / day case procedure outpatient care$580/visit, up to $3,000/policy year 

1 prior outpatient visit or emergency consultation/confinement or day-case procedure

3 follow-up outpatient visits/confinement or day-case procedure 

(within 90 days after discharge from hospital or completion of day case procedure)

Source: VHIS Certified Policy Template 

Remarks: Annual limit up to HK$420,000 without lifetime benefit limit

*Surgeon’s fee is the same as surgical procedure fee, which is classified into 4 categories: minor, intermediate major and complex. The claim limit for each category is $5,000, $12,500, $25,000 and $50,000 respectively. 

**Tests only include computed tomography (“CT” scan), magnetic resonance imaging (“MRI” scan), positron emission tomography (“PET” scan), PET-CT combined and PET-MRI combined. 

^Treatments only include radiotherapy, chemotherapy, targeted therapy, immunotherapy and hormonal therapy.  

To let you have a better idea of the coverage, we selected 5 common surgeries covered by “Standard Plan” and below is the claim amount: 

Surgery / Procedure

Category

Claim amount

Coronary artery bypass surgery

Complex

$50,000

Anterior cruciate ligament reconstruction

Major

$25,000

Breast tumour/ lump excision +/- biopsy

Intermediate

$12,500

Phacoemulsification and implant of intraocular lens

Intermediate

$12,500

Colonoscopy with polypectomy 

Minor

$5,000

Source: VHIS Certified Policy Template

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Up to $8,000 tax break on premiums paid

According to the Inland Revenue Department, some expenses such as self-education, MPF, charitable contributions are eligible for tax deductions. To attract more people to join VHIS, the government offers VHIS policyholders tax deduction on premiums paid.   

Starting from May this year, taxpayers can claim VHIS for a tax deduction while they file their tax returns. 

How much tax deduction will I receive? 

Tax deductions = VHIS annual premium x tax rate 

For example, If your annual VHIS premium is $5,000 and your tax rate is 15%, your will save = $5,000 x 15% = $750.

The Legco has passed the bill on 31 October 2018. Starting on the 2019/20 tax year, every insured person can claim up to $8,000 for tax deductions. You may not be able to save a lot if you only enrol VHIS for yourself, but if you enrol 4 policies for 3 other family members, you will be able to claim up to $32,000 for tax deductions! There’s no limit on the number of insured persons and/or policies claimed.

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Migrate to or enrol for VHIS?

The government estimated that 1.5 million will join VHIS, with many of them switching from their existing policies. Before making a decision, we suggest everyone compare their existing policy with VHIS in different aspects, such as coverage, claim limit, premium and underwriting policy.

If you do not have any medical insurance, you can enrol VHIS via traditional insurance brokers or agents, as well as online such as Bowtie’s online platform, which enables everyone to buy VHIS themselves.

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FAQ

Q: Does VHIS cover dental treatment and outpatient expenses?

Standard plan covers only the in-patient emergency dental treatments and surgeries. Some Flexi plans may provide benefits that cover other in-patient and out-patient dental treatment. 

For out-patient treatment, Standard Plan covers the out-patient care of pre- and post-confinement or day-case procedure with limitation on the number of visits per policy year. Standard plan also covers 70% of the expenses of prescribed diagnostic imaging tests, such as CT, MRI, PET-CT and PET-MRI. 

Q: Will my premium increase after I file a claim? 

VHIS premiums will be adjusted every year according to the age of the policyholder. VHIS providers cannot adjust the premiums because of your previous claims, claim amount or health conditions.

Q: Will I be denied to renew my insurance after I file a claim?

Policyholders of VHIS are guaranteed to renew their insurance until 100 years old. VHIS providers cannot deny the renewal because of your previous claims or health conditions.

Q: The difference between VHIS and general medical insurance when filing a claim? 

FHB does not regulate the claim process of VHIS, so VHIS providers can design their own claim process. In general, VHIS providers would ask policyholders to submit documents such as hospital receipt, hospital claim form and laboratory test report.

Q: I have group medical coverage already, do I still need VHIS? 

Group medical plan usually provides basic coverage only, and you will lose protection once leaving the company. You can also read the terms and conditions of your policy to understand whether the coverage is enough. If you think the group medical plan does not provide enough protection, you may consider buying personal medical insurance to get more protection and VHIS is one of the options. To learn more about insufficient coverage of group medical plan.

To read more frequently asked questions about VHIS,  its enrollment and claims!

In conclusion, the goal of launching VHIS is to provide one more option for Hong Kong people, so that we will use private hospital more and the burden on public hospitals will be eased. We will keep you updated on VHIS, so stay tuned!

The above information is for reference only. If you need any tax advice, please consult with your tax advisor. In no event shall Bowtie be liable to you or to any other party for any loss or damage whatsoever or howsoever caused directly or indirectly in connection with your access to or use of the content thereon.

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