What Is VHIS? A Guide to Hong Kong’s Voluntary Health Insurance Scheme
VHIS at a Glance
| Question | Quick answer |
|---|---|
| What does VHIS stand for? | Voluntary Health Insurance Scheme |
| Is VHIS mandatory? | No. Participation is voluntary for insurers and consumers |
| Who provides VHIS plans? | Participating insurance companies |
| Is VHIS a government insurance plan? | No. The Government sets the scheme requirements, while insurers issue and administer the policies |
| Are all medical insurance plans VHIS plans? | No. Only plans certified under the scheme are VHIS Certified Plans |
| Are VHIS premiums tax deductible? | Qualifying premiums may be eligible for tax deduction, subject to prevailing tax rules |
| What are the two main plan types? | Standard Plan and Flexi Plan |
What Is VHIS?
VHIS regulates individual indemnity hospital insurance products in Hong Kong.
An indemnity hospital insurance policy reimburses eligible medical expenses actually incurred, subject to:
- The benefit schedule
- Policy limits
- Exclusions
- Deductibles
- Coinsurance
- Reasonable and customary charges
- Other policy terms
VHIS does not mean that the Government directly pays your hospital expenses.
Instead:
- The Health Bureau establishes the scheme requirements.
- Participating insurers design and offer Certified Plans.
- Consumers choose and purchase plans from insurers.
- Insurers underwrite policies and assess claims.
- Qualifying policyholders may claim tax deductions on eligible premiums.
What Is a VHIS Certified Plan?
A Certified Plan is an individual indemnity hospital insurance plan that has been certified under VHIS.
Each Certified Plan is assigned a unique certification number.
You can usually find the certification number on:
- The insurer’s product webpage
- Product brochures
- Policy documents
- The official VHIS plan search platform
Before applying, check that the product is clearly identified as a VHIS Certified Plan.
Certified Plan vs Non-VHIS Medical Insurance
| Feature | VHIS Certified Plan | Non-VHIS medical plan |
| Subject to VHIS scheme requirements | Yes | No |
| Has a VHIS certification number | Yes | No |
| Meets or exceeds VHIS minimum product standards | Yes | Not required |
| Qualifying premiums may receive VHIS tax deduction | Yes | No |
| Issued and administered by an insurer | Yes | Yes |
Certification does not mean that every VHIS plan provides the same coverage or premium.
Consumers should still compare:
- Benefit limits
- Ward class
- Deductible
- Coinsurance
- Coverage area
- Exclusions
- Premiums
- Long-term affordability
Standard Plan vs Flexi Plan
There are two main types of VHIS Certified Plans:
- Standard Plan
- Flexi Plan
Key Differences
| Feature | Standard Plan | Flexi Plan |
| Basic coverage | Meets the minimum complying requirements of VHIS | Includes protection equivalent to the Standard Plan |
| Product design | Largely standardised | More flexible |
| Additional protection | Limited to the prescribed Standard Plan design | Includes top-up protection |
| Benefit limits | Standardised minimum levels | May offer higher limits |
| Coverage scope | Core VHIS protection | May provide broader benefits |
| Product variation | Generally similar across insurers | Can differ significantly between insurers |
| Premium | Generally positioned for basic protection | Depends on the additional benefits selected |
| Suitable for | People seeking essential certified hospital coverage | People seeking enhanced limits or broader protection |
Flexi Plans may provide additional features such as:
- Higher annual benefit limits
- Higher surgical limits
- Enhanced cancer treatment coverage
- Better ward-class options
- Broader geographical coverage
- Reduced itemised sub-limits
- Deductible options
- Extra medical services
Because Flexi Plans can vary significantly, compare the benefit schedule and policy provisions carefully.
What Does VHIS Cover?
The exact coverage depends on the selected Certified Plan.
Common benefit categories include:
- Room and board
- Miscellaneous hospital charges
- Surgeon’s fees
- Anaesthetist’s fees
- Operating theatre charges
- Doctor’s attendance fees
- Intensive care
- Day-case procedures
- Prescribed diagnostic imaging tests
- Prescribed non-surgical cancer treatment
- Pre-confinement outpatient care
- Post-confinement outpatient care
- Psychiatric treatment
- Emergency outpatient treatment following an accident
Common Coverage Examples
| Medical need | VHIS benefit that may apply |
| Hospital admission | Room, board and miscellaneous hospital charges |
| Surgery | Surgeon, anaesthetist and operating theatre benefits |
| Day surgery | Day-case procedure benefits |
| CT scan, MRI or PET scan | Prescribed diagnostic imaging benefit |
| Chemotherapy or radiotherapy | Prescribed non-surgical cancer treatment benefit |
| Follow-up after hospitalisation | Post-confinement outpatient benefit |
| Psychiatric hospital treatment | Psychiatric treatment benefit |
Actual reimbursement depends on the plan’s:
- Benefit limits
- Covered ward class
- Remaining annual limit
- Medical necessity requirements
- Deductible and coinsurance
- Exclusions and policy provisions
Latest Voluntary Health Insurance Policy Figures for Hong Kong
What Does VHIS Not Automatically Cover?
Purchasing a VHIS plan does not mean every medical expense will be reimbursed.
Expenses may not be fully covered if they involve:
- Treatment excluded under the policy
- Expenses above the benefit limit
- A deductible payable by the insured person
- Coinsurance or copayment
- A higher ward class than the plan covers
- Charges above reasonable and customary levels
- Treatment that is not medically necessary
- Cosmetic or elective procedures
- Experimental or unproven treatment
- Services outside the geographical coverage area
- Incomplete or unsupported claim documents
Always review the final policy schedule, benefit schedule and policy provisions before accepting the policy.
Key Features of VHIS Certified Plans
Certified Plans must meet or exceed the minimum product standards under VHIS.
Important scheme features include:
Guaranteed Renewal
VHIS policies are generally renewable up to the specified age under the scheme requirements, subject to policy terms and premium payment.
Guaranteed renewal does not mean the premium will remain unchanged.
Premiums may increase because of:
- The insured person moving into a higher age band
- Adjustments to the insurer’s premium schedule
- Medical inflation
- Changes approved under the policy terms
No Lifetime Benefit Limit for Standard Plan Benefits
Standard Plan benefits are designed without a lifetime benefit limit, although annual and itemised limits still apply.
Flexi Plans may provide higher annual limits or additional benefits.
Coverage for Unknown Pre-existing Conditions
VHIS provides an arrangement for unknown pre-existing conditions, subject to the applicable waiting period and reimbursement percentages under the scheme requirements.
This is different from a known pre-existing condition disclosed during underwriting, which may be subject to:
- Exclusion
- Premium loading
- Modified terms
- Application rejection
Coverage for Prescribed Non-surgical Cancer Treatment
Certified Plans include coverage for prescribed non-surgical cancer treatment, subject to the applicable benefit limits.
Examples may include:
- Chemotherapy
- Radiotherapy
- Targeted therapy
- Immunotherapy
- Hormonal therapy
Coverage remains subject to the treatment meeting the policy definition and requirements.
How Does VHIS Work?
The basic process can be divided into five steps.
| Step | What happens |
| 1. Compare plans | Review Standard and Flexi Plans, benefits, premiums and exclusions |
| 2. Apply | Submit personal and health information to the insurer |
| 3. Underwriting | The insurer assesses the application and issues its underwriting decision |
| 4. Receive treatment | Obtain medically necessary treatment covered by the policy |
| 5. Submit a claim | Provide invoices, receipts, medical reports and other required documents |
Possible Underwriting Outcomes
| Outcome | Meaning |
| Standard acceptance | Policy accepted without additional terms |
| Premium loading | A higher premium is charged because of increased risk |
| Exclusion | A specified condition or treatment is not covered |
| Modified terms | Coverage is offered with adjusted conditions |
| Postponement | The insurer delays its decision pending further information |
| Rejection | The application is not accepted |
VHIS certification does not remove the insurer’s underwriting process.
Does VHIS Cover Pre-existing Conditions?
The answer depends on whether the condition was known or unknown when the policy was purchased.
Known vs Unknown Pre-existing Conditions
| Type | General treatment |
| Known condition disclosed during application | Subject to the insurer’s underwriting decision |
| Unknown condition that the insured person was reasonably unaware of | May be covered under the VHIS phased reimbursement arrangement |
| Condition deliberately not disclosed | May affect policy validity and claims |
Applicants should answer all health questions fully and accurately.
Failing to disclose relevant health information may result in:
- Claim rejection
- Policy cancellation
- Revised policy terms
- Other consequences under the policy
Government data indicates that as of 31 March 2024, the number of policies for recognised Voluntary Health Insurance products reached 1,341,000. Over half of the insured persons (52.8%) were aged under 40, 35.4% were aged between 40 and 59, and 11.7% were aged 60 or above.
| Age of the insured | Number of insurance policies | Percentage of all policies |
| 0-9 years old | 129,000 | 9.6% |
| 10-19 years old | 122,000 | 9.1% |
| 20-29 years old | 179,000 | 13.3% |
| 30-39 years old | 278,000 | 20.7% |
| 40-49 years old | 263,000 | 19.6% |
| 50-59 years old | 212,000 | 15.8% |
| 60 years old or above | 157,000 | 11.7% |
| Overall | 1,341,000 | 100% |
Is VHIS Tax Deductible?
Qualifying premiums paid for VHIS Certified Plans may be eligible for tax deduction under Hong Kong tax rules.
Tax Deduction Overview
| Question | Answer |
| Which policies qualify? | VHIS Certified Plans |
| Can you claim for your own policy? | Yes, subject to eligibility |
| Can you claim for specified relatives? | Yes, subject to the prevailing rules |
| Is the deductible itself tax deductible? | No. The deduction relates to qualifying premiums paid |
| Are non-VHIS medical premiums eligible? | No, not under the VHIS tax deduction |
| Is the tax saving equal to the premium paid? | No. The actual tax saving depends on the deductible amount claimed and the taxpayer’s tax rate |
The maximum allowable deduction is subject to the prevailing statutory limit for each insured person in each year of assessment.
Keep the following records:
- Premium payment receipts
- Annual premium statements
- Policy certification information
- Insured person’s details
- Proof of relationship, where applicable
Tax rules may change. Refer to the latest Inland Revenue Department guidance when filing a tax return.
Can VHIS Be Used With Company Medical Insurance?
Yes. A personal VHIS plan and company medical insurance can complement each other.
Company medical insurance may provide:
- Basic hospital benefits
- Outpatient benefits
- Low or no employee premium
- Protection while you remain employed
A personal VHIS plan may provide:
- Coverage independent of your employer
- Higher hospital benefit limits
- Continued protection after changing jobs
- Certified-plan tax deduction eligibility
- Additional protection against major medical expenses
How Two Medical Policies May Work Together
A common claim sequence is:
- Submit the claim to the company medical insurer.
- Obtain the settlement statement.
- Submit the remaining eligible expenses to the personal insurer.
- The personal insurer assesses the balance under its policy terms.
The total reimbursement from indemnity-based medical policies cannot normally exceed the eligible expenses actually incurred.
Employees should compare:
- Ward class
- Company reimbursement limit
- Deductible
- Claims submission order
- Coverage after resignation
- Whether original receipts are required
Does Every VHIS Plan Have a Deductible?
No.
Some VHIS plans have no deductible, while some high-end Flexi Plans offer several deductible options.
A deductible is the amount of eligible medical expenses you must bear before the insurer starts reimbursing the remaining covered costs.
| Deductible level | General effect on premium | General effect during a claim |
| HK$0 or low | Higher premium | Lower initial out-of-pocket cost |
| Medium | Medium premium | Moderate out-of-pocket cost |
| High | Lower premium | Higher initial out-of-pocket cost |
People with company medical benefits or strong emergency savings may consider a higher deductible.
People without other medical coverage may prefer a lower deductible.
You can learn more in our guide to VHIS deductibles and how to choose one.
How to Choose a VHIS Plan
Do not compare VHIS plans based only on the first-year premium.
Quick Comparison Checklist
| Your priority | What to compare |
| Lower premium | Standard Plan, ward-class coverage and deductible |
| Higher protection | Annual limit, lifetime limit and itemised limits |
| Private hospital access | Covered ward class and private hospital reimbursement |
| Cancer protection | Non-surgical cancer treatment limits |
| Company medical coordination | Deductible and claims sequence |
| Overseas treatment | Geographical coverage and overseas reimbursement |
| Simpler claims | Cashless arrangements and digital claims support |
| Long-term affordability | Age-banded premiums and renewal adjustments |
| Tax deduction | Whether the policy is a VHIS Certified Plan |
Questions to Ask Before Applying
- Is the plan a Standard Plan or Flexi Plan?
- What ward class does it cover?
- What is the annual benefit limit?
- Are there itemised benefit limits?
- Does the plan have a deductible?
- Does coinsurance apply?
- Which geographical areas are covered?
- How are reasonable and customary charges assessed?
- What exclusions will apply after underwriting?
- Can I afford the premium after retirement?
Which Type of VHIS Plan May Suit You?
| Your situation | Plan features to consider |
| Looking for basic certified coverage | Standard Plan or entry-level Flexi Plan |
| Want higher private hospital protection | Flexi Plan with higher benefit limits |
| Have company medical insurance | Flexi Plan with a deductible matching group benefits |
| Self-employed | Personal coverage not tied to employment |
| Buying for a child | Low deductible and suitable hospital coverage |
| Concerned about major medical bills | High annual limit and broader cancer treatment benefits |
| Budget-conscious | Sustainable long-term premium rather than only a first-year discount |
Bowtie offers different certified medical insurance options for customers with different budgets and coverage needs.
How Many VHIS Policies Are There in Hong Kong?
According to the market data previously published by the VHIS authorities, there were approximately 1.341 million recognised VHIS policies as of 31 March 2024.
Age Distribution of Insured Persons
| Age group | Number of policies | Share of policies |
| Age 0–9 | 129,000 | 9.6% |
| Age 10–19 | 122,000 | 9.1% |
| Age 20–29 | 179,000 | 13.3% |
| Age 30–39 | 278,000 | 20.7% |
| Age 40–49 | 263,000 | 19.6% |
| Age 50–59 | 212,000 | 15.8% |
| Age 60 or above | 157,000 | 11.7% |
| Overall | 1,341,000 | 100% |
Age Distribution of Bowtie VHIS Insured Persons
Based on Bowtie’s portfolio data as of 29 August 2025:
| Age group | Share of Bowtie VHIS portfolio |
| Age 0–9 | 10.3% |
| Age 10–19 | 4.4% |
| Age 20–29 | 14.8% |
| Age 30–39 | 33.6% |
| Age 40–49 | 17.2% |
| Age 50–59 | 11.0% |
| Age 60 or above | 8.7% |
Key Observations
- Customers aged 30–39 represented the largest group
- People aged 20–39 accounted for almost half of Bowtie’s VHIS portfolio
- Children aged 0–9 represented approximately one in ten insured persons
These figures describe Bowtie’s portfolio only and should not be interpreted as the age distribution of the entire Hong Kong VHIS market.
What Is the VHIS Claim Reimbursement Rate?
Government data previously reported that more than 90% of VHIS claims received full or partial reimbursement each year from the scheme’s launch in 2019 through 2023.
| Year | Claims receiving full or partial reimbursement |
| April–December 2019 | 96% |
| 2020 | 94% |
| 2021 | 93% |
| 2022 | 92% |
| 2023 | 93% |
For Bowtie VHIS claims submitted between April 2019 and February 2025, 98.3% received full or partial reimbursement.
How to Interpret the Figures
A successfully reimbursed claim may receive:
- Full reimbursement; or
- Partial reimbursement
The figures do not mean that every successful claim was reimbursed in full.
The outcome of an individual claim may depend on:
- Whether the treatment is covered
- Medical necessity
- Benefit limits
- Deductible
- Coinsurance
- Ward class
- Exclusions
- Reasonable and customary charges
- Completeness of supporting documents
Historical claim statistics do not guarantee the result of a future individual claim.
Standard Plan or Flexi Plan: Which Should You Choose?
Consider a Standard Plan when:
- You want basic VHIS-compliant hospital protection
- Your premium budget is limited
- You prefer a more standardised product design
- You understand the prescribed benefit limits
Consider a Flexi Plan when:
- You want higher annual benefit limits
- You prefer broader hospital coverage
- You want semi-private or private ward options
- You need higher cancer treatment benefits
- You want deductible options
- You are concerned about major private hospital bills
The most suitable option is not always the plan with the highest benefit limit.
Choose a plan that balances:
- Coverage needs
- Existing protection
- Premium budget
- Out-of-pocket capacity
- Long-term affordability
Source
VHIS stands for the Voluntary Health Insurance Scheme.
No. Participation is voluntary for both insurance companies and consumers.
No. The Government establishes the scheme rules and certification requirements, while participating insurers issue and administer Certified Plans.
VHIS is a type of individual indemnity hospital insurance that meets or exceeds the scheme’s certification requirements. Other non-VHIS medical insurance products are also available in Hong Kong.
A Standard Plan follows a largely standardised product design and minimum benefit requirements. A Flexi Plan includes equivalent basic protection plus additional benefits, such as higher limits or broader coverage.
VHIS may cover eligible treatment at private hospitals, but the reimbursement level depends on the selected plan, ward class, benefit limits and policy terms.
Known pre-existing conditions are subject to underwriting. Unknown pre-existing conditions may receive phased coverage under the scheme requirements, subject to the policy terms.
Yes. The two policies may complement each other, but total reimbursement cannot normally exceed the eligible expenses actually incurred.
- Customers seeking higher benefit limits and deductible options may also explore Bowtie Pink VHIS.The information and statistics above are for general reference only. Product coverage, premiums, underwriting, claims and tax treatment are subject to the relevant product brochure, benefit schedule, policy provisions, prevailing premium rates, applicable laws and other terms and conditions. Historical market and claim figures do not guarantee future results.
