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自願醫保 VHIS
醫療保險

5-Star Voluntary Health Insurance Showdown: Product Upgrade with New Annual Coverage Breakthrough! (Comparison of Voluntary Health Insurance Semi-Private Room Plans) (Updated August 2021)

2021-08-19 8min read
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The Voluntary Health Insurance Scheme (VHIS) offers tax deductions and is government-recognised, making it highly popular in the market. As a result, insurance companies strive for excellence, continuously introducing enhanced medical insurance products with better coverage. Among these, the "full coverage" VHIS semi-private room plans offer high protection at relatively affordable prices, making them a preferred choice for many middle-class individuals. Consequently, competition among these products is particularly intense, with frequent product upgrades. Today, 10Life compares 5-star VHIS semi-private room plans to identify the best among the best, including AIA Voluntary Health Insurance Elite Plan (abbreviated as AIA Elite), AXA Hong Kong and Macau Smart Protector Medical Insurance (Supreme) (abbreviated as AXA Smart Protector Supreme), Bupa Hero VHIS Plan (Select) (abbreviated as Bupa Hero Select), Cigna Healthcare VHIS Series – Flexi Plan (Superior) (abbreviated as Cigna Flexi Superior), FWD vCare Medical Plan (abbreviated as FWD vCare), Manulife Advance VHIS Flexi Plan (abbreviated as Manulife Advance), and Prudential VHIS VIP Plan (abbreviated as Prudential VIP).
 
"Full Coverage" Plans Set New Annual Coverage Limits

 
"Full Coverage" (Note 1) medical insurance fully reimburses multiple coverage items, subject to annual and lifetime coverage limits. The annual coverage limit is particularly crucial, as patients facing serious illnesses may suddenly incur substantial medical expenses, and treatment durations can be lengthy. A sufficiently high annual limit, reset each year, provides peace of mind for policyholders to undergo treatment without worrying about future medical inflation. Among the 7 products, Cigna Flexi Superior sets a new record with an annual coverage limit of HKD 30 million, topping the VHIS semi-private room plans. As for lifetime coverage limits, only Bupa Hero Select and Cigna Flexi Superior have no upper cap.
 
From another perspective, 10Life consulted specialists on medical expenses for up to 12 cases of varying severity (including liver cancer, angioplasty, joint replacement surgery, etc.) and calculated the expected medical coverage ratio based on the product terms. The average expected medical coverage ratio for these 7 flagship products is close to 100% (Note 2), with Cigna Flexi Superior and AIA Elite achieving a perfect 100%, offering watertight protection! As savvy consumers, it’s also essential to understand potential coverage gaps before purchasing.
 
Table 1: Comparison of 5-Star VHIS (Semi-Private Room Plans) Expected Average Coverage Ratio and Reimbursement Limits
 
VHIS ProductExpected Average Coverage RatioPer Policy Year
Reimbursement Limit
Lifetime
Reimbursement Limit
AIA 友邦
AIA自願醫保尊裕計劃
100%$10,000,000$50,000,000
AXA 安盛
AXA 安盛智尊守慧醫療保障 (卓越)
99.9%$10,000,000$40,000,000
Bupa 保柏
Bupa Hero 非凡自願醫保計劃(智選)
99.9%$25,000,000No Limit
Cigna 信諾
信諾自願醫保系列-靈活計劃(優越) 1
100%$30,000,000No Limit
FWD 富衛
尊衛您醫療計劃
99.9%$8,000,000$45,000,000
Manulife 宏利
晉悅自願醫保靈活計劃
99.9%$8,000,000$32,000,000
Prudential 英國保誠
保誠自願醫保尚賓計劃
98.3%$12,000,000$56,000,000

Notes:
 

  1. The currency in the above table is HKD. 
     
  2. Product information updated as of 17 August 2021.
 
 
Addressing Coverage Gaps for Higher Protection

 
Prescribed Non-Surgical Cancer Treatments: Beyond surgery, patients may undergo prescribed non-surgical cancer treatments such as chemotherapy or targeted therapy. Targeted therapy focuses on cancer cells with fewer side effects, but it is extremely expensive and may require prolonged use. Therefore, some "comprehensive" medical insurance plans impose limits on prescribed non-surgical cancer treatments. However, AIA Elite, AXA Smart Protector Supreme, Bupa Hero Select, Cigna Flexi Superior, FWD vCare, Manulife Advance, and Prudential VIP all provide full coverage (Note 1) for prescribed non-surgical cancer treatments.
Pre- and Post-Hospitalisation or Day Surgery Outpatient Care: Pre-surgery outpatient visits ensure a patient’s suitability for surgery, while post-surgery follow-ups are also necessary. Some medical insurance plans limit the number of related outpatient visits (often just a few), which may not suffice for frequent follow-ups. However, AIA Elite, Bupa Hero Select, and Cigna Flexi Superior offer better coverage, including one outpatient visit within 30 days before surgery and all follow-up outpatient visits within 90 days after surgery.
Home Nursing: Patients recovering from conditions such as stroke, orthopaedic surgery, or kidney failure may require home nursing for rehabilitation exercises, wound care, or medication injections after discharge. Some insurance plans offer very short coverage periods for this. However, AXA Smart Protector Supreme, Bupa Hero Select, and Cigna Flexi Superior provide extended coverage of up to 90 days per policy year, while FWD vCare offers an even longer period of up to 196 days per policy year. Additionally, the AXA and FWD plans provide reimbursement on a full coverage basis.
Unknown Pre-Existing Conditions at Time of Application: VHIS covers unknown pre-existing conditions at the time of application, but reimbursement amounts depend on the waiting period, with most products offering insufficient coverage in the early policy years. However, AXA Smart Protector Supreme and Cigna Flexi Superior cover unknown pre-existing conditions from the first day of the policy’s effective date, with no waiting period.
 
Table 2: Comparison of 5-Star VHIS (Semi-Private Room Plans) Coverage
 
 
VHIS ProductPrescribed Non-Surgical
Cancer Treatments
Pre- and Post-Hospitalisation/
Day Surgery Outpatient Care
Home NursingUnknown Pre-Existing Conditions
AIA 友邦
AIA自願醫保尊裕計劃
Full Coverage
Full Coverage
 
1 visit more than 30 days before hospitalisation;
All visits within 30 days before hospitalisation; and
All visits within 90 days after discharge
Full Coverage
 
30 days per policy year
First 30 days: 0% coverage
From day 31 onwards: Full Coverage
AXA 安盛
AXA 安盛智尊守慧醫療保障 (卓越)
Full Coverage
Full Coverage
 
1 visit before hospitalisation; and
3 visits within 90 days after discharge
Full Coverage
 
90 days per policy year
From the first day of policy effective date
Full Coverage
Bupa 保柏
Bupa Hero 非凡自願醫保計劃(智選)
Full Coverage
Full Coverage
 
1 visit more than 30 days before hospitalisation;
All visits within 30 days before hospitalisation; and
All visits within 90 days after discharge
$750 per day
 
90 days per policy year
Basic VHIS Terms
Cigna 信諾
信諾自願醫保系列-靈活計劃(優越) 1
Full Coverage
Full Coverage
 
1 visit more than 30 days before hospitalisation;
All visits within 30 days before hospitalisation; and
All visits within 90 days after discharge
$1,000 per day
 
90 days per policy year
From the first day of policy effective date
Full Coverage
FWD 富衛
尊衛您醫療計劃
Full Coverage
Full Coverage
 
1 visit before hospitalisation; and
6 visits within 90 days after discharge
Full Coverage
 
196 days per policy year
First 30 days: 0% coverage
From day 31 onwards: Full Coverage
Manulife 宏利
晉悅自願醫保靈活計劃
Full Coverage
Full Coverage
 
1 visit before hospitalisation; and
3 visits within 90 days after discharge
Full Coverage
 
30 days per policy year
First 30 days: 0% coverage
From day 31 onwards: Full Coverage
Prudential 英國保誠
保誠自願醫保尚賓計劃
Full Coverage
Full Coverage
 
1 visit before hospitalisation; and
3 visits within 90 days after discharge
$1,600 per day
 
30 days per policy year 
(Only after surgery)
First 30 days: 0% coverage
From day 31 onwards: Full Coverage

Notes:
 

  1. “Full Coverage” means the insurance company will fully reimburse eligible medical expenses and other costs after deducting any deductible balance (if applicable), subject to the per policy year coverage limit (if applicable), lifetime coverage limit (if applicable), per policy year per illness coverage limit (if applicable), and/or other relevant conditions. Full Coverage applies only to specified coverage items, while other items are subject to reimbursement limits for the relevant items. Claims must meet the criteria of “medically necessary,” and expenses must be “reasonable and customary.”
  2. “Basic VHIS Terms” means no reimbursement in the first policy year for diagnosed conditions, 25% reimbursement in the second year, 50% in the third year, and full coverage from the fourth year onwards.
  3. The currency in the above table is HKD.
  4. Product information updated as of 17 August 2021.
 
 
To achieve watertight protection, insurance companies continuously improve by increasing coverage limits for the above items and refining terms. Apart from coverage, consumers are also concerned about premiums. The chart below shows the premiums for zero-deductible semi-private room plans. Across age groups of 25-34, 35-44, and 45-54, Cigna Flexi Superior offers the lowest 10-year average premium, approximately 30% lower than the most expensive, Prudential VIP.
 
Table 3: Comparison of 5-Star VHIS (Semi-Private Room Plans) Premiums
 
VHIS ProductAverage Premium ($0 Deductible)
 Age 25-34  Age 35-44  Age 45-54 
AIA 友邦
AIA自願醫保尊裕計劃
$13,366$16,592$23,799
AXA 安盛
AXA 安盛智尊守慧醫療保障 (卓越)
$10,783$13,390$18,951
Bupa 保柏
Bupa Hero 非凡自願醫保計劃(智選)
$10,112$13,502$21,029
Cigna 信諾
信諾自願醫保系列-靈活計劃(優越) 1
$8,482$11,152$16,803
FWD 富衛
尊衛您醫療計劃
$10,513$13,084$19,060
Manulife 宏利
晉悅自願醫保靈活計劃
$12,668$15,806$23,532
Prudential 英國保誠
保誠自願醫保尚賓計劃
$13,631$17,488$26,594

Notes:
 

  1. Assumes the policyholder is a non-smoker enrolled in a zero-deductible semi-private room plan. The premiums shown are the 10-year average for the respective age group. 
     
  2. The currency in the above table is HKD.
  3. Product information updated as of 17 August 2021.

 
Product Upgrades vs. New Products: Which Benefits Consumers More?
 
It is worth noting that in March 2021, AIA and Cigna Healthcare enhanced their VHIS coverage. Cigna Flexi Superior upgraded its existing product, while AIA launched the entirely new AIA Elite, with the original AIA Voluntary Health Insurance Prestige Plan (abbreviated as AIA Prestige) still available. How do these approaches impact customers? For new customers, having more products with better coverage is a positive development. However, for existing customers, the difference is significant.
 
Table 4
Comparison of Old and New Versions/Products of Cigna and AIA VHIS
 
 
Starting with Cigna Flexi Superior, the upgraded version significantly increases both annual and lifetime coverage limits, achieving a 100% expected medical coverage ratio for multiple illnesses as assessed by 10Life (Note 2). Despite the enhanced coverage, the premium remains unchanged, effectively offering existing customers a free upgrade. For the insurance company, this means bearing greater risk for existing policyholders.
 
As for AIA, existing customers of the original AIA Prestige who wish to switch to the better-covered AIA Elite may need to undergo re-underwriting. In such cases, the insurer may impose exclusions or additional premiums based on the customer’s health condition, such as prior claims history. From an actuarial perspective, if a large number of healthier policyholders switch to the new plan, leaving less healthy customers in the old plan, the risk profile of the latter increases, potentially leading to premium hikes. However, before existing AIA Prestige customers consider switching to the new plan, they should note the premium difference. Across the age groups shown in the table, AIA Elite’s premiums are nearly 20% higher than those of AIA Prestige.
 
As the saying goes, trust is paramount when buying insurance. To earn long-term customer trust, insurance companies must pay meticulous attention to detail. Consumers, in turn, should make thorough comparisons before purchasing. You can visit 10Life’s “Insurance Decoder” to gain deeper insights into product coverage.
 
Notes:

 

  1. “Full Coverage” means the insurance company will fully reimburse eligible medical expenses and other costs after deducting any deductible balance (if applicable), subject to the per policy year coverage limit (if applicable), lifetime coverage limit (if applicable), per policy year per illness coverage limit (if applicable), and/or other relevant conditions. Full Coverage applies only to specified coverage items, while other items are subject to reimbursement limits for the relevant items. Claims must meet the criteria of “medically necessary,” and expenses must be “reasonable and customary.”
  2. 10Life calculates the expected average coverage based on medical expenses for various common cases of differing severity and medical services under general circumstances, cross-referenced by 10Life actuaries against the reimbursement limits of medical products. For details, refer to the “Rating Methodology for Public Medical Insurance.” The expected coverage ratio for the above illness cases is calculated based on anticipated medical expenses under general circumstances, serving as a reference for “estimating” medical insurance coverage and out-of-pocket costs for consumers. This is for reference only and has not been confirmed by the relevant insurance companies.
  3. The above information is provided by 10Life, updated as of 17 August 2021, for reference only and does not constitute sales advice. 

This English version of this article has been generated by machine translation powered by AI. It is provided solely for reference purposes. In the event of any discrepancy or inconsistency between this translation and the original Chinese version, the Chinese version shall prevail.

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