Traditional medical insurance offers insufficient coverage. Cancer insurance enhances protection against cancer. Pay attention to 4 key considerations.

Traditional medical insurance covers hospitalisation expenses caused by injury or illness, often with a compensation limit for each specific item, which may not be sufficient to cover cancer treatment costs. On the other hand, cancer insurance typically sets a compensation limit per cancer diagnosis, reimbursing actual medical expenses incurred for cancer treatment on a more targeted basis.

Traditional medical insurance and cancer-specific medical insurance differ primarily in three aspects: covered conditions, compensation models, and waiting periods. Traditional medical insurance provides coverage for hospitalisation and day surgeries caused by injuries or illnesses. In contrast, cancer-specific medical insurance is limited to coverage for cancer only.

Moreover, the compensation models of the two types of insurance vary significantly. Traditional medical insurance often sets specific caps on individual items, such as a maximum daily reimbursement of HKD 500 for the attending doctor's ward visit fees. If the actual cost is HKD 900, the patient would need to pay the remaining HKD 400 out of pocket. On the other hand, cancer-specific medical insurance typically reimburses the actual medical expenses incurred due to cancer, subject to per-claim and lifetime compensation limits. Some cancer-specific plans even cover costs for purchasing or renting medical equipment, consulting dietitians, or receiving psychological counselling—expenses that are generally not covered under traditional medical insurance.

In terms of waiting periods, the duration for medical insurance depends on the type of plan, usually around 30 days, while some plans, such as Voluntary Health Insurance Schemes, have no waiting period. For cancer-specific medical insurance, the waiting period is generally 90 days, during which any cancer symptoms or diagnoses are not covered. It is important to note that even after the waiting period, if a claim is made within the first two years of the policy's effective date, insurance companies may scrutinise the claim rigorously due to the possibility of pre-existing conditions.

The advantages and disadvantages of cancer-specific medical insurance are relatively clear. If a consumer's existing medical insurance plan offers insufficient coverage and they have a limited budget but wish to enhance protection against cancer, adding a cancer-specific medical insurance plan could be a viable option. However, if a consumer does not have any other medical insurance and only purchases cancer-specific coverage, they would lack protection for other illnesses or procedures, such as angioplasty or joint replacement surgeries, which are common and costly medical cases.

When purchasing cancer-specific medical insurance, consumers should pay attention to the following four key points to avoid unexpected disappointments in the future.

The primary compensation mechanism of cancer medical insurance includes per insured cancer limit and lifetime compensation limit, covering expenses related to cancer treatment such as diagnostic tests, hospital room and board, ward rounds fees, specialist fees, surgical and anaesthetic fees, operating theatre fees, medication costs, intensive care unit expenses, and more. These expenses must be for customary and reasonable treatment methods and must meet medical necessity.

 Taking AIA's "Cancer Comprehensive Protection 2" as an example, the "Covered Cancer Limit" is HKD 1,000,000, while the lifetime cancer compensation limit is HKD 3,000,000.

Furthermore, if the insured person receives the first compensation and unfortunately faces a new cancer, persistent or spreading of the previous cancer, it is important to note the relevant waiting period. Compensation can only be claimed again after the waiting period has passed.

When purchasing cancer medical insurance, the ward level and coverage area are specified. If you wish to upgrade the ward level or seek treatment in the United States, the compensation limit is generally adjusted. For example, if a consumer opts for a semi-private ward plan with an annual compensation limit of HKD 1,000,000, the annual compensation limit will be reduced to 50% if they stay in a private ward or seek treatment in the United States.

Cancer medical insurance often includes a wide range of extended treatments, commonly covering Chinese medicine treatment, dietitian consultations, physiotherapy, occupational therapy, speech therapy, psychological counselling, home nursing, and medical equipment, among others. Policyholders should pay attention to the per-claim compensation limits and the number of covered sessions for these items. Certain plans may also cover psychological counselling (sometimes even for immediate family members) or expenses for wigs.

Some plans also include complementary therapies such as chiropractic treatment, aromatherapy, homeopathy, and art therapy. Additionally, there may be subsidies for transportation costs and expenses related to fertility preservation for cancer patients. Therefore, it is advisable to compare plans carefully before purchasing.

1. The above premium information is updated as of 27 June 2022 and does not include the premium levy collected by the Insurance Authority.
2. This article was last updated on: 27 June 2022.

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.