【Company Medical Insurance Not Enough】Comparison of 4 Tax-Deductible Voluntary Health Insurance Plans with High Deductibles. Which Offers the Best Value for Money?

Many employees are provided with company medical insurance by their employers, but the coverage often focuses on outpatient services, while aspects such as hospitalisation and surgical benefits may not be comprehensive. For instance, the coverage limit might be insufficient, the average protection rate for specific illnesses could be low, and hospitalisation compensation might be calculated based on itemised breakdowns. Additionally, as employees may change jobs at any time, it is more prudent to secure a comprehensive personal medical insurance plan.

When selecting medical insurance, several factors should be considered, such as the coverage limit of the plan, the geographical scope of protection, the level of hospital ward covered, and deductible options, to complement the company’s medical insurance. If chosen wisely, using a deductible to pair with company medical insurance can result in lower annual premiums while still obtaining adequate coverage for superior medical services. Moreover, if the chosen plan is a Voluntary Health Insurance Scheme (VHIS), employees may also apply for tax deductions on eligible premiums paid.

10Life, in its Insurance Decoder, has selected the top 4 VHIS plans with the highest ratings for private ward level in Asia, including AXA Hong Kong and Macau WiseGuard Pro Medical Insurance (Premier), Bupa Hero VHIS Plan (Deluxe), FWD vTheOne Medical Plan (Standard Plus), and HSBC Life Voluntary Health Insurance Flexi Plan Gold. These plans are analysed based on basic coverage, deductible options, and flexibility in plan changes.

Table 1: Comparison of Coverage Limits and Protection Rates of 4 VHIS Plans

With rising medical costs, medical insurance plans offering full reimbursement (or full coverage¹) and high coverage limits can address the increasing medical inflation and expensive healthcare services.

The above 4 products have no lifetime coverage limit, while the annual coverage limit is slightly higher for Bupa Hero VHIS Plan (Deluxe) and FWD vTheOne Medical Plan (Standard Plus), reaching HKD 35,000,000 per year. The other two products each offer HKD 30,000,000 annually.

In terms of the average protection rate for 12 common illnesses among Hong Kong residents, only HSBC Life Voluntary Health Insurance Flexi Plan Gold stands at 99.9%, making it the only plan among the 4 not reaching 100%. This is due to slight deductions in coverage for specific cancers such as breast cancer, lung cancer, and colorectal cancer, as well as certain vascular diseases, meaning policyholders may need to cover a small portion of medical expenses for these conditions.

Overall, the above products are quite comparable in certain coverage aspects, making premium costs a more critical factor. However, since most "working professionals" typically have corporate medical insurance, they generally do not opt for zero-deductible plans when purchasing personal medical insurance. Choosing plans with deductibles is often more cost-effective. For instance, if medical expenses for illness or injury amount to HKD 60,000, one can first claim through corporate medical insurance (assuming a successful claim of HKD 50,000). If the individual has purchased a plan with a HKD 50,000 deductible, they can claim the remaining expenses (HKD 10,000) through personal medical insurance, thereby securing comprehensive coverage at a lower premium.

Table 2: Comparison of 4 Voluntary Health Insurance Deductible Options and Premiums

If the coverage limit of corporate medical insurance is relatively low, one may consider lower deductible options (i.e., HKD 40,000 or HKD 50,000). Based on Table 2, for a 35-year-old non-smoker, the average premium for the first 10 years for FWD至．衛一醫療計劃 (標準優越版) is HKD 7,958, followed by AXA Hong Kong and Macau智尊守慧醫療保障 (優尚) at HKD 8,579, and BupaBupa Hero 非凡自願醫保計劃（尊尚） at HKD 9,853. The most expensive is HSBC Life自願醫保靈活計劃金級 at HKD 10,050.

On the other hand, if your corporate medical insurance coverage limit is relatively high, you may consider higher deductible options. FWD至．衛一醫療計劃 (標準優越版) offers a deductible plan of HKD 250,000, which is relatively rare in the market. For a 35-year-old non-smoker, the average premium for the first 10 years is HKD 4,597. The highest deductible options for the other plans mentioned generally do not exceed HKD 100,000.

Consumers should also take note of whether voluntary health insurance waives the deductible for specified critical illnesses. For instance, with the Bupa Hero VHIS Plan (Deluxe) by Bupa, if the policyholder opts for the highest deductible of HKD 80,000 and subsequently develops cancer, the HKD 80,000 deductible will also be waived. For a 35-year-old non-smoker, the average premium for the first 10 years is only HKD 7,250.

On the other hand, the FWD v.TheOne Medical Plan (Standard Plus) offers a broader range of critical illness waivers, covering 16 specified critical illnesses, including common conditions among Hong Kong residents such as specified cancers, stroke, and heart disease. Upon diagnosis, the deductible is waived. For example, if a policyholder selects the highest deductible option (HKD 250,000) and is diagnosed with a specified critical illness, they can benefit from an affordable average premium for the first 10 years (HKD 4,597), fully covering hospitalisation and surgical expenses.

Table 3: Comparison of 4 Voluntary Health Insurance Plans with Options to Reduce or Waive Deductibles and Upgrade Coverage Levels

As insured individuals age and retire, they may lose access to company-provided medical insurance and can no longer use it to "claim deductibles." Consequently, excessively high deductibles may impose a financial burden. Therefore, insurance companies generally offer flexibility to adjust deductible options, allowing a one-time lifetime opportunity to reduce the deductible without re-underwriting, typically starting from the age of 50 to 55.

Additionally, if consumers are considering seeking medical treatment overseas during illness before purchasing insurance, they should pay attention to the terms for upgrading coverage levels. For instance, upgrading the coverage area may require re-underwriting, and as the insured ages and their health condition deteriorates, re-underwriting can pose several issues, including increased premiums, exclusion of certain organs from coverage, or even rejection of the upgrade in coverage area. Options to upgrade coverage levels without the need for re-underwriting can meet the needs of seeking overseas medical treatment and receiving high-quality care at different life stages.

Among the four products, AXA Hong Kong and Macau WiseGuard Pro Medical Insurance Plan (Premier) allows a one-time upgrade of coverage level without re-underwriting, but this is limited to upgrading to a worldwide (excluding the USA) level; FWD v.TheOne Medical Plan (Standard Plus) also allows a one-time upgrade of coverage level without re-underwriting, offering flexibility to upgrade to different coverage levels, including worldwide (excluding the USA) and worldwide.

Table 4: Comparison of Cash Benefits for 4 Voluntary Health Insurance Schemes

Some premium voluntary health insurance plans offer hospital cash benefits, but these often require admission to lower-grade wards. AXA Hong Kong and Macau's Signature Care Medical Protection (Premier) or HSBC Life's Voluntary Health Insurance Flexi Plan Gold Level provide a daily cash benefit of HKD 2,000, with a maximum of 10 days per hospitalisation. FWD's vPrime Medical Plan (Standard Superior Version) offers hospital cash benefits depending on the deductible option, ranging from HKD 900 to HKD 1,600 per day, with a maximum of 30 days per policy year. Bupa Hero Extraordinary Voluntary Health Insurance Plan (Premier) does not provide this benefit.

Among the four products, FWD's vPrime Medical Plan (Standard Superior Version) includes cash benefits for major and complex surgeries as well as for stays in intensive care units in Hong Kong for 3 days or more. If the deductible is HKD 0, HKD 25,000, or HKD 40,000, the one-off cash benefit for each "complex surgery" and "major surgery" is HKD 15,000 and HKD 7,500 respectively, while the cash benefit for intensive care unit stays in Hong Kong is HKD 15,000.

If the deductible is HKD 80,000, HKD 120,000, or HKD 250,000, the one-off cash benefit for each "complex surgery" and "major surgery" is HKD 3,000 and HKD 1,500 respectively, while the cash benefit for intensive care unit stays in Hong Kong is HKD 3,000.

In fact, voluntary health insurance plans offer numerous additional benefits. For more details, you are welcome to explore further comparisons in the Insurance Decoder. In summary, for "working professionals" who already have corporate medical insurance, they can choose a suitable deductible option based on their needs to enjoy comprehensive medical protection at a lower premium.

Note: 

1. Full coverage refers to no sub-limit on compensation, covering the actual amount of eligible expenses and other costs after deducting the remaining deductible (if any), subject to annual and lifetime benefit limits (if applicable). Full coverage applies only to specified benefit items, while other benefit items are not fully covered and are subject to the compensation limits of the respective items. 
2. Data source: Hong Kong Department of Health, "Mortality Rates of Major Causes of Death from 2001 to 2020", 2020 
3. AXA Hong Kong and Macau Signature Care Medical Protection certified product number is F00034, Bupa Extraordinary Voluntary Health Insurance Plan certified product number is F00040, vPrime Medical Plan certified product number is F00067, HSBC Voluntary Health Insurance Flexi Plan certified product number is F00049. 
4. The above premium data assumes the insured is a 35-year-old non-smoker. 
5. The above premium information is updated as of 24 August 2022. Standard premiums are not guaranteed and will be determined annually based on the insured’s actual age at renewal. Premiums do not include the Insurance Authority levy. 
6. The above information is provided by 10Life for reference only and does not constitute a sales proposal. The last update of this article was on 24 August 2022. 
7. The above information does not include all terms and conditions, key product risks, or full exclusions of the relevant policies. For details on benefits and key product risks, please refer to the product brochure; for terms and conditions and full policy exclusions, please refer to the policy terms of the relevant plan. 
8. The above plans are standalone medical insurance products and can be purchased independently without being bundled with other types of insurance products.

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.