【Company medical insurance isn’t enough】 Comparison of 4 tax-deductible Voluntary Health Insurance high-deductible plans: which offers better value?

Many employees are provided with company medical insurance by their employers, but such cover usually focuses on outpatient care and may not be comprehensive enough in areas such as hospitalisation and surgery. For example, the benefit limits may not be high enough, the average coverage rate for each illness or injury may be low, and hospitalisation benefits may be calculated separately for each item. In addition, employees may change jobs at any time, so it is more prudent to supplement their cover with comprehensive medical insurance of their own.

When choosing medical insurance, several aspects should be considered, such as the plan’s benefit limits, geographical coverage, ward level and deductible options, so that it can complement company medical insurance. If selected appropriately, a deductible can be used to complement company medical insurance, enabling you to obtain sufficient protection and enjoy superior medical services at a lower annual premium. If the plan selected is VHIS, employees can also apply for a tax deduction on the eligible premiums paid.

In the Insurance Decoder, 10Life has selected the four highest-rated VHIS plans in the private ward category in Asia: AXA WiseGuard Pro Medical Insurance Plan (優尚), BupaBupa Hero 非凡自願醫保計劃（尊尚）, FWDFWDvTheOne Medical Plan (標準優越版), and HSBC LifeHSBC Voluntary Health Insurance Flexi Plan金級. These plans will be analysed in terms of basic benefits, deductible options and flexibility in changing plans.

Table 1: Comparison of the benefit limits and coverage rates of four VHIS plans

With medical costs continuing to rise, medical insurance offering full reimbursement (or full coverage¹, Full coverage) and high benefit limits can help cover increasing medical inflation and costly medical services.

None of the four products above has a lifetime benefit limit. BupaBupa Hero 非凡自願醫保計劃（尊尚） and FWDvTheOne Medical Plan (標準優越版) have a slight edge in terms of their annual benefit limits, reaching HK$35,000,000 per year, while the other two products each offer HK$30,000,000.

In terms of the average coverage rate for 12 common illnesses and injuries among Hong Kong people, only HSBC Life VHIS Flexi Plan Gold has a rate of 99.9%, making it the only one of the four products not to reach 100%. This is because it scores slightly lower in its coverage for certain cancers, such as breast cancer, lung cancer and colorectal cancer, as well as certain vascular diseases. This means that insured persons must pay a small portion of the medical costs for these conditions.

Overall, the above products are more or less on a par in certain areas of cover, making the premium a more important consideration. However, as employees generally have company medical insurance, they would not usually choose zero-deductible cover when purchasing personal medical insurance. Plans with a deductible offer better value. For example, when medical expenses arising from an illness or injury amount to HK$60,000, a claim can first be made under the company medical insurance (assuming a successful claim of HK$50,000); if a plan with a deductible of HK$50,000 has been purchased, the remaining expenses of HK$10,000 can be claimed under the personal medical insurance, providing comprehensive cover at a lower premium.

Table 2: Comparison of deductible options and premiums for 4 VHIS plans

If the coverage limit of the company medical insurance is relatively low, a lower deductible option (i.e. HK$40,000 or HK$50,000) may be considered. Based on the plans listed in Table 2, for a 35-year-old non-smoker, the average premium for the first 10 years of FWDvTheOne Medical Plan (Standard Plus) is HK$7,958, followed by AXA WiseGuard Pro Medical Insurance Plan (Premier) (HK$8,579) and BupaBupa Hero VHIS Plan (Deluxe) (HK$9,853). HSBC Life VHIS Flexi Plan Gold is the most expensive, at HK$10,050.

If the coverage limit of your company medical insurance is relatively high, you may consider a higher deductible option. FWDvTheOne Medical Plan (Standard Plus) offers a plan with a deductible of HK$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 HK$4,597. The highest deductible options of the other plans mentioned above generally do not exceed HK$100,000.

Consumers should also note whether the VHIS waives the deductible for specified critical illnesses. Taking BupaBupa Hero 非凡自願醫保計劃（尊尚） as an example, if the policyholder selects the highest deductible option of HK$80,000 and subsequently develops cancer, even the HK$80,000 deductible will be waived, while the average premium for a 35-year-old non-smoker during the first 10 years is only HK$7,250.

On the other hand, the critical illness waiver under FWDvTheOne Medical Plan (標準優越版) covers 16 specified critical illnesses, including the three major critical illnesses commonly suffered by Hong Kong people — specified cancers, stroke and heart disease². Once diagnosed, the deductible will be waived. For example, if the policyholder selects the highest deductible option (HK$250,000), once they are diagnosed with a specified critical illness, all hospitalisation and surgical expenses can be fully covered with an affordable average premium of HK$4,597 during the first 10 years¹.

Table 3: Comparison of the terms for reducing or waiving deductibles and upgrading the level of cover under four VHIS plans

As the insured person grows older and retires, they may lose their employer-sponsored medical insurance and no longer be able to use it to “Claim the deductible”. An excessively high deductible would therefore create a certain financial burden. As a result, insurers generally offer flexibility to change the deductible option, with one opportunity during the lifetime to reduce the deductible without undergoing medical underwriting. This conversion is generally available from around age 50 to 55.

In addition, if consumers are considering seeking medical treatment overseas in the event of illness before taking out a policy, they should pay attention to the terms for upgrading the level of cover. For example, upgrading the coverage area may require underwriting again, as re-underwriting when the insured person is older and their health has deteriorated may present a number of issues, including increased premiums, certain organs being excluded from cover, or even the upgraded coverage area not being accepted. Options to upgrade the level of cover without re-underwriting can meet the need to seek medical treatment overseas and receive quality treatment at different stages of life.

Of the 4 products, AXA WiseGuard Pro Medical Insurance Plan (Premier) allows the policyholder to exercise the right to upgrade the level of cover once without re-underwriting, but only to the Worldwide (excluding the USA) level; FWDvTheOne Medical Plan (標準優越版) allows the policyholder to exercise the right to upgrade the level of cover once without re-underwriting, with the flexibility to upgrade to different levels of cover, including Worldwide (excluding the USA) and Worldwide.

Table 4: Comparison of Cash Benefits under 4 VHIS Plans

Some high-end voluntary health insurance plans also offer a Hospital Cash Benefit, but policyholders must be admitted to a lower-tier ward. AXA WiseGuard Pro Medical Insurance Plan (Premier) or HSBC Life Voluntary Health Insurance Flexi Plan (Gold tier) respectively provides daily cash of HK$2,000, for a maximum of 10 days per hospitalisation; the hospital cash benefit under FWDvTheOne Medical Plan (Standard Plus) depends on the deductible option, providing either HK$900 or HK$1,600 per day, for a maximum of 30 days per policy year. BupaBupa Hero Voluntary Health Insurance Plan (Prestige) does not provide this benefit.

Among the four products, FWDvTheOne Medical Plan (Standard Plus) provides cash benefits for major and complex surgery, as well as a cash benefit for stays of three days or more in an intensive care unit in Hong Kong. If the deductible is HK$0, HK$25,000 or HK$40,000, the lump-sum cash benefits for each “complex surgery” and “major surgery” are HK$15,000 and HK$7,500 respectively, while the cash benefit for admission to an intensive care unit in Hong Kong is HK$15,000.

If the deductible is HK$80,000, HK$120,000 or HK$250,000, the lump-sum cash benefits for each “complex surgery” and “major surgery” are HK$3,000 and HK$1,500 respectively; the cash benefit for admission to an intensive care unit in Hong Kong is HK$3,000.

In fact, voluntary health insurance offers many other additional benefits. To find out more, please visit the Insurance Decoder for further comparison. In summary, “salaried employees” who already have company medical insurance can select a suitable deductible option according to their needs, allowing them to enjoy comprehensive medical protection at a lower premium.

Notes: 

1. Full coverage means that there are no sub-limits on claims, and that the actual amount of eligible expenses and other expenses is covered after deducting the remaining deductible (if any), subject to the annual benefit limit and lifetime benefit limit (where applicable). Full coverage applies only to specified benefit items, while other benefit items are not covered in full and are subject to the claim limits for the relevant items. 
2. Source: Department of Health, Hong Kong, “Mortality Rates for Leading Causes of Death, 2001 to 2020”, 2020 
3. The authorised product number of AXA WiseGuard Pro Medical Insurance Plan is F00034, the authorised product number of Bupa Hero VHIS Plan is F00040, the authorised product number of vTheOne Medical Plan is F00067, and the authorised product number of HSBC Voluntary Health Insurance Flexi Plan is F00049. 
4. The above premium data assumes that the insured is a 35-year-old non-smoker. 
5. The above premium information was updated on 24 August 2022. Standard premiums are not guaranteed and will be determined annually according to the insured person’s actual age at the time of renewal. The premiums do not include the premium levy charged by the Insurance Authority. 
6. The above information is provided by 10Life for reference only and does not constitute an offer for sale. Last updated: 24 August 2022. 
7. The above information does not include all the terms and conditions of the relevant policy, the key risks of the product or all policy exclusions. For details of the benefits and key risks of the product, please refer to the relevant product brochure; for the terms and conditions and all policy exclusions, please refer to the policy terms of the relevant plan. 
8. The above plans are medical insurance products under standalone policies and may be purchased together with other types of insurance products without being bundled.

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.