Low cost VHIS - medical coverage options at below HK$6000 a year (Updated Mar 2022) (Chinese Article)

Estimated reading time 10 minutes

10Life Team

04 Mar 2022
Low cost VHIS - medical coverage options at below HK$5000 a year | 10Life
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10Life Team

04 Mar 2022

Estimated reading time 10 minutes

新冠肺炎讓港人健康意識抬頭,附加扣稅功能的自願醫保(VHIS)更吸引不少人目光。但有意見認為醫療保險保費昂貴,對一般家庭而言負擔甚為沉重。究竟市場上有沒有每年平均保費低於6,000港元,保障又高的自願醫保呢? 

保費平  保障未必輸蝕

10Life從保險解碼器中篩選出10款保費少於6,000港元、無自付費,而平均保障率較高的自願醫保(普通房級別),再按醫療平均保障率(見註1)排序顯示。

表1:比較普通房等級、無自付費、平均年保費少於6,000港元之自願醫保
(假設受保人為35歲非吸煙人士)

普通房計劃 35-44歲男性
平均每年保費
35-44歲女性
平均每年保費
10Life
醫療預計平均保障
基本計劃保額
(每保單年度計)
額外醫療保障上限
(每保單年度計)
富衛 | FWD
易衛您醫療計劃(標準)

$5,401
$7,039
100%
$500,000 
每宗傷疾每保單年度計
不適用
富衛 | FWD
更衛您(優越版)醫療計劃

$4,680 $6,173 78.8%
$520,000
每保單年度計
$100,000
設15%共同保險
信諾 | Cigna
信諾自願醫保系列-靈活計劃(附加保障)
$5,207
$5,207
76.1% $570,000 
每保單年度計
$150,000
設10%共同保險
富通 | FTLife
「摯康保」醫療保障計劃
 (保障級別1,包括超額醫療保障)

$5,255
$7,688
69.2% 不設上限
$100,000
設15%共同保險
蘇黎世 | Zurich
「智選無憂」自願醫療保障計劃-
精選附帶附加醫療保障

$5,497
$6,984
67.6% $550,000
每保單年度計
$120,000
設20%共同保險
保泰人壽 | Bowtie
保泰自願醫保 - 靈活計劃 - 基本計劃1

$3,372
$4,394
66.7% $600,000
每保單年度計
$120,000
設20%共同保險
亞洲保險 | Asia Insurance
亞洲緻安心 – 計劃2
$5,082
$6,674
62.9% $500,000
每保單年度計
不適用
萬通保險萬通保險 | YF Life
「稅」安心醫療計劃(計劃1M)
$4,770
$8,206
62.1% $600,000
每保單年度計
$120,000
設20%共同保險
利寶 | Liberty Insurance
利寶國際自願醫保系列– 靈活計劃
(基本包括附加醫療保障)

$5,794
$5,794
61.8% $500,000
每保單年度計
$100,000
設20%共同保險
永明金融 | Sun Life
永明港稱心醫療保計劃2

$4,024
$4,633
59.7% $800,000
每保單年度計
$300,000
設20%共同保險
自願醫保標準計劃 $2,084
至 $
4,405
$2,567
至 
$5,147
36.9%
至 39.0%

$420,000
每保單年度計
$20,000
客戶先自付30%
 註:
1. 如保泰自願醫保 - 靈活計劃 - 基本計劃配搭戰癌保 100,預計平均保障將提升至92.2%。戰癌保 100並不是自願醫保計劃下之認可產品,不適用於任何稅務扣除。
2. 上述預計平均保障是根據12個多個常見、涉及不同程度、及醫療服務的傷病個案,於一般情況下的醫療開支,再由10Life精算師對照醫療保險產品的賠償上限,計算出來的預計平均保障,詳見《醫療保險的評分方法》。
3. 以上資訊更新至2022年2月18日,僅供參考,並非銷售提議。

在10款產品中,首位是FWD富衛易衛您醫療計劃(標準),預計平均保障率達100%。有別其他產品,它的的賠償上限以每宗傷疾每保單年度算計(見註2),對於一年多次傷病、或傷病橫跨年度的個案保障較佳。其餘9款靈活計劃預計平均保障率介乎59.7%至78.8%,皆高於標準計劃所訂立的最低要求,部分產品更設有額外醫療保障(見註3)。

以35至44歲男性平均每年保費為例,上述10款產品每年平均保費為3,372港元至5,497港元,對比自願醫保標準計劃保費介乎2,084 港元至 4,405港元,而預計平均保障率僅36.9%至39.0%,明顯表1列出的計劃較優勝。

由此可見,保障與保費不一定成正比,消費者要小心比較。不少計劃間中也會推出首年保費優惠,大家可以瀏覽10Life網站內的《產品解碼器》了解更多。

大病保障率差異大  肝癌預計自付額相差超過19萬

當然,大家或許會認為上述自願醫保也不是便宜,但若果看看大小傷病的開支,或許大家會覺得這個價錢買到較佳醫療保障,其實也不是特別昂貴。

表2:比較普通房等級、無自付費、平均年保費少於6,000港元之自願醫保預計保障率
(假設受保人為35歲非吸煙人士)

普通房計劃 指定傷病的保障
腸鏡檢查 (日間治療)
$18,100
割痔瘡手術
$45,600
通波仔,置入支架
$217,813
嚴重癌症 - 肝癌
$482,700
預計保障率 預計自付額 預計保障率 預計自付額 預計保障率 預計自付額 預計保障率 預計自付額
富衛 | FWD
易衛您醫療計劃(標準)
100% $0100% $0 100% $0 100% $0
富衛 | FWD
更衛您(優越版)醫療計劃
96.6% $624 97.6% $1,093 73.8% $57,093 89.0% $53,220
信諾 | Cigna
信諾自願醫保系列-靈活計劃(附加保障)
100% $099.2% $375 93.1% $14,936 80.8% $92,670
富通 | FTLife
「摯康保」醫療保障計劃
(保障級別1,包括超額醫療保障)
97.1% $525 97.2% $1,263 75.1% $54,213 95.2% $23,270
蘇黎世 | Zurich
「智選無憂」自願醫療保障計劃
-精選附帶附加醫療保障
95.1% $88895.5% $$2,050 84.2% $34,443 68.5% $151,950
保泰人壽 | Bowtie
保泰自願醫保 - 靈活計劃
- 基本計劃
100% $0 100% $0 81.3% $40,823 60.0% $193,270
亞洲保險 | Asia Insurance
亞洲緻安心 – 計劃2
97.0% $550
90.0%
$4,550
35.9%
$139,573
76.7%
$112,310
萬通保險 | YF Life
「稅」安心醫療計劃(計劃1M)
97.6% $440
96.4%
$1,640
86.8%
$28,803
61.0%
$188,230
利寶 | Liberty Insurance
利寶國際自願醫保系列–
靈活計劃(基本包括附加醫療保障)

97.0%
$550
97.4%
$1,190
75.7%
$52,993
68.9%
$150,150
永明金融 | Sun Life
永明港稱心醫療保計劃2
93.7% $1,140 95.4% $2,090 84.6% $33,553
59.3%
$196,350
自願醫保標準計劃 78.2% $3,940
79.8%
$9,190
24.4%
$164,743
41.3%
$283,150
 註:
1. 上述預計醫療開支是根據該傷病於一般情況下之開支來計算,用作預算醫療保險的預計保障率及消費者的預計自付額,僅作參考之用,用戶不應視之為實際醫療開支。每個傷病個案的嚴重程度、所需治療、及保險公司的理賠評核等,都未必相同,均影響受保人實際的賠償額。詳情請參閱《醫療保險的評分方法 》。
2. 以上資訊由10Life提供,更新至2022年2月18日,僅供參考,並非銷售提議。

對於公立醫院輪候時間頗長的小病,如腸鏡檢查(日間治療)、割痔瘡手術,不少自願醫保預計保障率超過95%;就算是最基本的標準計劃,對於此類小病的預計保障亦接近80%,所以受保人可透過自願醫保,在私營醫療機構進行較快及舒適的醫治。

至於大病,上述產品的保障率差異頗大,有些自願醫保對於上述疾病可以提供高度保障,毋須繳付自付額;而其他自願醫保,受保人自付額最少亦要數萬港元。

公立醫院自費項目 自願醫保發揮作用

如果財政緊絀,未必敢在私家醫院醫大病,寧願排公立醫院,在這情況下自願醫保仍可發揮部份作用,填補公立醫院中病人自費項目的開支。

舉例,如市民在公立醫院接受通波仔,手術中置入的支架開支(如2個支架花費約80,000港元)是自費項目,受保人可索償自願醫保,有關支架開支屬於「雜費」及「額外醫療保障」。上述平價自願醫保產品中,不少計劃也有附加額外醫療保障。

至於在公立醫院治療嚴重癌症,現時大部份標靶及免疫治療藥物均屬自費藥物,而上述大部份自願醫保產品,非手術癌症治療賠償上限為每保單年度80,000港元,只可彌補少部分開支。所以市民亦要積極預防癌症,保持健康生活習慣,定期接受篩檢,有病時及早求醫。

本文只討論平價產品。不過,如果大家有更多Budget,市場上確有保障更高產品。讀者需了解個人需要,在預算及保障中尋找平衡,認真比較產品。 


註﹕
  1. 上述預計平均保障是根據12個多個常見、涉及不同程度、及醫療服務的傷病個案,於一般情況下的醫療開支,再由10Life精算師對照醫療產品的賠償上限,計算出來的預計平均保障,詳見《醫療保險的評分方法》。
  2. 就同一傷病的每次住院或每宗日間手術,其適用的保障限額及/或每傷病每保單年度保障總額該傷病將會重新計算,前提是該住院或日間手術並不是在同一傷病之前一次住院或接受日間手術的最後日期起計連續90日期間發生。當受保人因多於1個傷病住院或接受任何日間手術時,在同一次住院或同一宗日間手術所涉及的所有不同的傷病將會受限於1個適用的保障限額及/或每傷病每保單年度保障總額。
  3. 額外醫療保障(Supplementary Major Medical,簡稱SMM)有兩點須留意:一、有些產品的SMM未必涵蓋「非手術癌症治療」保額。換言之,化療、標靶治療等非手術癌症治療時所產生,並且超出細項限額上限的醫療費用,SMM幫不上忙。二、不同計劃的SMM之賠償上限有異,而且SMM設共同保險,客戶一般要與保險公司攤分部份超出細項限額的開支(一般為20%)。
  4. 本文由10Life從不同途徑搜集市場資料製作而成,僅供一般參考之用,並沒有考慮任何個人需要及合適性,亦不應被視爲銷售建議。投保前應與持牌保險顧問商討適合自己的保險方案,並以保險公司提供的資料爲準。
  5. 以上保費資料更新至2022年2月18日,並未包括保險業監管局收取的保費徵費。
  6. 本文最後更新日期:2022年2月18日。

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