Comparing 5 Star VHIS Semi-private Plans (Chinese Article)

Estimated reading time 5 minutes

10Life Team

15 Mar 2022
「5星級」自願醫保強者對壘 邊款產品遇強越強?
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10Life Team

15 Mar 2022

Estimated reading time 5 minutes

自願醫保(VHIS)是獲政府認可的醫療保險,扣稅(註1)優惠成為一大誘因,但保障度及價格可以差天共地,今次我們集中比較保障度高的5星級自願醫保半私家房計劃,看看哪款屬於中產家庭之選?

為了讓消費者易於比較,10Life精算師以12個傷病個案(註2)醫療費用為基礎,逐一評估自願醫保的保障並作出評級。去年我們更優化評級方法,提升乳癌個案的醫療開支假設,並檢視產品的抗醫療通脹能力。

5星評級自願醫保是眾多產品中的強者,只有預計平均保障率達99.5%或以上、提供全數保障(註3)、每保單年度賠償上限大於或等於8,000,000港元的半私家房產品,才可獲此殊榮。今天,我們將比較10款5星級自願醫保,仔細看看它們的差異。

僅3款產品不設終身賠償上限  保費相差達48.8%

雖然產品全數保障(註3)多個項目,但賠償金額受每年及終身賠償上限所限。10款產品的每保單年度賠償上限分別為8,000,000港元至30,000,000港元。此外,只有3款產品不設終身賠償上限,分別是中國太平、保柏和信諾。

大部份半私家房產品僅涵蓋亞洲地區,只有藍十字(涵蓋全球)、Bowtie和保柏(涵蓋美國除外的全球地方)三款例外。產品保費介乎11,152港元至19,768港元,男女保費相同。以受保地區為亞洲的產品比較,35至44歲平均每年保費最高的是友邦(16,592港元),而最低的是信諾(11,152港元),兩者相差48.8%。

表1:比較5星級自願醫保計劃(半私家房)保障和保費(港元)

保險公司/
自願醫保產品
預計
平均保障
每保單年度
賠償上限
終身
賠償上限
35-44歲
平均每年保費
受保地區
100% $30,000,000 不設上限 $11,152 亞洲
99.5% $10,000,000 $50,000,000 $11,374 全球(美國除外)
藍十字保險 | Blue Cross
尊悅自願醫保計劃
(亞洲 ) 100% $10,000,000 $48,000,000 $12,190 亞洲
(全球 ) $19,768 全球
99.9% $10,000,000 $60,000,000 $13,084 亞洲
99.8% $10,000,000 $40,000,000 $13,390 亞洲
99.8% $20,000,000 不設上限 $14,003 亞洲
保柏 | Bupa
Bupa Hero 非凡自願醫保計劃
(智選)
100% $25,000,000  不設上限 $14,137 亞洲
(倍智選)
$30,000,000 不設上限 $15,890 全球(美國除外)
永明金融 | Sun Life
港卓越醫療保
100% $10,000,000 $40,000,000 $15,010 亞洲
99.8% $8,000,000 $32,000,000 $15,806 亞洲
100% $10,000,000 $50,000,000 $16,592 亞洲
註:
  1. 預計平均保障是以10Life根據產品對12個常見傷病個案預計保障率的平均值計算。
  2. 假設受保人為非吸煙男性或女性,投保0自付費的半私家房計劃,有關保費是該年齡層之10年平均保費。
  3. 按產品35-44歲平均每年保費排列。

訂明非手術癌症治療、住院或日間手術前後門診、家中看護保障比較

高階醫保保障當然不止於手術保障,為了進一步了解產品特點,我們特意挑選3個用家關心的項目來比較產品,包括訂明非手術癌症治療、住院或日間手術前後門診,以及家中看護。

表2:進一步比較5星級自願醫保計劃(半私家房)保障(港元)

自願醫保產品 訂明非手術
癌症治療
入院前或出院後/
日間手術前後的門診護理1
家中看護
全數保障
所有入院前30日內及;
所有出院後90日內之門診費用
每日: $1,000
每保單年度90 日
保泰人壽 | Bowtie
粉紅自願醫保
全數保障
入院前1 次;
出院後90日內3次之門診費用
每日$1,600
每保單年度180 日
藍十字保險 | Blue Cross
尊悅自願醫保計劃
(亞洲 ) 全數保障
入院前2 次;
所有出院後90日內之門診費用
全數保障
每保單年度196 日
(全球 )
全數保障
入院前1 次;
出院後90日內6次之門診費用
全數保障
每保單年度196 日
全數保障
入院前1 次;
出院後90日內3次之門診費用
全數保障
每保單年度90 日
$2,500,000
所有入院前30日內及;
出院後90日內3次之門診費用
全數保障
每保單年度200 日
保柏 | Bupa
Bupa Hero 非凡自願醫保計劃
(智選)
全數保障
所有入院前30日內及;
所有出院後365日內之門診費用
全數保障
每保單年度90 日
(倍智選)
全數保障
入院前31 次;
出院後90日內90次之門診費用
全數保障
每保單年度30 日
$2,500,000
入院前1 次;
出院後90日內3次之門診費用
全數保障
每保單年度30 日
全數保障
所有入院前30日內及;
所有出院後90日內之門診費用
全數保障
每保單年度30 日
註:
  1. 10款產品皆以全數保障入院前或出院後日間手術前後的門診護理。
  2. 「全數保障」指保險公司會全額支付扣除自付費餘額(如有)後的合資格醫療費用及其他費用,但受每保單年度保障限額(如適用)、終身保障限額(如適用)、每保單年度每傷病保障限額(如適用)及/或其他相關條件所限。全數保障只適用於指定保障項目,而其他保障項目受限於相關項目的賠償限額。有關索償需符合「醫療所需」,費用亦要「合理及慣常」。
  3. 按產品35-44歲平均每年保費排列。

訂明非手術癌症治療:見例子包括化療、標靶藥等,當中標靶藥集中對付癌細胞,副作用較少,但價錢非常昂貴,每月藥費隨時過萬,加上療程或許漫長。不過,大部份產品均全數保障訂明非手術癌症治療,令患者可以專注治療。

住院或日間手術前後門診:手術前門診讓患者了解手術的適合性,而手術後亦要透過門診跟進病情。部分醫療保險只保障數次門診,未必足以應付需要。在10款產品中,只有友邦、保柏和信諾全數保障至少入院前30日內及出院後90日內的門診費用,而且不限次數。

家中看護:中風、骨科手術、腎衰竭等患者,出院後或需聘家中看護來協助復康運動、護理傷口。大部份產品都以全數保障形式賠償相關費用,其中藍十字保險、中國太平、富衛人壽保障期較長,提供每個保單年度超過195日。

上述無自付費(墊底費)的計劃保費過萬,若想以較低廉的價錢投保,可考慮設有自付費的計劃。以同樣是自願醫保半私家房計劃,並以非吸煙成人為例,自付費港幣20,000至40,000以及自費港幣40,000至60,000的自願醫保,均有助減輕保費壓力。

醫療保險保障項目繁多,本文只比較了部份保障。此外,讀者亦需留意保費一般跟隨年齡、醫療通脹上升。因此,投保前宜考慮個人需要、供款能力、產品特點等因素。如有需要,可透過《保險解碼器》比較產品。

 
延伸閱讀﹕

註﹕
  1. 每個課稅年度每名受保人的最高保費扣除額為8,000港元。
  2. 10Life根據多個常見、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》。上述傷病個案的預計保障率是根據該傷病於一般情況下之預計醫療開支來計算,用作「預計」醫療保險及消費者大概要負擔的醫療開支,僅作參考之用,並未得到有關保險公司之確認。
  3. 「全數保障」指保險公司會全額支付扣除自付費餘額(如有)後的合資格醫療費用及其他費用,但受每保單年度保障限額(如適用)、終身保障限額(如適用)、每保單年度每傷病保障限額(如適用)及/或其他相關條件所限。全數保障只適用於指定保障項目,而其他保障項目受限於相關項目的賠償限額。有關索償需符合「醫療所需」,費用亦要「合理及慣常」。
  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3月15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3月15日。

Disclaimer

10Life Product Comparison and 10Life Insurance Ratings are developed by 10Life Financial Limited, an authorised insurance broker company licensed with the Insurance Authority under License Number FB1526. 10Life Product Comparison and 10Life Insurance Ratings are developed for generic customer segments using mathematical calculations based on product information, facts and data, and are not influenced by any partnerships with or fees received from insurance companies.

Any information on 10Life Platform ("10Life Information"), including but not limited to Product Comparison, Product Ratings, Blog Articles are intended for general education purpose and reference only. None of the 10Life Information is intended, nor should they be considered or relied upon, as regulated advice, insurance, financial, investment or professional advice, recommendation, approval, endorsement, invitation or solicitation in respect of any insurance, financial or investment products. 10Life Information does not take into account your individual needs. Reading 10Life Information should not be considered as conducting a suitability assessment, and is not sufficient to form the basis of any decisions to purchase any insurance products. You should rely on information authorised by insurance companies, carry out your own research and/or seek independent advice from licensed intermediaries before purchasing any insurance products or making any insurance decisions. While reasonable effort is used when collecting, validating and updating 10Life Information from various channels, none of 10Life Group and its subsidiaries, affiliates, agents, directors, officers and employees will be responsible for any liability, claim or loss arising from or associated with you using 10Life Information. No warranty, representation or guarantee is given by 10Life Group and its subsidiaries on the accuracy, completeness and timeliness of the information.

If you have any questions on 10Life Product Comparison and 10Life Insurance Ratings, please email us at enquiries@10life.com .

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10Life Financial Manager, Insurance Specialist

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4.6
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Nik, Leung Tsz Kei

梁芷萁

10Life Financial Manager, Insurance Specialist

4.8
1173
274

Jack, Ng Wai Lap

黃維立

AXA Unit Manager

4.7
4100
626

Arthur, Law Wing Kai

羅永楷

10Life Financial Manager of Business Development

5
255
4

Winnie, Ng Wai King

吳惠琼

FTLife Agency Manager

4.8
1859
312

Even, Shum Miu Chu

岑妙珠

恆泰 高級理財顧問

4.6
1349
249

Tony, Yeung Chun Fung

楊俊鋒

FWD Life Wealth Planner

4.7
1812
315

Philip, Lee Hon Lun

李漢麟

YF Life Branch Manager

4.4
1656
265

Mabel, Siu Sin Wan

蕭善尹

FTLife Wealth Management Director

5
1072
319

Edward, Lam Wing Chuen

林永泉