Is the Voluntary Health Insurance Scheme better than existing mass-market medical insurance? (Comparing cover for surgical fees.)

The Government has announced the details of the Voluntary Health Insurance Scheme, with the average premium expected to be around $4,800. Compared with mainstream medical insurance, is the Government-recognised Voluntary Health Insurance Scheme attractive, and can it raise the standard of medical insurance products? We compare the “Standard Plan” under the Voluntary Health Insurance Scheme with the Basic Plan (see Note 1) of mainstream medical insurance products currently available on the market, based on premiums and coverage for surgical fees.

Coverage for surgical fees

We compare the claim limits for common surgical procedures of varying complexity, including haemorrhoidectomy, colonoscopy or gastroscopy performed at a day procedure centre, and angioplasty. Patients may have to wait for a long time if these procedures are performed in public hospitals.

• Colonoscopy or gastroscopy performed at a day procedure centre (one of the two): The Voluntary Health Insurance Scheme classifies this as a minor surgery, with a claim limit of $5,000. This level of cover is around the middle of the market. There are many mainstream medical insurance products on the market with a coverage limit exceeding $5,000.
   
• Haemorrhoidectomy: The Voluntary Health Insurance Scheme classifies this as an intermediate surgery, with a claim limit of $12,500. This level of cover is higher than that of most mainstream medical insurance products on the market.
   
• Angioplasty: The Voluntary Health Insurance Scheme classifies this as a major surgery, with a claim limit of $25,000. This level of cover is only around the middle of the market.
   
• Note: The classification of surgical procedures varies between products. For example, for the same procedure A, the Voluntary Health Insurance Scheme may classify procedure A as a major surgery, while other mainstream medical insurance products may classify procedure A under a different category, resulting in different coverage percentages.
   

Premiums

The Government has announced that the average premium for the Voluntary Health Insurance Scheme is expected to be $4,800. However, medical insurance products are priced according to age, so consumers should pay attention to the premium for the relevant insured age when making comparisons. According to media reports, premiums for people under 24 who enrol in the Voluntary Health Insurance Scheme are approximately $2,400 per year; the expected premium for insured persons aged 40 to 44 rises to $4,600; and the expected premium for insured persons aged 60 to 64 reaches $10,200 (see Note 2). We will also compare these with the annual premiums of mainstream medical insurance for the corresponding age groups (see Note 3).

• For each of the above age groups, the expected premiums for the Voluntary Health Insurance Scheme are considerably higher than the average annual premiums of mainstream medical insurance products on the market, particularly for the 40 to 44 age group. 
   
• Based on the claim amounts for the procedures mentioned above, CignaHealthFirst Choice, ManulifeManuGuard and Zurich智樂人生 have claim limits similar to those of the Voluntary Health Insurance Scheme. However, these mainstream medical insurance plans are significantly cheaper than the Voluntary Health Insurance Scheme (for the above age groups).
   

In summary, for the common surgical procedures mentioned above, the claim limits of the Voluntary Health Insurance Scheme are broadly in line with the current market average. Only its claim limit for haemorrhoidectomy offers a notable advantage, while its expected premiums are substantially higher, exceeding the market average by more than 30%. Of course, there are many coverage items to consider when assessing a medical insurance product. Going forward, 10Life will analyse the Voluntary Health Insurance Scheme from more perspectives, so please stay tuned.

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Note:

1. All of the mainstream medical insurance products mentioned above are “Basic Plan” products, without additional medical coverage. The insured ward type is a standard ward, with worldwide coverage.
    
2. The estimated premium information for the Voluntary Health Insurance Scheme is taken from Wen Wei Po, “Average premium for Voluntary Health Insurance Scheme at $4,800”.
    
3. The premiums of the mainstream medical insurance products mentioned above are the average premiums for ages 18 to 23, 40 to 44 and 60 to 64, assuming that the insured person is male and a non-smoker.

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.