Most Comprehensive VHIS Flexi Plan Comparison on Coverage and Ranking (Updated June 2021) (Chinese Article)

Estimated reading time 10 minutes

10Life Team

27 Jun 2021
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10Life Team

27 Jun 2021

Estimated reading time 10 minutes

不知不覺,自願醫保(Voluntary Health Insurance Scheme,VHIS)推出了超過兩年,而且越來越多消費者對此感興趣。除了因為政府提供扣稅的經濟誘因,以鼓勵市民投保醫療保險來使用私家醫院服務外,自願醫保產品也與日俱進,保障越來越完善。然而,面對海量的自願醫保產品,特別是大部份人選購的靈活計劃(註1),普羅大眾未必有足夠的專業知識來評估產品特點及用處。為了比較自願醫保計劃的保障,10Life向專科醫生查詢12項常見傷病個案的醫療開支,再由精算師團隊根據醫保產品的條款及細則,進而推算靈活計劃的預計平均保障率,並以此作評分(註2),方便讀者了解產品的優劣。

自願醫保靈活計劃(普通房) 全數保障產品有增加趨勢

自願醫保靈活計劃以標準計劃的基本保障作基礎,再加上額外保障項目或提高保額,但有別於標準計劃設有劃一條款,靈活計劃產品的保障及條款不盡相同。以下是首10名獲得最高評分的靈活計劃(普通房): 

圖表1
比較自願醫保靈活計劃(普通房)(2021年6月更新)

保險公司/
自願醫保產品
產品結構 10Life
醫療保障評分
 (10分滿分)
預計平均保障 35-44歲
非吸煙男士
平均每年保費
富衛 | 易衛您醫療計劃(標準) 全數保障 10 100% $5,401
安盛 | AXA 安盛智尊守慧醫療保障 (標準) 全數保障
10
99.6% $9,597
滙豐保險 | 滙豐自願醫保靈活計劃銅級 全數保障
10 99.6% $10,784
保泰人壽 | 保泰自願醫保 - 靈活計劃 - 基本計劃 + 戰癌保 100 (註3)
細項限額
9.2 91.5% $5,401
富衛 | 更衛您(優越版)醫療計劃
細項限額
9.1 90.7% $4,680
信諾 | 信諾自願醫保系列-靈活計劃(附加保障)
細項限額
9.1
90.5% $5,207
富通 | 「摯康保」醫療保障計劃 (保障級別2,包括超額醫療保障)  細項限額
8.7 87.5% $6,282
富通 | 「摯康保」醫療保障計劃 (保障級別1,包括超額醫療保障)
細項限額
8.6 86.3% $5,255
保泰人壽 | 保泰自願醫保 - 靈活計劃 - 基本計劃  細項限額
8.5 84.9% $3,372
保柏 | 保柏靈活配自願醫保計劃 - 升級基本
細項限額
8.5 84.6% $6,731
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. 以上保費按無自付費的產品類型計算。
3. 保泰癌症醫療保險並不是自願醫保計劃下之認可產品。如需要,客戶可選擇加配保泰癌症醫療保險。
4. 以上資訊由10Life提供,更新至2021年6月28日,僅供參考,絕非銷售提議。

於普通房計劃中,多數產品按細項限額來賠償(註3),但首三位的保靈活計劃均採取全數保障的賠償機制。「全數保障」是指,保險公司會全額支付合資格醫療費用(註4)。位居榜首的FWD富衛易衛您醫療計劃(標準),以每保單年度每傷病計(註5)的賠償上限是50萬,當中全數保障合資格索償,對於一年多次傷病、或傷病橫跨年度的個案,在保障上都顯出優勢。

至於大多數細項限額的醫保,針對細項限額導致賠償不足的問題,有投保人或會選擇設有「額外醫療保障」(Supplementary Major Medical,簡稱SMM)的自願醫保,讓保險公司賠償部分超出細項限額的開支。不過,大家需要留意兩點: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%)。

大家可瀏覽10Life《產品解碼比較》,找出產品對於12種傷病的預計保障率,以及其SMM是否涵蓋「非手術癌症治療」: 


自願醫保靈活計劃(半私家房)排行榜 成全數保障產品天下

與自願醫保靈活計劃(普通房)一樣,全數保障的賠償方或對醫療保障有正面影響,在自願醫保靈活計劃(半私家房)的排名顯然而見:
 
圖表2
比較自願醫保靈活計劃(半私家房)(2021年6月更新)

保險公司/
自願醫保產品
產品結構 10Life
醫療保障評分
 (10分滿分)
預計平均保障 35-44歲
非吸煙男士
平均每年保費
富衛 | 易衛您醫療計劃(特等) 全數保障 10 100% $10,245
信諾 | 信諾自願醫保系列-靈活計劃(優越) 1
全數保障
10
100% $11,152
友邦 | AIA自願醫保尊裕計劃
全數保障
10 100%
$16,592
保柏 | Bupa Hero 非凡自願醫保計劃(智選)
全數保障
10 99.9% $13,502
富衛 | 尊衛您醫療計劃
全數保障
10 99.9% $13,084
安盛 | AXA 安盛智尊守慧醫療保障 (卓越)
全數保障
10
99.9% $13,390
滙豐保險 | 滙豐自願醫保靈活計劃銀級
全數保障
10 99.9%
$15,025
宏利 | 晉悅自願醫保靈活計劃
全數保障
10
99.9%
$15,806
 友邦 | AIA自願醫保尊尚計劃
全數保障
10
99.6%
$13,912
蘇黎世 | 「智選無憂+」自願醫療保障計劃
全數保障
9.9
98.7% $13,201
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. 以上保費按無自付費的產品類型計算。
3. 以上資訊由10Life提供,更新至2021年6月28日,僅供參考,絕非銷售提議。

評分最高的產品皆設有全數保障。可是,無自付費(墊底費)的全數保障計劃的保費通常較高(與細項設限的計劃相比)。若消費者既想得到全數保障,又想慳些保費,可考慮設有自付費的計劃,自付部分醫療開支:


醫療保險無疑是複雜的保險產品,不少人打算長期續保。隨著年齡增長,醫療通脹,皆會令保費上漲。讀者選購時必須考慮個人需要、供款能力、產品特點等因素,以選擇合適的產品,作長遠打算。

延申閱讀﹕

註:
  1. 自願醫保推行首年(截至2020年3月31日),認可產品的保單逾52萬張,當中97%為靈活計劃。
  2. 10Life就12個常見的傷病個案計算預計保障率,詳情請參閱《醫療保險的評分方法》。
  3. 細項限額賠償是指產品某產保障細項(例如住房費、手術費、雜費等)設有賠償上限。
  4. 「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」。
  5. 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。
  6. 以上資訊由10Life提供,更新至 2021年6月28日,僅供參考,絕非銷售提議。 

Disclaimer

10Life Product Comparison and 10Life Insurance Ratings are developed by 10Life Financial Limited, an authorised insurance broker with Insurance Authority 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 and should not be constituted as any insurance, financial, investment or other professional advice or solicitation to buy 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. You should only rely on information authorised by insurance companies and/or seek independent advice from licensed intermediaries before purchasing any insurance products or making any insurance decisions. While best 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 arising from using 10Life Information or for any claims and/or losses caused thereby, and no warranty or guarantee is made 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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Compare VHIS

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Licensed advisors will address all your insurance queries
Please select advisors

Jack, Ng Wai Lap

黃維立

AXA Unit Manager

4.6
3978
610

Nik, Leung Tsz Kei

梁芷萁

10Life Financial Manager, Insurance Specialist

4.8
1173
274

Winnie, Ng Wai King

吳惠琼

FTLife Agency Manager

4.8
1849
309

Even, Shum Miu Chu

岑妙珠

恆泰 高級理財顧問

4.6
1345
250

Philip, Lee Hon Lun

李漢麟

YF Life Branch Manager

4.4
1644
262

Tony, Yeung Chun Fung

楊俊鋒

FWD Life Wealth Planner

4.7
1763
308

Mabel, Siu Sin Wan

蕭善尹

FTLife Wealth Management Director

5
1058
313

Edward, Lam Wing Chuen

林永泉

Convoy Senior Wealth Management Advisor

4.6
1557
263

Noble, Suen Chit Yuen

孫哲遠

AIA Associate Director, Wealth Management and Protection

4.4
1114
249

Liu Lai Ting

廖麗婷

FWD Senior Branch Manager

4.8
1408
211
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Jack, Ng Wai Lap

黃維立

AXA Unit Manager

4.6
3978
610

Nik, Leung Tsz Kei

梁芷萁

10Life Financial Manager, Insurance Specialist

4.8
1173
274

Winnie, Ng Wai King

吳惠琼

FTLife Agency Manager

4.8
1849
309

Even, Shum Miu Chu

岑妙珠

恆泰 高級理財顧問

4.6
1345
250

Philip, Lee Hon Lun

李漢麟

YF Life Branch Manager

4.4
1644
262

Tony, Yeung Chun Fung

楊俊鋒

FWD Life Wealth Planner

4.7
1763
308

Mabel, Siu Sin Wan

蕭善尹

FTLife Wealth Management Director

5
1058
313

Edward, Lam Wing Chuen

林永泉