Traditional medical insurance may offer insufficient cover; cancer insurance enhances cancer protection. Note these 4 key points.

Traditional medical insurance covers hospital expenses arising from injuries or illnesses, usually with a compensation limit for each item, which may not be sufficient to cover the cost of cancer treatment. Cancer insurance, on the other hand, typically sets a compensation limit for each incidence of cancer and reimburses the medical expenses incurred for cancer treatment, providing more targeted coverage.

Traditional medical insurance and cancer medical insurance differ in three main ways: the illnesses covered, the claims settlement method and the waiting period. Traditional medical insurance covers hospitalisation and day surgery arising from injury or illness. Cancer medical insurance, on the other hand, only covers cancer.

In addition, the two differ significantly in terms of the claims settlement method. Traditional medical insurance generally sets claim limits for individual items. For example, a maximum of HK$500 per day may be payable for attending doctor’s ward rounds. If the actual cost is HK$900, the patient will have to pay the remaining HK$400 out of their own pocket. Cancer medical insurance reimburses medical expenses incurred as a result of cancer, subject to the per-cancer claim limit and the lifetime claim limit. Some cancer medical insurance plans also cover the costs of purchasing or renting medical equipment, consultations with dietitians or psychological counselling, whereas traditional medical insurance generally does not cover these extended care expenses.

As for the waiting period, this depends on the type of medical insurance plan. It is generally 30 days, while some plans, such as Voluntary Health Insurance, do not impose a waiting period. The waiting period for cancer medical insurance is generally 90 days, during which cancer for which symptoms appear or a diagnosis is made is not covered. It should be noted that even after the waiting period has elapsed, if a claim is made within 2 years of the policy taking effect, the insurance company may handle the claim very strictly, taking into account the possibility that the customer had taken out the policy after already developing the illness.
 

The advantages and disadvantages of cancer medical insurance are relatively clear. If the medical insurance plan originally purchased by a consumer provides insufficient cover, and they wish to enhance their cancer protection while working with a limited budget, they may consider adding a cancer medical insurance policy. However, if a consumer has no other medical insurance and purchases cancer medical insurance alone, they will lack cover for other illnesses. Common and costly medical cases such as angioplasty and joint replacement surgery would not be covered.

When taking out cancer medical insurance, you should pay attention to the following 4 key points to avoid being caught off guard in the future.

The main compensation mechanism of cancer medical insurance is to cover expenses required for cancer treatment, including diagnostic tests, ward and meal charges, ward rounds, specialist doctors’ fees, surgeons’ and anaesthetists’ fees, operating theatre charges, medication costs and intensive care unit charges, etc., subject to the per-cancer claim limit and lifetime claim limit. Such expenses must be for customary and reasonable treatment methods and must also be medically necessary.

 Taking AIA’s “Comprehensive Cancer Protection 2” as an example, the “covered cancer limit” is HK$1,000,000, while the lifetime cancer benefit limit is HK$3,000,000.

In addition, if, after receiving the first claim payment, the insured unfortunately develops a new cancer, experiences the continuation or spread of the original cancer, everyone should note the relevant waiting period. A further claim can only be made after the waiting period has ended.

When purchasing cancer medical insurance, the ward class and geographical area of coverage will be specified. If you wish to upgrade the ward class or receive medical treatment in the United States, the compensation limit will generally be adjusted. For example, if a consumer takes out a plan covering a semi-private room with an annual compensation limit of HK$1,000,000, the annual compensation limit will be reduced to 50% when staying in a private room or receiving medical treatment in the United States.

Cancer insurance plans cover a wide range of additional treatments, commonly including Chinese medicine, consultations with nutritionists, physiotherapy, occupational therapy, speech therapy, psychological counselling, home nursing care and medical appliances. You should note the maximum compensation per session and the number of sessions covered for each item. Some plans may also cover psychological counselling (even for immediate family members) or the cost of wigs.

Some plans also include complementary therapies such as chiropractic treatment, aromatherapy, homeopathy and art therapy. They may even provide transport subsidies and cover the costs of fertility preservation related to cancer, so it is advisable to compare plans carefully before taking out a policy.

1. The above premium information was updated on 27 June 2022 and does not include the premium levy collected by the Insurance Authority.
2. Last updated: 27 June 2022.

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.