Voluntary Health Insurance by multinational insurers: extra benefits comparison

As tax season approaches every year, insurance companies vigorously promote tax-deductible Voluntary Health Insurance Scheme (VHIS) plans. However, with so many Voluntary Health Insurance plans on the market, which products offer the best protection? In this comparison, we examine six flagship VHIS plans from major multinational insurance companies (semi-private room). Most of them have received a 5-star rating from 10 Life (Note 1), reflecting their high medical protection. To further enhance product quality, insurers have actively added a number of “additional benefits” (see below). However, we found significant differences in these “additional benefits” across the products, so consumers are advised to compare carefully before taking out cover.

10Life uses a rigorous and precise scoring methodology to assess each Voluntary Health Insurance product individually. Products that receive a 5-star rating (Note 1) offer high medical protection and strong resistance to medical inflation:

• An average weighted protection rate of 99.5% across 12 common illness and injury cases of varying severity, i.e. a medical protection score ≥9.95;
• Inflation-resistant features (no sub-limits, and an annual policy benefit limit of not less than $8,000,000).

At present, fewer than 10% of Voluntary Health Insurance products in the market are awarded the 5-star rating.

Table 1 shows that the Voluntary Health Insurance plans listed are mostly 5-star products, with at least 3 additional benefits. Among them, Bupa and Sun Life offer the most additional benefits (6), while AXA offers the fewest (3). The additional benefits we compared include:

• Second medical opinion service
• Worldwide medical assistance service
• Hospital cash benefit (without downgrading the class of private hospital room)
• Extended outpatient follow-up coverage after hospitalisation (180 days or more and at least 6 visits)
• End-of-life care cover / palliative care cover (lifetime limit of more than or equal to HK$80,000)
• Pregnancy complications cover (annual benefit of more than or equal to HK$100,000, or co-insurance of no more than 20%)
• Short waiting period: less than or equal to 30 days, applicable to unknown pre-existing conditions
• Waiver of deductible upon diagnosis of designated major critical illness

As for premiums, many consumers choose Voluntary Health Insurance plans with a deductible to reduce premiums, with the deductible potentially covered by corporate medical insurance (if any). This time, we selected a common deductible level (around HK$20,000) to compare the average annual premiums for ages 35 to 44, which range from HK$6,264 to HK$9,164.

Significant differences in 3 additional benefit items

The Voluntary Health Insurance market is highly competitive. Benefits that were previously considered selling points of premium medical insurance have gradually become “standard features”. Among the products above, all offer second medical opinion service, worldwide medical assistance service and a short waiting period. Apart from Prudential, the other products also include end-of-life care cover or palliative care cover.

We found that the main differences in additional benefits among the 6 products lie in the waiver of deductible upon diagnosis of designated major critical illness, pregnancy complications, and extended outpatient follow-up coverage after hospitalisation, as shown in Table 2.

Let’s first look at the waiver of the deductible upon diagnosis of specified major critical illnesses. “Major critical illnesses” refer to cancer, stroke and heart disease. If the insured unfortunately suffers from a specified critical illness, they will not need to pay the deductible, which can immediately ease the insured’s financial burden. Among the six products, only Sun Life waives the deductible upon diagnosis of specified major critical illnesses, and it further covers other critical illnesses, such as kidney failure, major organ transplant, and foot amputation resulting from diabetes complications.

As for pregnancy complications, these refer to ectopic pregnancy, molar pregnancy, miscarriage, amniotic fluid embolism, and so on. Pregnancy complication cover is especially important for pregnant women and those planning to conceive. Among the six products, only Manulife, Prudential and Sun Life offer full reimbursement for this item, while Bupa provides a coverage limit of HK$165,000 per policy year.

Voluntary Health Insurance mainly provides hospitalisation cover, but for some medical cases, such as stroke or knee replacement, treatment is not limited to hospitalisation, and the insured also needs ongoing follow-up consultations after discharge. Among the six products, most include outpatient cover within 90 days after discharge, while Bupa further extends this to 365 days.

Medical insurance claims require various documents to be handled, and the process can be cumbersome. If someone is available to help manage the paperwork or guide you through it, it can save considerable time and effort. In this respect, insurance agents can play a role by helping to ensure all documents are submitted when making a claim. Among the six insurers mentioned above, apart from Bupa, the others all have insurance company agents following up on claims, so readers may wish to take note.

This article only provides a brief discussion of the additional coverage under the flagship Voluntary Health Insurance plans of major multinational insurers. Readers are advised to understand their own personal needs before taking out insurance. If in doubt, please consult a professional insurance adviser.

Notes:    
1. See the scoring methodology for medical insurance.    
2. The premium information above was updated to 28 February 2023 and does not include the levy collected by the Insurance Authority.    
3. Last updated on 28 February 2023.

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.