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醫療保險
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【Elderly Medical Insurance】Can a 60-year-old senior take out a policy? What should they pay attention to when applying?

2025-04-14 5min read
長者醫療保險

As the saying goes, "older age, machinery breaks" — as people get older, bodily functions gradually decline and the risk of illness increases substantially. With medical inflation, Hong Kong’s healthcare costs rise year after year; public hospitals have long waiting times and private hospitals are expensive. Without medical insurance, elderly people may face heavy financial pressure that can even affect treatment choices. Many mistakenly think "it's already too late for seniors to buy medical insurance" — strict underwriting requirements and high premiums deter many. In fact, a 60‑year‑old can still purchase suitable medical insurance to prepare for future health needs. This time, 10Life will walk you through the issues surrounding senior medical insurance and the key things to consider when buying a policy.

Why do seniors need health insurance?

Health risks increase with age

After turning60, the risk of chronic diseases such as hypertension, diabetes, and heart disease increases significantly, and medical needs also rise. Even if you are currently healthy, you cannot predict whether major illnesses will occur in the future. If long-term treatment or hospitalization is required, the expenses can be considerable.

Long waiting times in public hospitals

Hong Kong's public hospitals are under strain, and elderly patients often face long waiting times for consultations. For cataract surgery, for example, the latest data show the overall median waiting time is14 months, and the longest can reach38 months. Although the authorities expect the average waiting time may be shortened by about10 months within the next five years1, for older people, long waits can delay treatment, affect disease progression, and even increase health risks.

Private medical care is expensive

If you want to shorten waiting times, choosing a private hospital is the quickest option, but the costs are relatively high. Although65-year-old seniors receive an annual Elderly Health Care Voucher of2,000 dollars, if they unfortunately suffer a major illness requiring admission to a private hospital, it cannot fully cover the surgery and hospitalization costs. Therefore, having appropriate medical insurance is particularly important to help relieve the financial pressure of unexpected medical expenses. 

Below are the cost ranges for some common private hospital procedures2,3 
Cataract extraction (single eye, day surgery): approximately $20,400 
Gastroscopy (± polypectomy): approximately $36,663 - $54,390 varies
Breast lump excision: approximately$54,136 - $81,910 varies

Faced with high medical costs, medical insurance can reimburse eligible expenses on a reimbursement (indemnity) basis, covering hospitalization, surgery and specified treatment costs, allowing seniors to receive timely treatment when needed without worrying about the financial burden.

No company medical insurance after retirement

Many employees have medical coverage through their company, but once they retire, company medical insurance will terminate. Seniors without medical insurance can only rely on the public healthcare system or have to pay out of pocket for better treatment options.

Ease financial pressure and ensure a stable retirement

Medical expenses are hard to predict. Without insurance, seniors may need to dip into retirement savings to pay medical bills, potentially disrupting planned retirement arrangements — at a minimum affecting travel and investment plans. In severe cases, they may require support from children or relatives, increasing the family's financial burden.

Can a 60-year-old also buy medical insurance?

There are currently many medical insurance plans on the market specifically designed for people aged 55 to 80, covering cancer, chronic illnesses, hospitalization, surgery, and other protections. Even if you are already around 60 and retired, you still have the opportunity to purchase a suitable medical insurance plan. However, because medical insurance underwriting and eligibility are closely related to health status, insurers may charge additional premiums based on individual circumstances—commonly referred to as a loading—or impose exclusions. Additionally, most medical insurance plans have waiting periods and do not take effect immediately. Therefore, the earlier you plan, the better.

Besides the coverage details, what should seniors pay attention to when purchasing medical insurance?

Understanding age limits for coverage

Most medical insurance policies have a maximum entry age of 65 to 70 years, but some Voluntary Health Insurance (VHIS) plans have an upper age limit of up to 80 years. However, note that even if you meet the age requirement, you may need to pass a health screening when applying; insurers may decide whether to underwrite the policy or adjust the coverage based on the applicant’s health condition.

The older you are, the fewer options you typically have and the higher the premiums will be; you may even be declined due to health issues. Therefore, buying insurance earlier can help you avoid losing out on better policy terms or the chance to obtain coverage because of age limits or changes in health.

Health conditions can affect underwriting terms

Generally, when applying for medical insurance, insurers assess risk based on health. For seniors, if there are "pre-existing conditions" (Pre-existing Condition), such as chronic illnesses (e.g., hypertension, diabetes) or a history of hospitalization, a loading may be applied, increasing the premium. In addition, certain prior conditions or specific diseases may be excluded— for example, if a person has had heart surgery, the insurer may not cover treatment costs related to that organ.

Nonetheless, honest disclosure of health information is very important because insurance contracts are based on the principle of "utmost good faith." Even if coverage is successfully obtained, when a claim is made the insurer will thoroughly investigate past medical records, especially in early claims. If it is found that medical history was not truthfully declared, or information was concealed or omitted, the insurer has the right to refuse payment or even cancel the policy (commonly referred to as "policy cancellation"). Therefore, seniors must truthfully declare their health conditions when applying for medical insurance to avoid affecting their coverage later.

Coverage and exclusions

Different medical insurance plans offer varying scopes of coverage; before buying you should carefully review the terms to ensure that hospitalization and surgical benefits are sufficient to cover private hospital expenses. In addition, some plans have waiting periods (such as 30 days, 90 days or longer), during which if you fall ill and require hospitalization you may not be eligible for claims—be sure to note when coverage takes effect. At the same time, understand the exclusions: some plans do not cover certain diseases or pre-existing conditions, so you should avoid discovering after purchase that key illnesses are not covered.

The following are common exclusions in medical policies4

  • Pre-existing illnesses or congenital deformities/conditions that existed before purchasing the policy 
  • Elective expenses, such as cosmetic treatments 
  • Routine check-ups, such as regular physical examinations, dental or eye examinations 
  • Maternity and related expenses, such as obstetric wards, contraception or fertility treatments 
  • Special hazardous situations, such as radiation exposure, war or hazardous activities 
  • Unacceptable coverages, such as illegal activities, self-harm or substance abuse 
  • Prosthetic-related costs, including artificial limbs, glass eyes and dentures 
  • Special treatments, such as psychiatric treatment or rehabilitation and convalescent care 
  • Non-eligible expenses, such as transportation costs, non-approved or experimental treatments 
  • Injuries resulting from participation in professional or competitive sports

However, because exclusions vary by insurer, be sure to read the policy terms carefully before purchasing to ensure the coverage meets your needs.

Review premiums and assess your financial ability

Medical insurance premiums vary according to age, health status and scope of coverage; generally speaking, the older you are, the higher the premium. Therefore, seniors should assess their financial capacity before applying and consider whether they can afford the annual premiums. In addition, you should evaluate whether the coverage is sufficient and not overlook the scope of protection because of lower premiums. When choosing insurance, weigh premiums against coverage to ensure you can obtain adequate protection.

Renewal terms and policy duration

After purchasing, whether you can remain insured is equally important, so pay attention to renewal terms. Some plans offer guaranteed renewal; for example, Voluntary Health Insurance (VHIS) can be renewed up to 100 years of age, and some even offer lifetime renewal, ensuring coverage is not affected by age or health. However, some plans may apply a loading or terminate the contract if health deteriorates, so be sure to understand this when applying.

Compare different insurance plans

There are many medical insurance options on the market; it is recommended to consult a professional adviser or do research online, and compare multiple providers to find the plan that best suits you. In addition, you should understand the insurer’s reputation and claims procedures to avoid problems when making a claim.

Can I purchase the Voluntary Health Insurance Scheme (VHIS) for my elderly parents?

The Voluntary Health Insurance Scheme (VHIS) has a maximum entry age of 80. Children can purchase it for elderly parents to ensure they have adequate medical coverage. In addition, as the policyholder, a child can claim a tax deduction of up to HK$8,000 per year to ease the financial burden. If you want to buy medical insurance for your parents, whether online or through an insurance intermediary, you need to prepare the following documents:

  • Parents' identity cards
  • Parents' medical records, or answer underwriting questions together with them (can be done online or in an interview with an insurance intermediary)

If parents are unable to manage the policy or claims themselves, children can choose to be the policyholder to assist with premium payments, policy management, and claims applications, ensuring parents receive timely protection. 

The Voluntary Health Insurance Scheme has many options — consult an expert before buying a policy

The maximum entry age for the Voluntary Health Insurance Scheme is80 years, and it can be renewed up to100 years, which is relatively suitable for60‑year‑old seniors. However, because VHIS involves considerable professional knowledge, ordinary consumers may find it difficult to analyse on their own. If you want to learn more, you can use the “Product Decoder” to compare coverage and price, orWhatsApp 10Life insurance advisor to inquire for details.

Further reading
【One policy, two generations covered】Want to protect yourself while also safeguarding your children? Can insured children with autism orADHD be covered#?
【Voluntary Health Insurance (VHIS) tax deduction guide】What is the tax-deduction limit for VHIS? Includes examples of claiming medical insurance tax deductions
【Which VHIS is best2025】Comparing “5‑star” plans — which option is right for middle‑class families?

References:

  1. Oriental DailyWaiting time for public hospital cataract surgery longest exceeds3 years; government says after5 years it can be reduced by10 months
  2. Hong Kong Adventist HospitalCataract extraction surgery
  3. Hong Kong Adventist Hospital.Reference charges for common surgical procedures
  4. Senior Community Legal NetCommon exclusions in medical insurance policies

Last updated: 14 April 2025

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.

10Life 編輯團隊

團隊成員由一群資料搜集員組成,主力保險相關資訊研究。

10Life 編輯團隊

團隊成員由一群資料搜集員組成,主力保險相關資訊研究。

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