The Ultimate Guide for Shopping Medical Insurance in Hong Kong17 Feb, 2022
Choosing the right health insurance plan is important in order to effectively protect from unexpected, high medical costs. Hong Kong is known for its excellent healthcare system with professional and efficient service delivery. However, medical costs can be very costly particularly if you are looking for specialist services or receiving treatment at a private hospital. Since the affordable public healthcare system has long waiting times and may not be an excellent option for all residents, many people result in purchasing private health insurance. This kind of medical protection safeguards your peace of mind and may cover a wide range of benefits to suit your requirements, including maternity, specialist dental services, and chronic illness.
Most Hong Kong residents find that selecting the best health insurance is easier said than done. It takes more than just choosing a company and having premiums deducted straight from your paycheck each month. Different policies have diverse elective options that can make all the difference between having a policy that has little value vs one that offers maximum coverage. We created this guide to help you navigate the health insurance market in Hong Kong and select a policy that is ideal for your specific needs.
How to Navigate the Hong Kong Healthcare System
Understanding how the Hong Kong healthcare system works is the first step towards getting the coverage you need. HK boasts one of the best healthcare ecosystems in the world. Other than the high levels of air pollution (contributed by power plants, motor vehicles, and marine vessels), the city has few hazards. There are more than 40 public hospitals, about a dozen private medical centers, abundant pharmacies, and fast emergency service response times.
Residents can choose from public healthcare and private medical care to suit their budget, preferences, and treatment requirements.
Public Healthcare in Hong Kong
The public healthcare sector in Hong is managed by the Hospital Authority and the Department of Health, which collectively administer public hospitals, outpatient treatment centers, and the day-to-day public healthcare including maternity services, child care, and family doctor services. The system provides healthcare (at virtually no cost) not just to Hong Kong citizens but also to non-permanent residents who can show a valid Visa and hold a HK ID Card. Those who are non-residents can access hospital care but are charged at market prices. The HK public healthcare sector today provides up to 90% of all medical care in the city.
→ What services are covered?
The Hong Kong public hospital system offers a comprehensive range of quality services at heavily subsidized prices. Hospitals, doctors, and other medical staff are organized in districts with each region extending specialist medical care to its residents. Public hospitals are equipped with modern equipment, and most provide 24-hour accident and emergency services. Services provided include maternity and childcare services, general outpatient care, specialist out-patient, and in-patient care, as well as community medical care (including psychiatric services and geriatric assessments).
→ What services are not covered by the HK public healthcare system?
Dental care is not covered by the HK public hospital system. You are only allowed to see a public dentist in HK if it is an absolute emergency. Otherwise, you’ll need to receive treatment from a private dentist. Another downside of HK public healthcare is the long queues and less than ideal customer service or bedside manner. Many residents – particularly expats – also prefer to be treated by doctors from Western countries, who are typically only available under private practice.
Private Healthcare in Hong Kong
Private hospitals in HK are internationally accredited and adhere to the highest global standards of care. The private healthcare sector offers personalized choices and provides more accessible services at a premium. Private medical care in HK is expensive due to local demand as well as increased demand from expats. Many HK companies employing foreigners provide or contribute towards employees’ private health insurance.
→ Are there any advantages to private healthcare in HK?
For HK residents who are able and willing to pay the higher medical expenses, private healthcare offers distinct benefits:
Receive immediate attention – unlike the public system that is overburdened by lengthy waiting lists and wait times for medical services.
Work with a medical person that you can choose and trust. Also, a higher proportion of staff in private hospitals also speak English.
Participate in decision-making regarding your own treatment, particularly when it comes to when you should be hospitalized and when to undergo surgery.
Enjoy more privacy and individualized attention in a service-oriented setting.
What is the Voluntary Health Insurance Scheme?
The Voluntary Health Insurance Scheme (VHIS) was launched by the HK Food and Health Bureau (FHB) in April 2019 following decades of public participation and consultation with insurance providers. The goal of this policy initiative was to enhance protection of inpatient plans, increase options for private healthcare, and relieve pressure from the public healthcare system. While all insurance plans in HK are regulated by the Insurance Authority, participating insurers agreed to comply with extra requirements set by the FHB:
Standardizing terms and conditions
Guaranteed renewal before the policyholder reaches the age of 100 years
More comprehensive benefits including congenital conditions, unknown pre-existing conditions, psychiatric inpatient care, and non-surgical cancer treatment
Premium schedules publicly posted on a website
Many HK residents choose to purchase VHIS-certified plans over ordinary healthcare insurance. This is because these policies allow tax deductions of up to $8,000 per person per year. They also include outpatient coverage for imaging scans such as CT, MRI, and PET that can help medical specialists detect certain diseases. More so, premium details for VHIS products are publicized online for full transparency.
Individual vs Employer-Provided Insurance Plan
Many employers provide healthcare protection as part of their employee benefits package. If you are enrolled in your workplace’s health plan, make sure you know what services are covered. Particularly, check to ensure that your family (spouse and children) are automatically enrolled. Residents who do not have employer-sponsored healthcare coverage can purchase their own individual healthcare plans to suit their needs. In many individual plans, it is possible to include your family and pay a higher premium rate. Individual tailored medical plans are also available for pregnant moms (maternity), students, and residents who are on a short-term stay in HK.
Can I Get Medical Insurance If I Have an Existing Condition?
If you have any healthcare problems prior to buying medical protection, they qualify as pre-existing conditions. Most healthcare insurance providers discriminate against applicants who have ‘known’ conditions in both the local and international medical protection plans. There is a long list of existing illnesses that can lead to disqualification, including diabetes, eczema, asthma, back pain, chronic migraines, cancer history, high blood pressure, psoriasis, and HPV, among others. Under the VHIS, medical protection plans can cover pre-existing conditions if you were not aware you had the illness at the time when you applied for the policy. However, eligible medical expenses over the first policy year are not covered. In the second policy year, you get a 25% reimbursement for expenses and a 50% reimbursement in the third policy year. Your insurance plan will then provide full coverage from the fourth policy year onwards.
Medical Coverage Options in Hong Kong
There are different types of insurance coverage you can expect from your individual insurance plan.
Inpatient – also referred to as hospital insurance coverage, this insurance covers your hospitalization expenses, including diagnostic tests, anesthetist and surgical fees, inpatient medication, organ transplants, and general hospital expenses. All plans offer this coverage as a bare minimum.
Outpatient – plans that have this kind of add-on benefit also pay for medical services that don’t require hospital admission, including things such as GP consultations, homeopathy, psychology care, and traditional cultural medicine.
Dental – dental health coverage pays for dental care. This coverage may have a waiting period (for instance 6 months) before you can claim benefits to pay for care. While purchasing dental medical protection, ask to find out whether it includes specialty dental care such as orthodontics.
Maternity – maternity coverage is available as an elective option for those who are expecting a child. This coverage pays for prenatal and delivery costs, but may also include postnatal emergency care. Maternity health plans usually have a waiting period (usually spanning 10 to 24 months) before you are able to collect benefits.
Note: your insurance plan may also include additional wellbeing benefits such as vaccinations, routine cancer screenings, and annual health checks. You can also choose to include optical care such as eye checkups, glasses and contact lenses, and laser eye surgery as an add-on. Chronic conditions benefits may cover acute and palliative chronic care, newborn care, and terminal illness benefits.
Local vs International Health Insurance Hong Kong
You may choose between a local health plan and international coverage. An international health plan is a great option if you are an expat, travel a lot, or are not staying in Hong Kong for long. Since this type of coverage can be transferred to another country, premiums are usually computed based on the rate of international medical costs. Options for international insurance plans include Asia-only coverage and worldwide coverage excluding the United States.
How to Compare Health Insurance in Hong Kong?
Not all insurance plans are the same. Prospective policy owners need to evaluate each insurance company and policy on its own merits. Below are some questions that can help you identify the right medical protection package.
Does the policy include coverage for your entire family?
What (if any) annual limits does the policy have?
What options are supported in terms of hospital rooms?
Are co-payments needed?
Are you limited to specific doctors and hospitals or do you get to choose where to receive care?
Does the policy provide credits for hospital treatments so you do not have to foot the bill out of your pocket first?
Does the policy offer coverage add-ons such as maternity and dental care? Do these have limits?
Are preventive measures such as free regular check-ups included in the policy?
What is the underwriting process? Is a prior health examination needed?
What are the rules regarding coverage of pre-existing conditions?
These are just a few of the many considerations that you should take into account when shopping for medical insurance protection. Working with a Quote Lion Health Insurance Professional can help make this process less hectic for you.
Cost of Medical Insurance in Hong Kong
The cost of medical insurance varies from one to the other plan to the other based on the company that sells it, and the coverage benefits provided. It is important to note that the cost of medical insurance is impacted by factors such as the average cost of care, demand for private care, and increased regulation. The goal is to find a comprehensive plan that meets your needs (or the needs of your family). Our medical protection experts at Quote Lion can help you wade through the multiple options and identify the right policy for your specific coverage requirements.
What is the cost of healthcare in Hong Kong?
Hong Kong residents can receive care from either a public hospital or a private clinic. The government heavily subsidizes the public hospital system and fees are very low. For eligible persons, general outpatient service costs about 50 HK dollars ($6.5 USD) per attendance, while inpatient admission costs about $100 HK dollars ($13 USD) per day. The government has a fee-waiving mechanism for residents who can prove they cannot afford these low fees in the public system. Non-eligible residents of Hong Kong (such as short-stay expats) are subjected to a different pricing arrangement that may be more expensive compared to charges in their home countries. The cost of treatment in private hospitals is even higher. Average outpatient fees can range from 200 HKD to $1,000 HKD while the cost of specialist outpatient care can range from $500 HKD to $3,500 HKD. Inpatient costs in a private healthcare facility in Hong Kong are way higher.
Do I need medical insurance in Hong Kong?
Hong Kong has among the highest healthcare costs in the world. While the government covers treatment costs for most residents through the public health system, there are longer-waiting times, doctor shortages, and other disadvantages. Many expats and some natives of Hong Kong choose to purchase medical insurance so they can receive care from private hospitals. A private hospital means that you get personalized attention and work with a specialist of your choosing.