Outpatient insurance varies in definition and coverage across insurance companies. Most plans cover general and specialist doctor visits, while some extend to Chinese medicine, physiotherapy, chiropractic care, and even prescription drugs, X-rays, laboratory tests, occupational/speech therapy, or outpatient surgery expenses.
| Age Restrictions | Details |
| Minimum age for application | 15 days to 18 years |
| Maximum age for application | 50 to 64 years |
| Renewal age | 65 to 75 years / lifetime |
Outpatient insurance does not require underwriting, meaning applicants do not need to provide health information for themselves or the insured. However, there are age limits: the youngest can be as early as 15 days old, and the maximum age for application is generally 64 years. It’s important to note that outpatient insurance plans may not guarantee lifetime renewal; renewal depends on individual circumstances.
| Main Medical Services | Deductible* |
| General Practitioner | HK$0 – HK$50 |
| Specialist | HK$0 – HK$100 |
| Physiotherapist | HK$0 – HK$150 |
| Chinese Medicine Practitioner | HK$0 – HK$50 |
| Bonesetter | HK$0 – HK$50 |
Having outpatient insurance doesn’t mean you get a “medical card” for free doctor visits. To prevent abuse, some plans require a fixed deductible (co-payment) per visit, meaning the insured must pay part of the cost, with the insurer covering the rest. Some plans have no deductible, but these typically come with higher premiums. Prospective buyers should weigh the premium against the deductible to choose the right plan.
*Depending on the plan level.
Most outpatient insurance plans have a medical network, meaning policyholders must choose doctors or clinics within the insurer’s network for treatment. The size of these networks can vary greatly, ranging from over 200 to more than 2,000 providers. Prospective buyers should check if their family doctor or preferred clinic is within the network.
Some companies set annual visit limits, such as 20 to 40 visits for all services, while others set limits per service type, like unlimited general practitioner visits but only 10 or 15 visits per year for Chinese medicine or specialists. Additionally, some policies limit the number of days for prescribed medications per visit, such as a 5-day limit, to prevent abuse.
Beyond traditional general, specialist, and Chinese medicine outpatient services, many outpatient insurance plans now offer additional benefits like free health check-ups, bonesetting (Chinese orthopedic care), physiotherapy, dental cleaning, and other dental services. Some even cover outpatient surgery and cancer treatment. Prospective buyers should compare these additional coverage options and their premium levels based on their needs.
| Age | Annual Premium | |
| Outpatient Insurance* | Bowtie VHIS^ | |
| 15 days to 5 years | HK$2,676 – HK$8,016 | HK$1,560 – HK$1,296 |
| 6 to 60 years | HK$2,080 – HK$7,212 | HK$1,236 – HK$5,268 |
As shown in the table, outpatient insurance premiums can be quite high. For a plan with no deductible, you might pay over HK$7,000 annually. In contrast, a 25-year-old non-smoking male can get Bowtie’s VHIS Standard Plan with HK$420,000 annual coverage for just HK$1,296 per year—a significant difference.
The primary function of insurance is to transfer risk to the insurer, especially for financially burdensome risks. While outpatient medical expenses of a few hundred dollars per visit or a few thousand per year may not pose a significant financial strain for those who can afford the premiums, hospitalization and surgery costs running into tens of thousands can be a major financial burden and uncertainty for many.
If your budget is limited and you want to transfer medical expense risks to an insurer, purchasing inpatient medical insurance or VHIS is more crucial than outpatient insurance.
*Depending on the company and plan level
^Bowtie VHIS “Standard Plan”
VHIS primarily covers hospitalization and surgery expenses but also includes some outpatient costs, such as “outpatient surgery fees” and “pre- and post-surgery outpatient fees.” Bowtie’s Flexible Plan (Basic) even adds “emergency outpatient coverage for accidents.” For example, a 25-year-old non-smoking male can get this coverage for HK$2,376 annually.
© 2025 Bowtie Life Insurance Company Limited. All rights reserved.
