Bowtie VHIS: Should you choose Flexi Plus or Bowtie Pink?

When selecting a Voluntary Health Insurance Scheme (VHIS) plan, it’s essential to understand the differences between available options. Bowtie offers two popular plans: Bowtie Pink and Flexi Plus. In this article, we’ll explore the coverage and premiums of both plans to help you decide which one best suits your needs.

Actuarial Brief

Coverage:

• Bowtie Pink provides full reimbursement*, with an annual limit of HK$10 million (Semi-Private Ward) / HK$20 million (Private Ward), capable of withstanding years of medical inflation.
• Bowtie Voluntary Health Insurance “Flexi Plus” includes sub-limits for specific items, with an annual limit of HK$1 million.

Premiums:

• Bowtie Pink with HK$0 deductible is more expensive, while the Flexi Plus costs about half as much.
• However, if the insured has corporate health insurance or basic health insurance to offset the deductible, opting for a deductible of HK$20,000 or higher makes Bowtie Pink premiums comparable to or even cheaper than the Flexi Plus.
• The higher the deductible, the lower the premium!

*Full reimbursement means no sub-limits on specific items and applies only to designated coverage items. Claims are subject to the remaining deductible (if applicable), annual benefit limit, lifetime benefit limit, and other conditions, including reasonable and customary charges, pre-existing conditions, designated hospital lists in mainland China, and treatment in the US. For detailed terms, conditions, product risks, and exclusions, please refer to the relevant product website and policy.

Overview of Differences

The primary differences between Bowtie Flexi Plusand Bowtie Pink Semi-Private Ward (hereinafter referred to as Bowtie Pink) are: (1) premium costs and (2) annual benefit limits.

From the table above, both plans cover semi-private ward expenses and global medical costs, but Bowtie Pink offers a HK$10 million annual limit, sufficient to withstand years of medical inflation. However, Bowtie Pink (with HK$0 deductible) has premiums that are more than double those of Bowtie VHIS Flexi Plus.

❓ Which one to choose?

If you already have corporate health insurance or other personal health insurance, selecting Bowtie Pink with a HK$20,000 or higher deductible is the most cost-effective option, providing full reimbursement* at a lower premium. If not, you can choose a plan based on the premium you can afford, as both offer sufficient coverage!

Diagnosis and Hospitalization Coverage Comparison

❓ Is the coverage sufficient?
Since 2016, the government has implemented a pilot program to enhance the transparency of private hospital charges. All private hospitals in Hong Kong now list their fees (including room charges and diagnostic imaging costs) on their official websites, allowing you to check the costs at your preferred hospital.

Bowtie Pink provides full reimbursement*, ensuring sufficient coverage.

But what about Bowtie VHIS Flexi Plus?

For example, at Hong Kong Sanatorium & Hospital, the most expensive private hospital in Hong Kong, semi-private ward charges range from HK$2,600 to HK$3,600. With Bowtie VHIS Flexi Plus, you might need to pay a few hundred dollars out-of-pocket to stay in a semi-private ward there.

Additionally, this plan features “co-insurance” for certain items, such as prescribed diagnostic imaging tests, meaning the insured shares the cost with the insurer. For instance, at Gleneagles Hospital, an MRI scan for the breast in a semi-private ward costs HK$21,360. A Bowtie VHIS Flexi Plus policyholder would pay: HK$21,360 × 30% = HK$5,913, with Bowtie covering the remaining 70%.

*Full reimbursement means no sub-limits on specific items and applies only to designated coverage items. Claims are subject to the remaining deductible (if applicable), annual benefit limit, lifetime benefit limit, and other conditions, including reasonable and customary charges, pre-existing conditions, designated hospital lists in mainland China, and treatment in the US. For detailed terms, conditions, product risks, and exclusions, please refer to the relevant product website and policy.

³ Includes CT Scan, MRI Scan, PET Scan, PET-CT combination, and PET-MRI combination.
⁴ Subject to 30% co-insurance.
Note: Hospital charges are sourced from official hospital websites and are for reference only. Charges may be updated periodically; please refer to the official websites for the latest fees._

Surgery Coverage Comparison

❓ Is the coverage sufficient?

Surgery costs are difficult to predict, as fees can vary widely between renowned doctors and resident doctors. However, Bowtie VHIS Flexi Plus includes “Supplementary Major Medical” (SMM⁷), which covers most excess amounts if surgery fees exceed the limits. For example, for an HK$80,000 major surgery, after exhausting the limits, the out-of-pocket cost would be approximately: (HK$80,000 – 37,500 – 13,150 – 13,150) × 20% = HK$3,240.

Meanwhile, Bowtie Pink offers 100% full reimbursement*, ensuring more than adequate coverage for treatment costs!

*Full reimbursement means no sub-limits on specific items and applies only to designated coverage items. Claims are subject to the remaining deductible (if applicable), annual benefit limit, lifetime benefit limit, and other conditions, including reasonable and customary charges, pre-existing conditions, designated hospital lists in mainland China, and treatment in the US. For detailed terms, conditions, product risks, and exclusions, please refer to the relevant product website and policy.

⁵ Depending on surgery complexity (as defined in the VHIS surgery schedule): Minor surgery HK$9,000/surgery; Intermediate HK$22,500/surgery; Major HK$45,000/surgery; Complex HK$90,000/surgery.
⁶ Depending on surgery complexity (as defined in the VHIS surgery schedule): Minor surgery HK$3,200/surgery; Intermediate HK$7,900/surgery; Major HK$15,800/surgery; Complex HK$31,500/surgery.

⁷ Subject to 20% co-insurance._

Pre- and Post-Hospitalization Care Coverage Comparison

❓ Is the coverage sufficient?

Voluntary Health Insurance primarily covers essential examinations, hospitalization, and treatment expenses. Thus, both Bowtie Pink and Flexi Plusset limits on non-essential post-discharge care or treatments. Both plans are sufficient to cover nursing services at most medical institutions, though Bowtie Pink provides greater coverage.

*Full reimbursement means no sub-limits on specific items and applies only to designated coverage items. Claims are subject to the remaining deductible (if applicable), annual benefit limit, lifetime benefit limit, and other conditions, including reasonable and customary charges, pre-existing conditions, designated hospital lists in mainland China, and treatment in the US. For detailed terms, conditions, product risks, and exclusions, please refer to the relevant product website and policy.
⁸ The company reserves the right to request proof of written recommendation, such as a referral letter or a statement from the attending physician or registered doctor on the claim form._

Non-Surgical Treatment Coverage Comparison

❓ Is the coverage sufficient?

The cost of non-surgical cancer treatments is hard to predict, as new cancer drugs (e.g., chemotherapy drugs) can be significantly more expensive than older ones. However, Bowtie Pink offers full reimbursement*, so policyholders need not worry about insufficient coverage! It also fully reimburses* psychiatric treatment and outpatient kidney dialysis.

For Bowtie VHIS Flexi Plus policyholders, there are ways to increase coverage—check out this article to learn how to boost your coverage by HK$3 million!

⁹ Includes radiotherapy, chemotherapy, targeted therapy, immunotherapy, and hormone therapy.

¹⁰ The company reserves the right to request proof of written recommendation, such as a referral letter or a statement from the attending physician or registered doctor on the claim form.

*Full reimbursement means no sub-limits on specific items and applies only to designated coverage items. Claims are subject to the remaining deductible (if applicable), annual benefit limit, lifetime benefit limit, and other conditions, including reasonable and customary charges, pre-existing conditions, designated hospital lists in mainland China, and treatment in the US. For detailed terms, conditions, product risks, and exclusions, please refer to the relevant product website and policy.

Premium Comparison for Different Ages

Male Non-Smokers

Female Non-Smokers

¹¹ Bowtie Pink’s pricing is not affected by the policyholder’s smoking status.

Choosing the Most Suitable Plan for You

While Bowtie Pink offers the advantage of full reimbursement, without a deductible, the premiums can be prohibitively expensive—for example, nearly HK$30,000 annually for a 60-year-old. However, by opting for a deductible of HK$20,000 or more, the premiums become lower than those of Bowtie VHIS Flexi Plus. The higher the deductible, the lower the premium!

Thus, if you have corporate health insurance or other personal health insurance to offset the deductible, Bowtie Pink is an excellent choice! Otherwise, you might consider starting with Bowtie VHIS Flexi Plus.