自願醫保計劃

According to the Health Bureau's Voluntary Health Insurance Product Template and leaflet, the terms and conditions and benefit schedule of the VHIS Standard Plan must meet the 10 minimum requirements, including guaranteed renewal up to age 100, no lifetime coverage limit, coverage for hospitalisation and prescribed day case procedures, pre-existing medical conditions, prescribed diagnostic imaging tests, etc.

VHIS Flexi Plan takes the basic benefits of the Standard Plan as a framework and adds some additional benefits, and the Flexi Plan is also regulated and certified by the Health Bureau. You can click here to learn more about the differences between the Standard Plan and the Flexi Plan.

"Unknown pre-existing conditions" refer to the pre-existing conditions that the insured person was not aware of and should not have been aware of prior to the policy. The Voluntary Health Insurance Scheme will pay for eligible expenses based on the following waiting period and medical benefit rates:

1.      No benefit in the first policy year;

2.      25% of the benefit limit in the second policy year;

3.      50% of the benefit limit in the third policy year;

4.      Full benefit is payable from the fourth policy year and onwards.

"Prescribed diagnostic imaging tests" under the Voluntary Health Insurance Scheme refer to Computed Tomography (“CT” Scan), Magnetic Resonance Imaging (“MRI” Scan), Positron Emission Tomography (“PET” Scan), PET-CT Combo and PET-MRI Combo. VHIS will cover 70% of the eligible cost of the relevant tests, of which 30% will be paid by the policyholder.

"Prescribed non-surgical cancer treatments” include radiotherapy, chemotherapy, targeted therapy, immunotherapy and hormonal therapy.

The outpatient coverage is mainly for outpatient treatments before pre and post-hospitalization and day case procedures, with a maximum number of visits and benefit amount. In addition, 70% of the eligible costs for prescribed diagnostic imaging tests (i.e. CT, MRI, PET, PET-CT, PET-MRI) are covered for outpatient visits.

Some insurance companies also include "Accidental Emergency Outpatient" coverage in their Flexi Plan, which provides coverage for treatment such as wound care and stitches at a hospital emergency room or outpatient clinic within 24 hours of an accidental injury.

VHIS does not cover regular dental check-ups, scaling, fillings, etc. However, if the insured requires emergency oral or dental procedures as a result of an accident, the relevant payments will be covered under the "Surgical Fee".

All basic benefits (e.g. rent and food, surgical fees, miscellaneous charges, etc.) of the certified products under the VHIS allow free choices of hospitals and doctors. However, the additional benefits under the Flexi Plan may only apply to certain hospital and doctor networks.

Yes, except for psychiatric treatment. However, insurance companies may restrict the additional coverage to specified areas when designing a flexi plan.

If you feel that group medical insurance does not provide comprehensive coverage, you may also consider buying personal medical insurance or voluntary medical insurance to enhance the protection. Group medical insurance policies offered by employers usually provide only basic coverage and expire when the employment ends. You may refer to the terms and conditions of the policy to see if you have adequate coverage.