Most workplace staff in Hong Kong get pleasure from their company-provided medical insurance coverage. Nonetheless, ever because the authorities began providing the Voluntary Well being Insurance coverage Scheme (VHIS), increasingly more folks have turn out to be serious about shopping for a plan for themselves. You would possibly query, if you have already got group medical insurance from work, is there a necessity to purchase a VHIS plan? At this time at INO, our professional insurance coverage advisors will break down the variations between group and particular person medical insurance.
Company medical insurance has restricted cowl
Totally different firms provide completely different well being advantages. Various companies provide the identical group well being plan for all workers. Nonetheless, others present differing ranges of well being advantages relying on the worker’s job title or their place within the firm hierarchy.
Sadly, most SMEs (small and medium enterprises) in Hong Kong have restricted sources. What’s extra, securing worker medical insurance will not be a authorized requirement. Due to this fact, most plans merely present essentially the most primary outpatient and inpatient protection. For instance, once you catch a chilly, you could go to your normal doctor for a low worth and even at no cost. Nonetheless, this comes connected with quite a few phrases and situations. As an illustration, the compensation quantity is restricted per yr, per declare filed, and there is a cap on the variety of occasions you are allowed to file for claims. Additionally, your insurance coverage firm could solely cowl in-network medical doctors, specialists should maintain a legitimate referral letter, and so forth.
What in case you are critically ailing and should be admitted to a hospital? Right here, personal hospitals cost round $750 to $1,200 per day for a big room. Nonetheless, your company well being advantages could also be restricted to round $400 to $600 solely. What’s extra, most firms place limitations on every protection merchandise. In different phrases, there’s a compensation restrict set for every merchandise. This may occasionally embrace room bills, surgical bills, miscellaneous bills, and extra (see the desk under). Ultimately, workers nonetheless should pay out-of-pocket.
An instance of primary inpatient advantages
Essential protection gadgets
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Protection limitations
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Room keep and meals
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$650 to $800 per day
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Miscellaneous bills
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$10,000 to $15,000 per yr
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Surgical procedure charges
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$10,000 (minor surgical procedure) to $45,000 (advanced surgical procedure) per harm/sickness
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Outpatient charges
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$4,000 to $5,000 (restricted by the compensation quantity per go to and the variety of visits)
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You might lose all medical advantages if you happen to’re fired, in between jobs, or simply not too long ago started your retirement. Planning to purchase a well being plan after you’ve got retired? The premium will probably be quite a bit larger. In addition to, your insurance coverage firm would possibly simply reject your software based mostly in your pre-existing situations. Some group medical insurance coverage insurance policies allow you to swap to particular person medical insurance once you retire with out having to reinstate your medical insurance. Nonetheless, there is no such thing as a assure that you just will not change jobs or you can retire easily. Due to this fact, it’s the greatest and most secure choice to safe a person medical insurance plan as quickly as doable.
Select a VHIS plan with deductibles
Already enrolled in an worker medical insurance plan? Take into account shopping for a VHIS plan with deductibles. Often known as “extra”, deductibles are the quantity you are required to pay your insurer when submitting for claims earlier than your insurer covers the remainder of your medical bills based on the phrases and situations of your plan.
As an illustration, if you are going to buy a well being plan with a $5,000 deductible, and your complete inpatient prices quantity to $40,000, then you must first pay $5,000. Then, your insurance coverage firm can pay for the leftover quantity, which is $40,000 – $5,000 = $35,000.
You would possibly ask, “why do I nonetheless should pay out-of-pocket to file for a declare? Is not that ridiculous?”. In actual fact, deductible and your premium are interlinked. Typically, an insurance coverage coverage with a deductible is often cheaper however supplies a better protection value/insured quantity. It’s because the policyholder is keen to be accountable for a part of the loss. Additionally, they have an inclination to need to keep away from accidents, in order that’s why the upper the deductible is, the decrease the premium.
To sum up, an insurance coverage coverage with deductibles is extra appropriate for individuals who already produce other types of safety (ex. company group medical insurance) and nonetheless desires a plan with a fair larger protection quantity.
After buying each the company well being plan and your particular person medical insurance, once you file for claims, you should utilize the group plan compensation to make up on your particular person insurance coverage’s deductible. This provides you full compensation.
What you must know when submitting for claims for the group and particular person medical insurance
Planning to file for claims together with your firm’s well being plan and VHIS? Learn on for 2 essential ideas!
Collect your entire claims paperwork to save lots of time
To begin with, the claim-filing course of has a time restrict. Normally, inside 30 days of therapy or discharge, you could submit a declare kind and different supporting paperwork. Because you’re compensated by completely different insurance coverage firms, keep in mind to put aside sufficient time to keep away from delays. Acquire a number of declare varieties and submit them to your attending physician directly, along with the hospital receipt and diagnostic report. When submitting your declare for the primary time, keep in mind to request a verified copy of the paperwork out of your first insurer. That is in an effort to declare out of your second insurance coverage firm as quickly as doable. Earlier than your admission into the hospital, you may even inform the insurance coverage marketing consultant and let him comply with up for you.
Decrease your deductible when your group medical insurance expires
Once more, once you depart your job, you could lose the group medical insurance coverage protection. At the moment, it is higher to scale back the deductible on your medical insurance coverage. Some medical insurance insurance policies help you change the deductible with out having to re-underwrite. That is to keep away from the affect of getting to underwrite sooner or later when your bodily situation deteriorates. You must take note of whether or not the VHIS plan supplies related choices earlier than you even apply for canopy.
Extra helpful insurance coverage data
The earlier you buy VHIS, the sooner you may get pleasure from your tax deductions. If you’d like the low-down for tax deduction, you may consult with our earlier article VHIS Tax Deduction Technique in 2020.
Along with VHIS, INO additionally supplies automobile insurance coverage (third-party and complete), bike insurance coverage, home helper insurance coverage and different merchandise. You should utilize our on-line citation system to get a free quote. Need to chat with us? Contact our skilled insurance coverage advisors for neutral recommendation that can aid you to search out one of the best insurance coverage answer on your funds!