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01 November 2023

Understanding health insurance in Hong Kong

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Residents of Hong Kong SAR have a wide range of options when it comes to their health insurance. Considering the fact that Hong Kong is home to a diverse number of local and international insurance providers, and that most health insurance policies on offer in the city can be tailored to meet your specific medical requirements, there is no one size fits all solution when it comes to Hong Kong health insurance.

Then there is the question of is health insurance actually needed in Hong Kong. This is particularly relevant as Hong Kong is home to an exceptional publicly operated medical system that is able to provide high quality care for relatively nominal fees. Understanding whether health insurance is right for you, or particular policy is going to be able to cover your needs well into the future can be difficult.

With that in mind, here’s what you should be thinking about when looking at Health Insurance in Hong Kong.

Hong Kong Health Insurance

Public and Private Healthcare Facilities

The first thing to understand in Hong Kong is that not all health care is created equally. In the city there are actually two separate health care systems operating alongside each other. Public hospitals like the Queen Mary in Pok fu lam, and private hospitals like the sanatorium and Happy Valley, exist to offer the same services but in different ways.

But the biggest difference between the public and private health care systems in Hong Kong is mainly found in their costs of service. Studies conducted by insurance companies have determined that, when it comes to private medical care, the cost of treatment in Hong Kong is the second highest in the world falling only behind the USA. Public healthcare services, on the other hand, are much, much cheaper. Accessing care at the Queen Mary Hospital is going to be a fraction of the cost of accessing the same care somewhere like the Adventist or Matilda. However, the environment in which the care is provided may not be as comfortable.

Receiving emergency care at a public hospital means you’ll have to undergo triage. This means that, depending on the severity of your injury or illness, you could be waiting a significant length of time before you are admitted to see a doctor. There are also very limited amenities at a public hospital — if you are receiving maternity care, for example, it is quite often the case that you would need to provide your own toilet paper in the delivery room.

At the end of the day both public and private medical facilities in Hong Kong are able to offer the same standards of care. Their differences are mainly in the fringe benefits to the treatment they are providing. It is normally quicker, and more efficient, to receive care at a private institution, however you will expect to pay significantly more than you would at a government run hospital or clinic. Understanding where you will be receiving your medical treatment while you’re in Hong Kong is a critical component to deciding whether any health insurance is necessary for you or your loved ones.

International Health Insurance

Selecting your Health Insurance Policy Type

As an international city Hong Kong is serviced by both local and globally operated insurance underwriters. When it comes to health insurance, there will be differences between the plans underwritten in Hong Kong and the plans underwritten elsewhere in the world.

Two of the biggest factors to consider when evaluating the suitability of an international health insurance or a Hong Kong health insurance policy for your personal needs, are going to be premium ratings and global protection.

Health Insurance Coverage Areas

The biggest difference between internationally underwritten and locally underwritten health insurance policies are going to be their geographic scope of coverage. In general, Hong Kong health insurance policies (that is to say, plans underwritten and administered by Hong Kong insurance companies) will only cover medical treatment within the borders of HKSAR.

In stark contrast to this international health insurance policies will generally allow for coverage anywhere in the world. In fact, many international health insurance products will allow you as the policyholder to select exactly where in the world your health insurance will provide you with protection. With choices commonly ranging from Worldwide, Worldwide excluding the USA, Asia only, and even Hong Kong only, an international health insurance plan enables you to receive a constant umbrella of medical protection no matter where in the world you may be.

Further to this many international health insurance products will even allow for portability. This means that if you should relocate away from Hong Kong, to another city like Singapore or Dubai, you will be able to take your health insurance policy with you while it continues to provide uninterrupted coverage. This continuity of protection can prove to be invaluable for internationally mobile expatriates. However, this does mean that international insurance products are typically more expensive than their Hong Kong counterparts.

Health Insurance Premiums

The other fundamental difference between internationally underwritten and locally underwritten health insurance plans is how medical insurance premiums are calculated.

Hong Kong health insurance is normally valued on a historical or experience rating. This means that your claims history under a policy will typically impact the cost of coverage when you renew your plan at the end of the policy year.

Obviously, if you have no medical history under a policy with an experience based premium calculation, then the premium is going to look extremely attractive at first purchase. However, any claims made under the policy will now be part of the “experience” of the plan and will be taken into consideration when factoring next year’s premium. This means that if you claim for treatment under most Hong Kong health insurance policies then you can expect to pay more for any continuing coverage you may receive on that plan.

In contrast to this international health insurance products will normally operate on what’s known as a community rating. This means that (ideally) all people of the same age, with the same coverage area, holding the same plan, will expect to pay the same amount for their policy. A community rating, or the price you’ll pay for your insurance under a community rating, is calculated based on the expected levels of medical treatment anyone of a given age can expect to receive within a calendar year. Individual claims do not impact a community rating, as such the premium associated with international health insurance products will generally only increase because of a person’s age, and the overall rate of global medical inflation.

Consequently, international health insurance products tend to be more expensive on initial purchase than plans which are designed and underwritten domestically in Hong Kong. However, price increases on international health insurance plans tend to be less stark, and more predictable.

Hong Kong Medical Insurance

Choosing your Health Insurance Coverage

Once you’ve established which type of health insurance is right for you, international or Hong Kong underwritten plans, it’s then up to you to select which benefits or types of coverage you will be receiving under that policy. In this regard, all health insurance is largely the same and, depending on the insurer that you choose to work with, you may be given the option to extensively tailor your coverage to meet you and your family’s specific needs.

Inpatient Insurance Protection

All health insurance will start with inpatient coverage; this is the protection that you’re going to be receiving under the policy for any health care that requires an overnight stay in a medical facility.

Major surgeries and illnesses will normally be classified as impatient treatment, and full under the inpatient benefit offered by any given insurance policy. Inpatient care is probably going to be one of the most important choices you will make with regards to any health insurance policy.

This is due to the simple fact that inpatient health care is extremely expensive— any hospitalization will likely be the most expensive treatment you are ever going to receive in your life. The coverage offered by different inpatient benefits can be extremely varied so it’s important that you assess the products on the market and choose a plan that you feel comfortable with

Outpatient Insurance Protection

Once you’ve chosen your inpatient benefit and selected your insurer you then normally have the option to include additional types of coverage on the policy.

A commonly chosen supplemental benefit would relate to outpatient protection.

Under outpatient insurance you would be covered for the costs associated with receiving treatment where an overnight stay is not medically necessary. General practitioners, specialist consultations, routine vaccinations, and family medicine are all examples of things that would traditionally fall under outpatient health care, and be covered by an outpatient insurance benefit.

While the cost associated with outpatient treatment is generally much lower than that of inpatient health care, it is normal that a family or an individual will receive far more outpatient medical treatment over the course of their lifetime. All those visits will add up and in a decade’s time you could find yourself having spent a significant amount on health care— especially if you have children.

Additional Health Insurance Benefits

From here, there are myriad different coverage options that you can elect to include in your health insurance. Things like maternity protection, or coverage against the cost of alternative therapies and complementary medicine, or even the ability to receive emergency evacuation protection if your injured or ill while on holiday in a remote location.

Because there are so many different health insurance companies offering coverage in Hong Kong there is no overall rule or guideline as to what will actually go in a plan. Consequently, it is important for you to decide what your medical needs are and then shop the market to find the plan that fits that requirement. You can choose to only have inpatient coverage, or you can build a plan that includes as many different coverage benefits as possible —giving you a robust umbrella to protect against any annual medical eventualities, no matter where you are in the world.

Health Insurance Advice

Hong Kong Health Insurance from CCW Global

CCW Global works with more than 50 leading insurance companies who are able to offer both Hong Kong and International health insurance products to residents of HKSAR. Our expert, independent insurance brokers will work with you to compare leading options on the market and find the health insurance coverage that best meets your specific and unique needs.

If you need help with your health insurance coverage, in Hong Kong or elsewhere around the world, why not Ask CCW? We’re simplifying insurance.

About Author

Michael Lamb is an insurance industry professional with many years of experience within the Hong Kong Insurance market. Focusing on APAC coverage issues, Michael is able to provide extensive analysis and insight to a range of pressing topics. Previously, Michael provided insurance broker Globalsurance.com with their most highly valued articles and was a key influence in the development of all the content on Pacificprime.com, Michael has a passion for insurance matched by few others in the region.

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