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Section 1: Introduction
Section 2: Hong Kong Health Insurance Benefits
Section 3: Hong Kong Health Insurance Services
Section 4: International Health Insurance Benefits
Section 5: Health Insurance Premiums
Section 6: Conclusion

 

Companies in Hong Kong continue to differentiate benefit levels split by employee grade, however, 2009 saw significant changes in corporate attitude in a number of key areas, these include:

  • Home Health Care Benefits
  • Increased Chinese Medicine Practitioner Visits and Cover Levels
  • Inclusion of Routine Physical Examinations

The following table shows Average benefit levels and covers provided by companies with more than 50 employees in Hong Kong.  Data is taken from the Alliance Insurance Survey of 250 companies providing local Hong Kong health insurance to employees as an employee benefit.

Executive Plus: Senior Managers and Directors

General Executive: Middle Managers & Specialist Employees

General Staff: Administrative, Support and Level Entry Positions 

 

GROUP MEDICAL INSURANCE  - BENEFITS COMPARISON
  Executive Plus General Executive General Staff
HOSPITALIZATION   
Daily Room & Board per day 2,000 800 500
max. no. of  days per disability 45 45 45
Hospital Special Services
per disability 30,000 20,000 8,000
Surgical Fee, per disability
    Complex Operation 200,000 100,000 40,000
    Major Operation 100,000 40,000 20,000
    Intermediate Operation 50,000 25,000 10,000
    Minor Operation 20,000 10,000 5,000
Anaesthetist's Fees, per disability
    Complex Operation 60,000 30,000 15,000
    Major Operation 30,000 10,000 7,500
    Intermediate Operation 15,000 4,500 3,750
    Minor Operation 6,000 3,000 1,875
Operation Theatre Fee, per disability
    Complex Operation 60,000 28,000 15,000
    Major Operation 30,000 11,000 7,500
    Intermediate Operation 15,000 4,500 3,750
    Minor Operation 6,000 3,000 1,875
In-hospital Physician's Visit per day 2,000 800 500
max. no. of  days per disability 45 45 45
In-hospital Specialist's Visit 10,000 8,000 1,500
Intensive Care
max. no. of  days per disability 30,000 20,000 10,000
Home Health Care 39,000 15,000 N/A
Private Nursing 800 500 N/A
Max. days per disability per year 45 45 N/A
Hospital Cash Benefit 750 400 N/A
max. no. of  days per disability 91 91 N/A
Post-Hospitalization Treatment 5,500 4,000 N/A
Max. no. of days from day of discharge 30 30 N/A
Worldwide Emergency Assistance YES YES YES
Medical Evacuation / Repatriation
SUPPLEMENTARY MAJOR MEDICAL
SMM Benefit
max. benefit per disability 200,000 100,000 50,000
Deductible 1,000 1,000 500
Co-insurance 80% 80% 80%
OUTPATIENT COVERAGE
Out-patient Physician's Visit
per visit per day 500 280 200
max. no. of visits per policy year 30 30 20
reimbursement % 100 100 100
Physiotherapist's or Chiropractor's Visit
per visit per day 500 400 200
max. no. of visits per policy year 30 20 10
reimbursement % 100 100 80
Out-patient Specialist's Consultation
per visit per day 600 400 300
max. no. of visits per policy year 30 20 10
reimbursement % 100 100 80
Chinese Medicine Practitioner's Visit
per visit per day 250 200 150
max. no. of visits per policy year 20 15 10
reimbursement % 100 100 80
Out-patient X-ray / Laboratory Test
limit per policy year 3,600 2,000 1,000
reimbursement % 100 100 80
Routine Physical Check Up
Per visit per day limit 500 300 N/A
reimbursement % 100 100 N/A

 

 

 

 

DENTAL INSURANCE

 

4000 3000 N/A
Routine oral examination, scaling, polish
intraoral X-ray & medications
fillings & extractions
drainage of abscesses
pins for cusp restoration
dentures, crowns and bridges
 

Additional Notes:

Maternity Benefits:

Cover for routine pregnancy and childbirth continues not to be a priority under corporate health insurance plans in Hong Kong. 

Health Checks:

Routine Physical examinations are playing a larger part of the group health insurance plans with many companies seeing them as an opportunity to proactively manage health care needs whilst providing additional cost controlling benefits.

Although local health insurance companies prefer to restrict benefit levels, recent years have seen considerable flexibility from providers in tailoring to the needs of a specific company.  It has never been easier for companies in Hong Kong to shop around and make like for like comparisons as most insurers, on the whole, will be able to reflect their existing and future benefit requirements.  This ability has placed more emphasis on price and service as the primary decision factor for companies when choosing their provider.