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<Prudent Strategies in Taking Out Medical Insurance> pdf (Chinese Version only)

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Seven basic "must-knows" when taking out medical insurance

Frequently Asked Questions

 
Smart Tips

Two main scopes of medical insurance

1. In-patient plan

It mainly provides cover to policyholders for hospitalisation expenses like room and board, meal expenses,surgery fee, etc.

There will be a maximum indemnity limit for each item in medical insurance generally. The indemnity may not be 100%.  Besides, many medical insurance products will also provide hospital cash benefit from which a policyholder will receive a daily fixed amount of cash according to the terms of the policy for the number of days confined in a hospital.

2. Out-patient plan

Generally covers consultation fees of registered doctors and/or specialists.

Same as in-patient plan, there is also a maximum indemnity limit for different medical items under the out-patient plan; and there may even be a maximum indemnity limit for each policy year.

(Scope of cover will be clearly stated in all insurance products.  It is the responsibility of policyholders to read them thoroughly.)

To Understand the Medical Insurance Terms is the Most Important

Following the increase in fees of public hospital and the release of healthcare financing proposal by the Government, people in Hong Kong gradually attach much importance to taking out medical insurance.  As such, major insurers have tailor-made a number of medical plans to suit different customers’ needs.  But, how should we choose among them?  What should we be aware of when taking out our cover?

Confused about the contents of the policy?

Mr Chan said grudgingly: “I went to a dental clinic for scaling.  The dentist noticed that I had a few decayed teeth and there were abscesses on the gum.  Other than having the abscess drainage, I had also root canal treatment and crown as well.  Totally, I paid over thirty thousand dollars.  I thought my medical insurance would provide certain cover.  I subsequently found out that my medical insurance policy covered only out-patient and in-patient services, but all dental related items were excluded.  I could only blame myself for not having read the scope covered by the policy.  I was out of my budget.”.

Read the policy and know your coverage

Many policyholders, like Mr Chan, are not fully aware of the nature and terms of medical insurance.  In fact, it covers the medical expenses of the policyholder, and is mainly divided into out-patient, in-patient and hospital cash allowance plans.  Regardless of which kind of plan a policyholder takes out, the scope of cover and the excluded items will be clearly stated in the policy.  Unless otherwise stated, medical insurance policies generally will not cover dental care or oral surgical therapy, cosmetic surgery or plastic operation, as well as treatment and operation arising out of pregnancy, miscarriage and childbirth.  These will be clearly stated under  “excluded items” of the policy.  As a prudent policyholder, you will not get confused over the scope covered if you have read the contents of the policy in details and understand the definitions of medical insurance.