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

Cases

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

Frequently Asked Questions

Smart Tips

Comparison between group and individual medical policies

	Group Policies	Individual Policies
Report on Health Status	Employees may not need to report (depending on the total number of insured employees).	Applicant has to declare medical history.
Excluded Items	General excluded items apply. Unless medical history of individual employee is requested, otherwise, specific excluded items will not be applied to respective employees.	Other than general excluded items, additional excluded items may also apply depending on the medical condition of the applicant in question.
Continuity	Employee loses cover on leaving his job.	Can choose individual medical plan without maximum insured age limit.
Out-Patient Protection	Main protection item for group medical policies. Premium differs between plans.	Policyholder can choose either in-patient or out-patient plan.
Claim Procedure	Claim through employer.	Claim insurance company directly.

Group and Individual Insurance
- How They Complement Each Other

Medical insurance is usually arranged on group basis or individual basis. Each has its own characteristics and desirable features, complementing to each other and providing policyholders with more comprehensive cover.

How to choose between group medical policy and individual medical policy

The insurance agent of Mr Chan suggested that Mr Chan to take out medical insurance cover, but he opined, "My employer has taken out medical insurance which provides both out-patient and in-patient cover. For general out-patient, the compensation amount is $130 per visit and the claim for in-patient is up to 80%. Why do I need to pay for another medical insurance out of my own pocket?"

Group medical policy satisfies basic cover needs

Group medical policy is, in fact, a benefit provided to the employees by their employers. In general, group cover provides basic out-patient and in-patient protection, employees have “no say” on the insured amount. However, the extent of cover of individual medical policies can be assessed according to the policyholder’s actual need. Besides, group medical covers a number of people, insurance companies will evaluate the average risk to charge one premium rate for all employees. If the number of employees reaches the required number, insurance companies may waive the requirement for declaration of the past medical history of the employees. Under this circumstance, other than the usually excluded items, insurance companies will not generally apply specific excluded items for respective employees.

Individual medical policies provide greater flexibility

Since there is a limit to the amount of coverage for group medical policies, employees should consider taking out individual medical insurance if they want to have more comprehensive medical cover.

It is the view of the experts that health condition of individuals usually deteriorates with age. Therefore, they should see if their medical insurance consists of a maximum insured age limit. Generally speaking, group medical policy has a maximum insured age limit . If employees leave their job, they will lose the medical coverage immediately. However, some individual medical policies consist of no maximum insured age limit.