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Six tips for buying family health insurance in Hong Kong

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By Pacific Prime Hong Kong

Did you know? Hong Kong is the second most expensive location in the world for healthcare after the US. For example, a standard General Practitioner visit at a private clinic – the preferred option for most expats – can easily set you back over HKD 1,000.

And if you’re living in the SAR with kids, private treatment costs can easily send your living expenses into the stratosphere if you don’t have adequate family health insurance.

Finding insurance in Hong Kong is easy. The trick is, however, to navigate the hundreds and thousands of options available and find the perfect plan, especially when you have to secure health coverage for your entire family at once.

To help make the process easier for our readers, we here at Pacific Prime Hong Kong have decided to share with you the below six tips for buying family health insurance in Hong Kong.

1. Make a decision on what coverage level your family needs
When buying family health insurance in Hong Kong, one of the first decisions you will need to make will be on what type of coverage level you need.

Some plans only cover overnight hospital stays, while the more expensive plans will feature comprehensive benefits like health checkups, vaccination coverage, and sometimes even dental and pregnancy coverage.

Main levels of Hong Kong health insurance
Here are the three main levels of health insurance coverage in Hong Kong:

Inpatient only: This is the most basic level, typically only covering hospitalization treatment (i.e. treatments that require an overnight stay at the hospital). When buying family health insurance in Hong Kong, we suggest at least getting inpatient coverage, as these treatments tend to be the most costly.

Inpatient + outpatient: This offers more extensive coverage than inpatient-only plans in that it not only covers hospitalisation treatment, but also outpatient benefits like General Practitioner and specialist visits, prescription medication, medically-required diagnostic tests (e.g. X-rays), etc. Usually, these plans will also cover physiotherapeutic and chiropractic treatments, as well as Traditional Chinese Medicine (TCM). While more expensive than inpatient-only plans, we recommend securing this level of plan if your family members often need to visit the doctor.

Full coverage: This level of plan goes beyond inpatient and outpatient coverage to include add-on benefits like dental and maternity insurance. These coverage elements can be added to your plan at an additional premium, but it’s important to bear in mind that they will come with a waiting period. For example, maternity insurance usually comes with a waiting period of 10 to 12 months, meaning you’ll need to obtain it ahead of conception if you want to access its benefits.

2. Ask yourself these questions
Once you know what and your family need from your health insurance, you can better narrow down your selection of family health insurance options. Here are a few important questions to ask yourself:

What area of coverage do I want? Are you looking for health insurance that you can use only in Hong Kong, or one that covers you overseas – including back home? If you plan on relocating in the future, we recommend opting for international health coverage. International health insurance plans provide global coverage, so even if you relocate to another country or move back home, the plan will protect you wherever you go.

How often do I want to pay for my health insurance? Raising children in Hong Kong is expensive. There may be months when money is tighter than usual, so it’s important to consider how often you want to pay your premiums. Many plans offer monthly or annual payments; choosing one option over another could result in you saving money.

Does anyone in my family have, or previously had, any illnesses, ailments, or injuries? These are considered pre-existing conditions, and are often excluded in family health insurance plans. Some insurers, however, will provide the option to cover the treatment of pre-existing conditions by placing an additional premium or waiting period on these conditions.

3. Read the fine print carefully
If you’ve ever secured health insurance before, you’ll likely know that all plans come with lengthy terms and conditions detailing what is and isn’t covered. Here are a number of things that are worth paying extra attention to:

The plan’s exclusions: As with virtually every other type of insurance, every health insurance plan will have a list of exclusions – which are the treatments that your plan won’t cover. Every plan is different, but the most common exclusions include assisted reproductive services, pre-existing conditions, dangerous/hazardous scenarios, pregnancy and childbirth (unless you have a maternity insurance plan), and cosmetic procedures.

Coverage of congenital or heritable diseases: This is particularly important if you plan on having a baby in the near future, and/or if you have a family history of certain diseases.

Co-pays and deductibles: A deductible is the amount you pay first, either on an ‘annual, per medical condition, per person basis’, or on an ‘annual, per person’ basis before your health insurance takes care of the rest. A co-pay, on the other hand, is the amount you pay each time you submit a claim after the deductible is met. Introducing cost sharing options is a great way to get a discount on your family health insurance premium, but it’s important to weigh up how much the deductible or co-pay will cost you over one year as opposed to having a fully covered plan.

4. Look out for family health insurance discounts
Some insurers will offer discounts on family plans, such as a multi-child discount. This may mean you’ll only need to pay for the first two children, with any subsequent child covered for free. Not all insurers will offer this, but it’s worth asking if you’re looking to add children to your health insurance plan.

5. Find a plan with a wide network of healthcare providers
A healthcare provider network is the network of facilities and doctors that insurers will either suggest or require you to go to for care. While seeking care in-network does save you money, the downside is that it can limit parents’ options of where they can take their children for treatment.

Of course, you can still choose to go to a clinic outside of your plan’s provider network, but the plan may only pay for a very small portion on any claims made, or even not provide reimbursement at all. We therefore recommend finding a provider that has a large network, as your family will be able to seek care from a wider range of facilities.

6. Get help from a family health insurance broker
Some people believe that intermediaries charge a higher price than insurers. The truth is, reputable brokers, such as Pacific Prime Hong Kong, offer the same premiums as the insurers they work with. Not only will you be charged the same rates as you would going directly to the insurer, but you will also be able to choose from a vast range of plan options, get impartial advice, and benefit from additional help on your renewals and claims submission – at no extra cost.


About Pacific Prime Hong Kong
Since it was first established in 2000, Pacific Prime Hong Kong has grown from its humble beginnings to becoming one of Asia’s leading brokers of corporate and family health insurance products. As an independent broker, you can rest assured that your family is at the center of our decision making – not the profit of the insurers. For a free quote, or some impartial advice, contact Pacific Prime Hong Kong’s advisors today!

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