2010 Health Insurance Benchmark
Introduction
Hong Kong Health Insurance Benefits
Hong Kong Health Insurance Services
International Health Insurance Benefits
Health Insurance Premiums
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 |
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Executive Plus |
General Executive |
General Staff |
|
HOSPITALIZATION |
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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 |
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SUPPLEMENTARY MAJOR MEDICAL |
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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 |
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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 |
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Routine oral examination, scaling, polish |
4000 |
3000 |
N/A |
intraoral X-ray & medications |
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fillings & extractions |
|||
drainage of abscesses |
|||
pins for cusp restoration |
|||
dentures, crowns and bridges |
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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.
