Claim case sharing
Mind the gap: don't get caught out by uninsured medical expenses
Medisure Plus is an effective solution for guarding against the cost of uninsured medical expenses. As a “Top Up” plan it is particularly helpful for many Hong Kong residents who have group medical benefits provided by their employer, but whose plans do not cover the full cost of medical treatment. In particular, some group medical plans include a sizeable deductible which means that the individual insured may have to cover an unaffordable portion of the final hospital bill from their own pocket.
The most cost-effective way to insure against this 'gap' is to purchase an Medisure Plus plan containing deductible options which means you can get a better insurance cover with a higher premium discount. The deductible can be offset by the amount already paid by the group medical policy. Here is an example of how the deductible works in practice:
Example: $40,000 Deductible Option
|Incurred Claim Expenses||$65,000|
|Paid by Group Medical||$35,000|
|Balance Claimed from MSIG||$30,000|
|Less Amount Paid by Group Medical||$35,000|
|Balance Deductible Amount||$5,000|
|Net Claim Reimbursed by MSIG||$25,000|
|Before Top Up|
|Total Amount Claimed by Client||$35,000|
|Amount Paid by Client||$30,000|
|After Top Up|
|Total Amount Claimed by Client||$60,000|
|Amount Paid by Client||$5,000|
Mr Chan receives a hospital bill for $65,000. But his employer-provided group medical policy will only reimburse him $35,000, leaving him to pay the balance of $30,000 himself.
To 'top up' his overall level of protection, Mr Chan can sign up for Medisure Plus with a deductible amount of $40,000 and enjoy a premium discount as high as 45%. Therefore, he will only need to pay $5,000 himself after deducting the $35,000 that has already been paid out by the group medical policy. And MSIG will cover all the balance.
In this way, his uninsured cost of treatment is reduced from $30,000 to just $5,000.
In addition, If Mr Chan makes a subsequent claim during the same policy year, he will not have to be responsible for the deductible again as it is calculated in aggregate for each policy year under our Medisure Plus plan. Mr Chan will also receive up to 65% premium discount depending on the deductible option he chooses.