Time to top up your health cover?

Recent market volatility and economic uncertainty have left many employees grappling not only with financial pressures but also with growing concerns about interrupted health cover. This challenge becomes particularly pronounced during career transitions, when individuals lose access to the group medical plan provided by their employer. In response, more people are choosing to take out personal healthcare insurance and supplementary plans to broaden their protection. These options help bridge the gaps left by group medical plans, offering added reassurance for themselves and their families.

As we move through different life stages – whether starting a family, preparing for parenthood or entering retirement – health cover purchased earlier in life may no longer meet current medical needs. Yet seeking additional protection is often limited by age restrictions or pre-existing health conditions. Let us explore how to approach career changes and life milestones with confidence, ensuring comprehensive health protection at every stage. 

As healthcare costs continue to rise, corporate health cover often struggles to meet the substantial expenses associated with critical illnesses. Most corporate schemes currently offer only basic cover, such as routine outpatient care, while hospital reimbursements typically account for just 60–70% of actual costs. 

Should an employee be diagnosed with a serious illness, such as cancer or kidney disease, the associated treatment costs can place a significant financial strain on both the employee and their family. For instance, the cost of cancer treatment often exceeds HK$500,000, while the cost of annual dialysis can potentially surpass that amount.

Healthcare top-up plans act as a second safety net, designed to bridge gaps in cover. Most of these plans reimburse the balance not covered by corporate health insurance, enabling employees to receive treatment without bearing significant out-of-pocket costs. They typically provide 3 to 4 months of employment-related hospital cover to maintain continuous private health protection and avoid any gap in cover. When combined with existing health insurance products, they can help meet major medical expenses, surgical costs and various incidental hospital fees.

It is worth noting that many corporate schemes waive health examinations upon enrolment, with insurers often incorporating pre-existing conditions into the cover. Policyholders may also use the reimbursement ceiling of their corporate health insurance as the excess for top-up plans, allowing flexible plan combinations. This approach not only reduces premium costs but also provides residual compensation when needed, easing the financial and emotional pressures that come with medical expenses.

Healthcare top-up plans on the market offer a range of options, varying by premium and scope of cover. These include non-hospital cancer treatments such as dialysis, chemotherapy, targeted therapy, immunotherapy, hormone therapy and radiotherapy. Some plans extend their cover to 30 days prior to hospital admission and 90 days post-discharge, providing exceptionally thorough protection.

Certain schemes also feature a Hong Kong and Greater Bay Area hospitalisation payment guarantee. If the insured requires admission in Hong Kong or the Greater Bay Area, they can apply to the insurer in advance for this guarantee. Once approved, the insurer settles the hospital fees directly, allowing the insured to focus on recovery without financial concerns.

When choosing a healthcare top-up plan, it’s essential to understand the scope of cover and any exclusions. Commonly excluded items include pre-existing illnesses, cosmetic surgery, maternity-related expenses and dental treatment. In addition, some plans impose a waiting period, requiring a specified time to elapse after enrolment before full cover begins. 

If your existing health insurance and new top-up plan are provided by different insurers, pay particular attention to the claims process. You must obtain the original receipt, or a stamped copy, from the first insurer when submitting a claim to the second. This serves as supporting documentation and helps ensure the claims process is completed smoothly.

This Chinese version of this article was published in the Hong Kong Economics Journal 

If you have any queries regarding Healthcare Insurance, please feel free to contact us or find out more about our insurance plans:

View product

Read more: 

Stay wise to the rise of infectious diseases this winter

Hospital cash benefit: daily income subsidy for freelancers

Learn more about EASY Claims and file your claims online anytime, anywhere.

EASY Claims – A simpler and faster way to claim!