FAQs

The Voluntary Health Insurance Scheme (VHIS) is a policy measure introduced by the Food and Health Bureau ("Food and Health Council"), to regulate individual reimbursement hospitalization insurance (individual hospitalization insurance). One of the underlying purposes for this initiative is to regulate hospital insurance products by inviting companies and consumers to participate in a voluntary scheme that offers plans certified by the FHB.

The voluntary health insurance plan was fully implemented on April 1, 2019.

Under the Voluntary Health Insurance Scheme, insurance companies who participate in VHIS must provide Certified plans, along with Flexi Plans if offered. The certified plan is to offer the public additional options for individual products and private medical services when needed. The VHIS encourages more people to use private healthcare services through hospital insurance, thereby relieving the pressure on the public healthcare system in the long run.

Voluntary health insurance Scheme provides "standard plan" and "flexi plan" for consumers to choose. The flexi plan provides a higher level of protection under the premise of a standard plan.

On 29th March 2019, the Food and Health Bureau announced the average standard premium for approved standard schemes is about $4,000 per year.

All Hong Kong residents between 15 days old and 80 years old.

Yes, but the insured person must be a Hong Kong resident for the purpose of tax deduction. Under VHIS, the participating insurance companies are required to consider applications for Certified Plans in relation to insured persons being Hong Kong residents aged between 15 days and 80 years. However, it is at the discretion of the companies whether to consider applications in relation to insured persons being non-Hong Kong residents according to their business practices.

According to the government's estimations, 1 million people will be insured under Voluntary Health Insurance Scheme in the first two years, and will increase to 1.5 million in the third year.

You can view the list of participating insurance companies published on the voluntary medical insurance website.

Standard Plan benchmarks the minimum complying requirements of VHIS. As the policy terms and benefits of Standard Plan are standardised, the Standard Plans offered by different insurance companies will be virtually the same (except for very limited minor allowable variations).

Flexi Plans offer basic protection equivalent to Standard Plan coverage, plus a flexible top-up protection such as higher benefit amounts and broader benefit coverage, which vary from plan to plan and company to company.

Standard Plan Benefit Schedule

Benefit Items	Benefit Limit (in [HKD])
(a) Room and board	$750 per day Maximum 180 days per Policy Year
(b) Miscellaneous charges	$14,000 per Policy Year
(c) Attending doctor's visit fee	$750 per day Maximum 180 days per Policy Year
(d) Specialist's fee	$4,300 per Policy Year
(e) Intensive care	$3,500 per day Maximum 25 days per Policy Year
(f) Surgeon's fee	Per surgery, subject to surgical category for the surgery/procedure in the Schedule of Surgical Procedures Complex $50,000 Major $25,000 Intermediate $12,500 Minor $5,000
(g) Anaesthetist's fee	35% of Surgeon's fee payable
(h) Operating theatre charges	35% of Surgeon's fee payable
(i) Prescribed Diagnostic Imaging Tests	$20,000 per Policy Year Subject to 30% Coinsurance
(j) Prescribed Non-surgical Cancer Treatments	$80,000 per Policy Year
(k) Pre- and post-Confinement/Day Case Procedure outpatient care	$580 per visit up to $3,000 per Policy Year 1 prior outpatient visit or Emergency consultation per Confinement/Day Case Procedure 3 follow-up outpatient visits per Confinement/Day Case Procedure (within 90 days after discharge from Hospital or completion of Day Case Procedure)
(l) Psychiatric treatments	$30,000 per Policy Year
Other Limits
Annual Benefit Limit for benefit items (a) - (l)	$420,000 per Policy Year
Lifetime Benefit Limit for benefit items (a) - (l)	Nil

(The content on this page is for reference only. The insured should check with the insurance company or insurance agent/broker for the details of the coverage of VHIS certified plans).

FHB will not regulate the premiums of Certified Plans. However, the participating insurance companies will have to publish the premium schedules of their Certified Plans that facilitate comparison.

Yes, in general.

Yes, but the rate of adjustment in your case must equally apply to other customers within the same age-gender group of your insurance plan. This restriction can prevent the insurance companies from treating you unfairly.

If your insurance company has participated in VHIS, it must offer its existing policyholders of individual hospital insurance hospital insurance an opportunity to switch to Certified Plans. The timing of the migration may depend on the renewal cycle of your existing insurance policy or other arrangements that your insurance company may offer. You may wish to approach your insurance company or agent/broker.

In any case, the policy transfer must be arranged within ten years of the full launch of the Voluntary Health Insurance Scheme on April 1, 2019. Please check with your insurance company directly for the relevant arrangements. The Food and Health Bureau expects most insurance companies to arrange transfers for existing customers as soon as possible.

Here are two types of arrangements for policy transfer:

• Occurs on the next renewal. The insurance company directly renews your existing policy to a certified plan (ie, the same product is added to the warranty characteristics of the voluntary health insurance plan); or
• To your existing policy, you can also choose to transfer to a certified plan(ie, another product has the added benefit of a voluntary health plan). In this case, you may need to re-enroll and disclose your latest health status. If your transfer request is rejected or you refuse to accept the result of the re-underwriting, you may still choose to continue to be covered by the existing policy.

You can purchase VHIS on "myVHIS" (myvhis.hk) website. You can also check the insurance company participating in the voluntary health insurance plan and the certified plan information provided by the voluntary health insurance plan and the certified plan information provided by the Voluntary Health Insurance Scheme Official website.

Yes, VHIS is voluntary and does not affect your right to use a public hospital. You can also pay for public hospitals with VHIS.

No. Under the Voluntary Health Insurance Scheme, the coverage provided by all certified plans must include day surgery (such as endoscopy), prescribed diagnostic imaging tests, and prescribed non-surgical cancer treatments that are performed without overnight hospitalization. However, if the doctor thinks the patient has medical needs for hospitalization, the treatment received will also be guaranteed.

Yes. Unless important information (such as pre-existing health conditions) required in the process of application is not provided accurately and completely.

Yes it may be possible, however participating insurance companies must reject your application for insurance after a fair and reasonable underwriting procedure in accordance with the principles set out in the Code of Practice under the Voluntary Health Insurance Scheme.

Yes. If you have not filed a claim, you have the right to cancel the policy and get back the paid premium in the cooling-off period (at least 21 days).

An existing disease that is not known at the time of insurance coverage refers to a health condition that you already had when you were insured, such as an existing condition, but you did not care at the time. The existing general illness that is unknown to the applicant at the time of insurance is not covered by the current general hospitalization insurance. However, for products under the Voluntary Health Insurance Scheme, full compensation (ie 100% claim amount) will be provided from the fourth year after the policy becomes effective. The compensation arrangements for the first three years are as follows:

• Year 1: No claim amount
• Year 2: 25% claim amount
• Year 3: 50% claim amount

Subject to the same reimbursement arrangements that apply to unknown pre-existing conditions.

Coinsurance refers to a percentage of Eligible Expenses the Policy-Holder must contribute after paying the Deductible (if any) in a Policy Year. For the avoidance of doubt, coinsurance does not refer to any amount that the Policy Holder is required to pay if the actual expenses exceed the benefit limits under these terms and benefits.

From 1 April 2019, the Inland Revenue Ordinance (Chapter 112) has introduced a new preferential tax deduction for salaries tax and personal assessment. A taxpayer may apply for tax deduction if he or she purchases a certified plan under the voluntary health insurance plan for him/herself or a specified relative.

The tax deduction will be effective in the assessment year starting from 1 April 2019. This means that the policies issued under Certified Plan that are effective and with premium paid on or after 1 April 2019 will be eligible for the tax deduction.

If you are a taxpayer and you or your spouse is an approved product policy holder under Voluntary Health Insurance Scheme, you will be able to apply for a tax deduction for the premium paid for the purchase of the approved product.

Voluntary health insurance policies must meet all of the following conditions before tax deductions can be made:

1. the policy must provide coverage for the certified plan under the voluntary health care plan;
2. the policyholder is a taxpayer of personal income tax or his or her spouse;
3. the insured is the policy holder or the specified relatives specified under the Inland Revenue Ordinance (Chapter 112); and
4. The insured is a Hong Kong resident*.

(^*) Includes Hong Kong identity card holders; and persons under the age of 11 who do not hold a Hong Kong identity card, but their parents are Hong Kong identity card holders when they are born or adopted.
For details, please refer to the detailed definitions in the Inland Revenue Ordinance (Chapter 112).

A specified relative of a policyholder refers to the policyholder’s

1. Spouse;
2. Children^* aged less than 18/aged 18 to less than 25 receiving full-time education/ aged 18 or above but incapacitated for work by reason of physical or mental disability.
3. Brothers or sisters^* aged less than 18 / aged 18 to less than 25 receiving full-time education / aged 18 or above but incapacitated for work by reason of physical or mental disability; or
4. Parents or grandparents^* aged less than 55 but eligible to claim an allowance under the Government’s Disability Allowance Scheme / aged 55 or above.

(^*) Both adoption and adoption relationships apply. For details, please refer to the detailed definitions in the Inland Revenue Ordinance (Chapter 112).

No.

No.

The premium limit for tax deductions is $8,000 per insured person.

It will not. The maximum premium limit for tax deductions per year is calculated on a per-insurer basis. Regardless of whether you are insuring one or more products, the annual premium limit for tax deductions remains the same at $8,000.

The amount of tax deduction will depend on the number of VHIS policies claimed, the amount of premiums, and the tax rates that apply in your case. See the following example - Basic equation:
Tax deduction amount = Voluntary medical insurance eligible policy premium x Tax rate

For the year of assessment 2018/19, the standard rate is 15% and the marginal tax rate is 2%, 6%, 10%, 14% and 17%.

Tax Deduction Example 1: I am a taxpayer and I bought a voluntary medical insurance eligibility policy for myself. My tax rate is 15% of the standard rate.

Policyholder	Insured	Annual Premium Paid	Eligible Premium (up to $8,000 for the insured)	Assumed Tax Rate	Tax Saved
I (taxpayer)	I	$10,000	$8,000	15%	$1,200

Tax Deduction Example 2: I am a taxpayer. I bought a voluntary medical insurance policy for myself and my 60-year-old father. My tax rate is 15% of the standard rate.

Policyholder	Insured	Annual Premium Paid	Eligible Premium (up to $8,000 for the insured)	Assumed Tax Rate	Tax Saved
I (taxpayer)	I	$10,000	$8,000	15%	$1,200
I (taxpayer)	Father	$15,000	$8,000	15%	$1,200
Total:					$2,400

Tax Deduction Example 3: I am a taxpayer and I bought a voluntary medical insurance policy for myself, a daughter under the age of 18 and a father who has reached the age of 60. My tax rate is 15% of the standard rate.

Policyholder	Insured	Annual Premium Paid	Eligible Premium (up to $8,000 for the insured)	Assumed Tax Rate	Tax Saved
I (taxpayer)	I	$10,000	$8,000	15%	$1,200
I (taxpayer)	Father	$15,000	$8,000	15%	$1,200
I (taxpayer)	Daughter	$5,000	$5,000	15%	$750
Total:					$3,150

The contents of the FAQs on this website are for reference only. The actual "Voluntary Health Insurance Scheme" coverage is subject to the policy. For details, please check with your insurance company or insurance agent/broker. Regarding the tax deduction arrangement for the Voluntary Health Insurance Scheme, please refer to the official website of the Voluntary Health Insurance Scheme and the Inland Revenue Department. This website does not provide any tax advice and is not responsible for any loss caused by anyone using the content.

Source: Voluntary Health Insurance Plan Official Website