Health Insurance Deductibles and Excesses
When choosing the perfect Hong Kong Health Insurance plan you will often be afforded the option of selecting a deductible, which is also known as an Excess in the United Kingdom.
A deductible is the total amount that you will contribute to the costs of your healthcare, with the insurance company covering any remaining expenses.
While a deductible is not mandatory on a Hong Kong health insurance plan, and you can choose to take out a policy which has no deductibles, choosing to add one to your coverage can mean a significant reduction in your overall policy premium. Additionally certain types of coverage, such as an Inpatient Only Policy, can be taken with a high-deductible; keeping the costs of your coverage down but ensuring that you are adequately protected in the event of a medical catastrophe.
What is a Deductible?
Per Condition Insurance Deductible
The most common form of deductible on a Hong Kong health insurance plan will occur on a per-condition basis. This means that for each separate medical condition you receive treatment for you will contribute towards the cost of your healthcare.
If your Hong Kong Health Insurance policy has a $100 per condition deductible and you need to visit the doctor because you have a throat infection, you will have to pay $100 of the total cost of treatment with the insurance company covering any remaining fees. This means that if the total bill for treatment your sore throat came to $200 that you would pay $100 and the insurance company would pay $100.
If you return to the doctor for further treatment on the throat infection you have been suffering, you will have already paid the deductible associated with the condition, and will not have to contribute towards the costs of any further treatment. However, if you needed to go back to the doctor because you have broken your toe, for example, you would then be expected to contribute $100 towards the costs of treatment for your toe as this is a completely separate medical condition from your sore throat.
A Per Year deductible on a Hong Kong medical insurance plan will mean that you are expected to contribute a certain amount towards the costs of your medical treatment over the course of an entire policy year. Consequently, Per Year deductibles will normally be higher than a Per Condition deductible.
A Per year deductible on a HK health insurance policy will work like this: if your deductible is $1,000 then this is the total amount you must contribute towards the cost of your healthcare before the insurance company will provide cover. If you have been to the doctor a number of times and the total bill comes to $1,000 then your per-year deductible will mean that you are responsible for these costs. Any further treatment you receive, however, will be covered by the insurance company.
A Per Year Deductible on a medical insurance plan in Hong Kong will reset each year that you renew the policy.
Co-Insurance and Co Pays
A Co-Pay, also known as Co-Insurance, will normally operate on a Per-Condition basis and works like a deductible, but is a percentage of the bill which you are responsible for covering, rather than a fixed figure.
From our example of a Per-Condition deductible above it can be seen that for each separate medical condition you receive treatment for you will be responsible for covering some of the costs. However, a Co-Pay will set this as a percentage of the total bill.
If your plan includes a 20 percent Co-Pay then you will need to pay 20 percent of the bill for each separate medical condition you receive treatment for. If you need to visit the doctor because you have a throat infection, and the bill is $200 you will have to pay $40 of the total cost of treatment with the insurance company covering any remaining fees.
If you return to the doctor for further treatment on the throat infection you have been suffering, you will have already paid the Co-Pay associated with the condition, and will not have to contribute towards the costs of any further treatment. However, if you needed to go back to the doctor because you have broken your toe, for example, and the treatment cost is $1,000 you would then be expected to contribute $200 towards the costs of treatment (under a 20 percent Co-Pay) for your toe as this is a completely separate medical condition from your sore throat.
Why do you need a deductible in Hong Kong?
Although including a deductible on you Hong Kong health insurance plan is not necessary, choosing to add one to your policy can have a significant benefit in that it will drastically lower your overall policy premium.
Additionally, you will normally have the ability to choose the deductible level which you are comfortable with. Deductibles can start from US$ 50 and go as high (or higher) than US$ 2,500. The higher the deductible on your policy the more you will save on the premium of your plan, so it is only a question of what you are comfortable with. If you would like a policy with No Deductible so that you never have to contribute towards the costs of your healthcare this is also possible.
There are some types of plans where it makes sense to include a very high deductible. A good example of this would be an Inpatient Only Health Insurance policy which include a US$ 2,500 (or more) deductible. This type of plan would typically be referred to as “Catastrophe” coverage as the high deductible means that it is not suitable for every day healthcare needs, but will be able to provide protection in the event of a serious medical emergency.
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