Ailing state of private health-care cover

Hong Kong's public health-care system is one the best and most generous in Asia. For a paltry $60 - $100 for an emergency room visit - Hong Kong residents have access to all the trappings of a true centre of medical excellence. Nonetheless, the average white-collar expatriate is likely to prefer the comfort and convenience offered by private health care.

Unfortunately, despite the huge number of health plans on offer, it's a seller's market, and consumers can usually expect a terrible deal.

Most individual schemes available are expensive, laced with explicit and hidden exclusions and offer inadequate protection for serious or complicated illnesses.

Policyholders are typically cut off at age 65. Most policies impose strict pay-out limits that would be quickly exceeded by surgeries and extended treatments for heart disease or cancer.

Private maternity coverage in Hong Kong is virtually non-existent. If coverage is offered at all, benefits are limited to $25,000 or less - a bit less than two years' premiums -- and provide no protection for the newborn child. Most plans exclude all conditions related to pregnancy.

It is also worth considering that Hong Kong's insurance sector is 'self-regulated'. The Office of the Insurance Commissioner only ensures that local insurance companies are solvent.

Marketing ethics and insurance agencies are all primarily subject to codes enforced by bodies set up by the industry. And Hong Kong's lack of competition laws allows insurers to offer unified premium pricing - ie, anti-competitive price fixing.

Money DOES talk

Fortunately, there are a few plans available that, although expensive, offer something close to the comprehensive coverage available in Europe and the United States.

Local hospitalisation schemes, which reimburse policyholders for billed expenses from hospital stays, are perhaps typified by ING's Caring Family Insurance Plan. For a 35-year-old man, the top-tier ING health option in Hong Kong costs $4,953 a year; for a woman of the same age, the annual premium is $6,472, even though the scheme entirely excludes pregnancy.

If you are diagnosed with cancer or heart disease in the first six months of cover, you are also out of luck. Coverage for a complex operation maxes out at $126,000. ING will reimburse up to $2,600 a day for a private room. Coverage expires at age 65.

BUPA Hong Kong's Gold Plan is far pricier, at $12,637 for a man aged 36. But benefits are capped per-procedure, rather than per-disability. This means that should you require several surgeries for the same illness, the benefit is renewed for each operation.

For women, pregnancy is excluded unless a $7,000 rider is elected. Benefits are limited to $30,000 and are subject to a one-year elimination period.

Unquestionably the best individual hospitalisation policy available in Hong Kong is sold by International Health Insurance of Denmark. A comprehensive policy with a US$400 excess costs US$2,322 between the ages of 26 and 44. Coverage is capped at US$1.5 million per year with far fewer exclusions than local policies. It even offers a modest maternity benefit. Pregnancy-related pathology is fully covered.


Most critical illness plans in Hong Kong offer a lump-sum payout if you are diagnosed with a disease specifically listed in the policy. Generally, cancer is covered, but the fine print in some policies excludes particularly common malignancies such as melanoma. Premiums for a 36-year-old man average only about $200 per month, but the benefits are modest at $300,000.

Optional 'female benefit' riders on such policies are best avoided. Although they cover a few common congenital disorders, such as Down's syndrome or spina bifida, most birth defects are not so easily categorised and hence are excluded.

Surprisingly, the best-value local critical illness plan is offered by a bank, HSBC. The list of illness covered under its 'Preferred Care' scheme is longer than most. Instead of settling claims with cash, beneficiaries are assigned a 'personal care manager' who will arrange for treatment at a top US hospital, such as the Mayo Clinic or Sloan-Kettering. Medical benefits are capped at US$2 million, plus another US$20,000 for travel expenses covering the patient and a companion.

At US$445 a year for a 36-year-old man, it's a good deal.