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How Our Health Plans Are Changing for Hong Kong Residents

Home Blog How Our Health Plans Are Changing for Hong Kong Residents

William Cooper

Head of Marketing

The headline changes to our health plans for Hong Kong residents:

  • Changes to excess loadings and discounts
  • Reasonable average inflationary premium increases for new customers
  • Improvements to our cancer benefits on the Gold plan
  • Changes apply to health plans starting on or after 01 March 2021

Our values

We believe in people

Some insurers rely on AI and Big Data to do their work for them. We think differently. Healthcare is a highly personal experience, so it deserves a personal service. We’re a team of real people, at the end of a phone call when customers really need us. We don’t hide behind call centres or bot webchats.

Committed to fairness

Healthcare is expensive, and— sadly—costs are on the up. We do everything possible to spread this inflation fairly. We calculate premiums with a long- term pricing model, and we give customers tailoring tools to help reduce their premium without significantly compromising their cover.

Transparency matters to us

Insurance is about trust, so we believe in being fair and open. This belief informs our idea of healthcare as a partnership between our customers and us. That’s why we’re completely upfront with our health plans, and we want customers to understand precisely what they’re buying.

Some housekeeping

Higher maximum age of entry

We can accept applicant customers up to and including age 75 on both personal plans and plans for businesses. Customers applying over age 69 are subject to full medical underwriting.

Clarification on the different options for hospital accommodation

Customers can choose from four options for hospital accommodation while they receive in-patient or day-patient treatment:

  • The standard option is general ward accommodation, which means a room with three beds or more.
  • With semi-private accommodation, customers will share a double room with one other patient. Semi-private rooms have an ensuite bath or shower room.

Private accommodation means a single, private room with ensuite bath or shower room. There are two different options for private accommodation:

  • Full cover in most hospitals & clinics in Hong Kong, with a 20% co-insurance for treatment received in restricted hospitals in Hong Kong. (The restricted hospitals are the Matilda International Hospital, the Hong Kong Adventist Hospital, and the Hong Kong Sanatorium & Hospital.)
  • Full cover in all hospitals & clinics in Hong Kong.

Clarification on what happens if a customer receives treatment in a hospital room of a higher tier

If a customer needs emergency hospital treatment and a semi-private room or general ward is not available, we’ll reimburse 100% of in-patient and day-patient accommodation and treatment costs while they’re staying in accommodation of the next highest available tier. We’ll transfer the customer to the appropriate accommodation type when it becomes available.

If a customer chooses a tier of hospital accommodation for their in-patient or day-patient treatment that’s higher than the one included on their plan, we will subject their treatment and accommodation costs to the following co-insurances: –

  • If a customer chooses semi-private accommodation for in-patient or day-patient treatment, but only the general ward option is included in their plan, we will subject their treatment and accommodation costs to a 15% co-insurance.
  • If a customer chooses private accommodation for in-patient or day-patient treatment, but only the semi-private accommodation option is included in their plan, we’ll subject all treatment & accommodation costs to a 15% co-insurance.
  • If a customer chooses private accommodation for in-patient or day-patient treatment, but only the general ward accommodation option is included in their plan, we’ll subject all treatment & accommodation costs to a 30% co-insurance

If a customer chooses private accommodation for in-patient or day-patient hospital at a restricted hospital, we’ll subject all treatment and accommodation costs to an additional 20% co-insurance. (Unless the customer has included private accommodation at restricted hospitals in their plan).

Clarifications to the introductory discount

First-year premiums include a 15% introductory discount automatically. This discount will not apply to customers’ renewal premiums, but they may be eligible for the Low Claims Discount at renewal.

Clarifications to the Low Claims Discount at Renewal

We calculate your customers’ eligibility for a 15% Low Claims Discount at each renewal. We base the calculation on the total value of claims and claims pending, against the premium the customer has paid.

Optional personal accident plan

From 01 January 2021, Allianz will underwrite the optional personal accident plan. For customers in Hong Kong, AWP Health & Life SA will be the insurer.

Optional travel plan

We’re withdrawing the optional travel plan for Hong Kong customers at all renewal dates from 01 January 2021 for new business and renewal.

General benefit changes

Cancer benefits

We’ve added cover for mental health treatment under the counselling benefit of each plan. We’ve also made some changes to differentiate the cancer benefits under Silver and Gold.

Plans starting in 2020 Plans starting in 2021
Wig benefit
(Gold)
US$150* US$250*
Counselling benefit
(Gold)
US$500* US$750*
Dietitian benefit
(Gold)
US$100* US$250*
Counselling benefit
(all plans)
10 consultations with a psychologist/counsellor 10 consultations, plus drugs prescribed for mental health treatment*

*Lifetime limit

Treatment for congenital conditions or hereditary conditions for newborn babies

We’ve changed the name of the emergency medical treatment for newborn babies benefit. It’s also no longer linked to hereditary and congenital conditions elsewhere in the table of benefits. Children who are added to the plan without this cover will still have cover under their own plan once they are added.

Waiting periods for mental health benefits

Mental health is an increasingly important focus for our health plans. We’re halving waiting periods for mental health benefits, and we’re including consultations with counsellors in the benefit for out-patient mental health treatment.

Frames in the optical benefit (plans for businesses)

We’ve added frames into the optical benefit available with health plans for businesses.

Option to remove co-insurance on out-patient benefits (plans for businesses)

As standard, the primary medical care benefit on the Bronze and Silver plans and the monitoring and maintenance of chronic conditions benefit on the SIlver plan are subject to a 15% co-insurance. You can now choose to ‘buy out’ this co-insurance on health plans for businesses.

Changes to our pricing model

Average inflationary premium increase

The average inflationary premium increase from ANS-2020 to WRE-HK-2021 is 9.5%. We’re funding this increase in different ways across our portfolio. The inflationary premium increase is in addition to the normal age-related premium increases.

Does the average inflationary premium increase vary?

Yes, by quite a margin. It depends on several factors (e.g. excess, date of entry, currency, age, and plan type). We estimate that the lowest inflationary premium increase that a customer can expect is 4.82%, while some customers can expect to face an increase over 11%. As with last year, customers who form part of the ‘legacy GBP’ block and customers with a US$250 per annum excess will face the steeped premium increases.

Have we increased our base premium rates?

Yes.

Changes to child discounts

We’re reducing the discount we give to second and subsequent children on health plans. The discounts apply to new business and renewals.

Discounts for plans
starting in 2020
Discounts for plans
starting in 2021
First child 0% 0%
Second child 10% 5%
Third child onwards 15% 7.5%

 

Changes to exchange rates we use for legacy customers

Legacy customers who joined us before 2019, and who pay their premiums in pounds sterling or Euros, may experience higher than average premium increases as we continue to normalise currency exchange rates.

Dollar exchange rates
for plans starting in 2020
Dollar exchange rates
for plans starting in 2021
Legacy GBP renewals 1.48 1.42
GBP new business & renewals 1.30 1.28
EUR new business & renewals 1.20 1.18

Customers with a US$250 excess

Legacy customers who joined us before 2019 and who enjoy a higher discount with the US$250 excess may experience higher than average premium increases as we continue to normalise the excess discounts.

Who will be affected most by the increases?

Renewing customers paying in pounds sterling will see the highest inflationary premium increases. Customers with a personal plan and a nil or US$50 per claim excess can also expect higher inflationary increases.

Moving towards modular pricing

We are moving towards a modular pricing model. This means departing from the current percentage-based approach for certain pricing levels. This transition will take time, and—for 2021—we have only applied it to the well-being and dental optional benefits.

Changes to plan options

Changes to excess discounts

The following excess discounts and loadings apply to health plans starting on or after 01 March 2021.

Bronze 2020 Bronze 2021 Silver 2020 Silver 2021 Gold 2020 Gold 2021
Personal
Nil excess 0.00% 1.50% 20.00% 22.00% 20.00% 22.50%
US$50 per claim n/a n/a 1.50% 5.50% 1.50% 5.50%
Business
Nil excess 0.00% 1.00% 7.50% 9.50% 7.50% 10.00%
US$50 per claim n/a n/a 1.50% 4.00% 1.50% 4.00%
Per claim
US$100 n/a n/a -3.00% 0.00% -3.00% 0.50%
US$400 -4.00% -2.00% -9.00% -7.00% -9.00% -7.00%
US$800 -9.00% -8.00% -14.00% -13.00% -14.00% -13.00%
US$1,600 -14.00% -12.50% -24.00% -23.00% -24.00% -21.50%
US$5,000 -29.00% -23.00% -39.00% -33.00% -39.00% -33.00%
US$10,000 -49.00% -49.00% -49.00% -48.00% -49.00% -48.00%
Per annum
US$250 -1.00% -0.50% -1.00% -0.50% -1.00% -0.25%
US$250 (legacy) -3.50% -2.50% -7.00% -5.00% -5.00% -4.00%
US$500 -4.00% -3.50% -5.50% -5.00% -5.50% -4.50%
US$1,000 -9.00% -9.00% -14.00% -14.00% -14.00% -14.00%
US$2,500 -19.00% -16.00% -29.00% -24.00% -29.00% -24.00%
US$5,000 -24.00% -24.00% -34.00% -34.00% -34.00% -34.00%
US$10,000 -39.00% -39.00% -49.00% -49.00% -49.00% -49.00%

 

Enhanced well-being (personal plans)

Enhancing the well-being benefit on Silver or Gold now costs an age-related, fixed price.

Silver

Increase in well-being limit from US$300 to US$500

Gold

Increase in well-being limit from US$750 to US$1,300

19-40 US$170 US$323
41-50 US$180 US$480
51+ US$190 US$500

 

Enhanced well-being (plans for businesses)

Enhancing the well-being benefit on Silver or Gold costs a fixed price.

Silver Gold
Increase in well-being limit to US$500 US$1,300
Price on Silver US$156 n/a
Price on Gold n/a US$420

 

Dental Basic & Dental Plus (personal plans)

The dental options on Silver or Gold now cost an age-related, fixed price.

Age group Silver

Dental Basic
(20% co-insurance, 6-month waiting period, US$1,000 limit)

Silver

Dental Plus
(20% co-insurance, 6-month waiting period, US$1,500 limit)

Gold

Dental Plus
(20% co-insurance, 6-month waiting period, US$2,000 limit)

0-18 US$180 US$30 US$180
19-30 US$450 US$263 US$750
31-40 US$525 US$315 US$900
41-50 US$728 US$450 US$1,275
51-60 US$975 US$750 US$1,650
61+ US$975 US$1,450 US$1,950

 

Other changes to optional benefits available on plans for businesses

There are changes to the optional benefits available on plans for businesses, the main ones of which are summarised here:

  • Changes to prices for dental options for both adults and children

Changes to exclusions

We’re making the following changes to the exclusion section of the plan agreements for health plans starting in 2021.

Accidents or injuries resulting from your failure to adhere to local motoring laws

Plans starting in 2020 Plans starting in 2021
n/a You are not covered for accidents or injuries arising from: –

  • travelling in, or on, a motorised vehicle as a driver or passenger if the driver does not have a valid license and insurance, as required by the law of the country where the accident or injury occurred
  • failure to wear the relevant safety equipment (including but not limited to helmets and seat belts), as required by the law of the country where the accident or injury occurred

 

Drugs prescribed for out-patient mental health treatment

 

Plans starting in 2020 Plans starting in 2021
You are not covered for drugs prescribed for out-patient mental health treatment. You are not covered for drugs prescribed
for out-patient mental health treatment. However, there may be some cover under the Cancer treatment, Counselling section of the table of benefits.

 

Eyesight

Plans starting in 2020 Plans starting in 2021
You are not covered for: –

  • treatment to correct your eyesight, such as laser treatment, refractive keratotomy and photorefractive keratotomy
  • upgraded lenses as part of an eye operation, such as cataract surgery spectacles, and other visual aids, treatment of strabismus (squint) or amblyopia (lazy eye)
  • sight tests (unless covered under your plan in the well-being benefits section of the table of benefits)
You are not covered for: –

  • LASIK eye surgery or any other surgical correction of short-sightedness (myopia), long-sightedness (hyperopia) or irregular- shaped cornea (astigmatism)
  • any lens other than a standard mono-focal replacement lens as part of an eye operation, such as cataract surgery
  • spectacles, and other visual aids, treatment of strabismus (squint) or amblyopia (lazy eye)
  • sight tests (unless covered under your plan in the well-being benefits section of the table of benefits)

 

Nasal septum deviation

Plans starting in 2020 Plans starting in 2021
You are not covered for treatment related to nasal septum deviation and nasal concha resection. Removed

 

War and terrorism

Plans starting in 2020 Plans starting in 2021
You are not covered for treatment arising directly or indirectly from war, foreign enemy hostility, terrorism, rebellion, civil war, revolution, military coup, riot, strike, martial law, state of siege or attempted overthrow of a government, in a country or region that the British Foreign & Commonwealth Office has advised its citizens to leave, or advised its citizens against all travel to, unless you are an innocent bystander. You are not covered for treatment arising directly or indirectly from war, foreign enemy hostility, terrorism, rebellion, civil war, revolution, military coup, riot, strike, martial law, state of siege or attempted overthrow of a government, unless you are an innocent bystander.

 

Temporomandibular joint (TMJ) disorders

Plans starting in 2020 Plans starting in 2021
n/a You are not covered for treatment of disorders of the temporomandibular joint (TMJ) including any related condition.

 

The above changes apply to residents of Hong Kong whose plan renews on or after 01 March 2021. Our article on the changes we’ve made to health plans for residents living anywhere other than Hong Kong is available on our blog.