The Ultimate Guide to Top-up Insurance in Hong Kong

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Wondering what is top-up insurance? Many people in Hong Kong have health insurance through work (i.e. group medical insurance). However, there are many reasons why work coverage may be insufficient or your personal situation may require better coverage. Here is your expert guide to top-up insurance in Hong Kong!

What is top-up insurance?

A top-up plan (or top-up insurance) covers the deficiencies of your employer-provided health insurance or any other medical insurance coverage you may have. In fact, it is a full individual health insurance coverage that adds up to your other health plans. It is therefore more than a simple "top-up" plan (yes, the name is confusing!). Due to the specifics of insurance policies and the local healthcare system, top-up insurance is common in Hong Kong.

➜ EXPERT TIP: Add top-up plans as you want! Plans’ coverage may overlap, which allows you to optimize your reimbursements by claiming with your group insurer, your personal insurer, or both.

Warning: the same claim can only be reimbursed once even if there are multiple insurers. You can not receive more than you have spent.

How do I know if I need top-up insurance in addition to my work medical insurance?

Here are the key points you should look at:

Pre-existing conditions

Pre-existing conditions is your known state of health (injury or disease) before subscribing to the insurance contract.

In Hong Kong, they are generally excluded by health insurers and if they are taken into account, there is an increase in your premium. Insurers do not want to cover a period when you did not pay anything.

➜ EXPERT TIP: In Hong Kong, large groups almost always cover pre-existing conditions for their employees. SMEs have less bargaining power with insurers so pre-existing conditions of their employees may be excluded from their health insurance plans. In this case, top-up insurance may be needed especially if you want to go in the private healthcare sector. It is best to check your health insurance policy and ask an expert.

International coverage

This allows you to get treated in your country of origin, as well as to go to nearby countries in Asia with more affordable prices and high-quality healthcare services (for example: Thailand or Taiwan for health checkups ). International health insurance is not always provided by group medical insurance, but you can get it through top-up insurance plans.

Your health providers network

Check the network of health providers covered by your group health insurance. It may be limited and may not meet all your expectations and/or needs.

Sub-limits

Check the sub-limits in your health insurance policy. In Hong Kong, they are often intentionally low in order to direct people to the public sector (thus making it less expensive for the insurer.) If you want to go to a private hospital or clinic in Hong Kong, pay extra care to your sub-limits! Hong Kong has the second most expensive private health system in the world after the United States. Top-up plans are a good way to increase your sub-limits.

Reimbursement or direct billing

Some insurers do direct billing but this is not always the case. This is an important point to check with your employer-provided insurer. Without direct billing, you may have to advance the money yourself. In Hong Kong, the cost of surgeries or treatments in private hospitals can be extremely high.

Specific health benefits (dental, eye-care, maternity ...)

Depending on your needs, make sure that your health insurance has the right benefits. If you plan to be pregnant, get dental care, or if you wear glasses and need optical insurance, make sure you have the right coverage to cover specific expenses in Hong Kong (or outside).

Dependent coverage

Families are not systematically covered by health insurance. If you want your spouse or your children to be covered, top-up insurance may be needed.

➜ EXPERT TIP: If any of the points above have caught your attention, contact our experts to explore your options.

Can I just keep my company health insurance when I leave my job?

Some insurers offer the "portability" of your group health insurance. This means that you can stay with the same insurer even if you change employers, or stay unemployed and wish to pay for your own health insurance. However, this is rare and most of the time it is subject to premium overload and different conditions such as:

• certain seniority (1 or 2 years),
• a time limit to exercise the right (generally 1 month).

➜ EXPERT TIP: If you are planning or going to leave your job, speak to an expert to carefully assess your health insurance situation and see if and how you (and your family) can stay covered throughout this transition.

What is the average cost of top-up insurance in Hong Kong?

Here are examples of inpatient-only plans for worldwide coverage excluding the USA. Full reimbursement for private room level and no deductible:

• An active single woman under 30, without children: US$1,590 / year
• A 35-year-old couple with two children aged 3 and 6: US$6,050 / year
• A 50-year-old man and a 48-year-old woman without dependent children: US$6,280 / year

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