Expert Guide to Children Health Insurance in Hong Kong

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Parents in Hong Kong invest heavily in education but often overlook the importance of health insurance for children in the long run. Most large companies provide health coverage to employees as well as spouses and children. While such benefits are good to have, they are rarely good enough for private sector medical costs especially high ticket items such as hospitalizations, surgeries for congenital conditions or cancer treatments. Plus when leaving your job, you lose your employee benefits and may not be able to purchase health insurance if your child is sick or has pre-existing conditions.

We at Alea are a team of parents and believe in empowering you with trusted health insurance information so that you make the best decisions for yourself and your loved ones. Here is a practical guide to kids health insurance in Hong Kong. Read on for tips and tricks to make sure your child’s health is well covered including pre-existing conditions and congenital conditions.

Why should I get medical coverage for my child in Hong Kong?

If you wish to avoid public sector waiting times for your child and get insurance reimbursements for your private medical fees, it is recommended to have private medical insurance. Hong Kong’s private healthcare is the 2nd most expensive in the world after the United States [1] and there is no limit to what medical providers can charge. Health insurance coverage for your child can give lifelong coverage for all forms of medical conditions. Most of these policies will cover inpatient and outpatient treatments up to a specific overall annual limit, alongside vaccination, check-up and dental options.

How can I get health insurance for my child in Hong Kong?

In Hong Kong, there are three means by which your kid can be covered by health insurance. You can add as many plans as you wish to maximize reimbursements as long as you do not claim twice for the same thing - that’s fraud [2].

1. Employee Health Benefits
2. Individual Family Health Insurance
3. Stand-alone child health Insurance

1 - Child coverage through parents’ employee health benefits

In Hong Kong, most large companies provide health coverage to employees [3] as well as their spouses and children. You should always check with your HR whether children are covered. Here are some pros and cons of having your child covered under your group medical insurance.

Advantages

• Premium is paid by the employer.
• Your child is covered for pre-existing conditions.

Inconvenience

• The plan’s benefits may be insufficient when seeking private medical services in Hong Kong. This is often the case for standard local plans with multiple sub-limits.
• Congenital conditions may be excluded.
• If you leave your job, your child will lose coverage (unless there is portability). This can be a problem if your child has pre-existing conditions or is undergoing medical treatment. When purchasing insurance yourself, insurance providers can reject the application, or impose exclusions or surcharges on your child’s pre-existing conditions.

Read more about top-up insurance in Hong Kong.

2 - Child coverage through family health insurance

Your child can be covered through an individual family insurance policy that covers all family members (parents and children).

Advantages

• You can keep this coverage for life regardless of job changes [4]. Plus, if you onboard an insurance product when "young and healthy" and before any pre-existing conditions are declared, then you and your family members will be covered for such conditions in the future.
• Your child is covered for pre-existing conditions if he/she is added to the plan right after birth. This will allow an infant to be born into the plan, receiving coverage immediately after birth. Pre-existing conditions and congenital conditions can be covered and there are no waiting periods.
• Some insurance products offer family discounts or free coverage for kids below the age of 10.

Inconvenience

• Premiums are paid by you and are expensive in Hong Kong.
• Some insurance products require that all family members have the same level of coverage. When purchasing insurance for yourself and your family members, insurance providers can reject the application, or impose exclusions or surcharges on each member’s pre-existing conditions.

IMPORTANT: Please beware that insurance providers are increasingly scrutinizing claims in relation to pre-existing conditions and whether applicants have completed the application’s medical questionnaires accurately and to the best of their knowledge.

Read more about health insurance in Hong Kong.

3 - Child coverage through a stand-alone child policy

Very few insurance providers offer stand-alone child products.

A stand-alone child policy is a form of insurance product that is purchased under the child’s name. While one parent is the policyholder, only the child’s health and medical expenses are covered. Stand-alone child policies are available for children from birth to 18 years old, but pre-existing medical conditions will come into play, meaning that any conditions that occurred before the starting date of the policy may be excluded or give rise to a premium surcharge.

Advantages

• Your child can keep this coverage into adulthood and for life regardless of the parent’s life decisions and job changes.
• Plus, if your child onboards an insurance product when "young and healthy [5]" and before any pre-existing conditions are declared, then he/she will be covered for future conditions.

Inconvenience

• Premiums are paid by you.
• When purchasing insurance for your child, insurance providers can reject the application, or impose exclusions or surcharges on your child’s pre-existing conditions.
• Congenital conditions [6] may be excluded.

➜ Tips & Tricks: While you can apply for a stand-alone application at any time, it is crucial to send a stand-alone child application as soon as you can and ideally immediately after birth. That way, you reduce the risks of your child having any pre-existing condition you would have to declare - therefore exposing your child to exclusion or surcharge.

How Alea can help you save on insurance

How much does it cost to get a stand-alone child policy in Hong Kong?

Annual premiums for comprehensive stand-alone policies for children from birth to 18 vary between HK$ 15,000 and HK$ 40,000 for inpatient and outpatient coverage that would reimburse you in full (100%) for private hospital and doctor fees in Hong Kong.

How can I reduce premium costs for a stand-alone child policy?

If you are looking to minimize premium costs while maximizing coverage, you can choose some of the below product options:

• adding a deductible (also known as excess) or co-insurance %
• reducing the level of coverage
• paying the insurance premium on an "annual" basis as opposed to quarterly or monthly which generally involves a payment surcharge
• opting for an inpatient-only plan that covers your child for high ticket items only (hospitalizations, surgeries, cancer care)

There are also several tricks to [reduce healthcare costs [7] such as room type, healthcare practitioners or medical tourism.

In Hong Kong today, we all need health insurance. Your child too.

Footnotes:

[1] https://www.healthymatters.com.hk/8-things-you-should-know-about-healthcare-in-hong-kong/
[2] https://www.clic.org.hk/en/topics/insurance/general_matters_concerning_all_types_of_insurance/q6
[3] https://www.scmp.com/business/article/2089261/hong-kong-firms-arent-meeting-employees-expectations-health-care-study
[4] https://www.gov.hk/en/residents/employment/jobsearch/changingjobs.htm
[5] https://www.gov.hk/en/residents/health/healthadvice/healthcare/childshealth.htm
[6] https://www.who.int/topics/congenital_anomalies/en/
[7] https://www.healthymatters.com.hk/5-tips-to-reduce-your-healthcare-costs-in-hong-kong/