How to choose the right insurance
How can I make use of “deductible” to lower my medical insurance cost?
Deductible is the portion of eligible medical expenses paid by the subscriber up to an agreed amount before the insurance company starts to pay for expenses over that amount in a claims settlement.
At present, most companies provide group medical insurance for their employees. However, most group medical insurance plans have a maximum benefit limit. This benefit limit may not meet the needs of employees. If the medical cost is more than the maximum benefit limit, the employee will have to pay for the remaining cost on their own. Therefore, even if your employer provides group medical insurance, you should still get added protection through your own medical insurance.
If you are worried about duplicating the same cover provided by your employer, we suggest you to get a medical insurance plan with deductible options. This type of plan generally offers lower subscription, while the benefit limit is higher. You can use the group scheme from your employer to offset your own medical insurance’s deductible. This lowers your out-of-pocket cost, or in some cases, you don’t have to pay for anything. The following explains how to use your group cover to offset the deductible:
Assuming the subscriber chose the HK$12,000 deductible for his individual medical scheme, and was admitted to hospital for surgery due to illness:
Total hospital expenses: HK$50,000
Maximum limit of group cover from employer: HK$23,000
Maximum limit of individual medical scheme: HK$3 million (with HK$12,000 deductible)
The subscriber can first lodge a HK$23,000 claim under the employer’s group cover to meet the HK$12,000 deductible requirement. The remaining HK$27,000 of hospital expenses (ie HK$50,000 - HK$23,000) can be reimbursed in full using your individual medical scheme that covers up to HK$3 million.
How much in subscription fee can you save if you choose a deductible option?
Assume a 35 years old subscriber opting for a deductible option offered by Bupa HealthPlus:
Benefit level: Semi-private room
Annual limit: HK$3 million
|Annual subscription (HK$)*||$10,921||$7,080||$5,897|
|Savings compared with $0 deductible||-||Save $3,841 (35% savings in subscription)||Save $5,024 (46% savings in subscription)|
*According to 2023 subscription rate
- Full cover for hospital expenses at semi-private room level
- Three deductible options - lower your subscription up to 46%
- Covers follow-up outpatient consultations after surgery or cancer treatment
- Specially designed for employees who are already covered under group medical insurance
- Receive 80% reimbursement in medical expenses that exceed your group cover or the deductible
- Modest subscription
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