Are Clinic Visits Covered? | VHIS vs Outpatient Benefits

Understanding VHIS: Optional Outpatient Cover

With increasingly busy lifestyles, many people choose to visit outpatient clinics for common conditions such as colds, flu, or minor ailments, seeking consultations and prescribed medication. As demand for outpatient services continues to grow, the range of treatments and clinical services available has also expanded.

In recent years, the Government has encouraged the public to consider enrolling in the Voluntary Health Insurance Scheme (VHIS) to strengthen their medical protection. However, VHIS coverage varies across plans, and many people may be unsure whether their plan includes outpatient consultation fees, offers cashless arrangements similar to employer-provided group medical insurance, or provides coverage for specialist outpatient visits. These questions relate directly to the different healthcare expenses individuals may encounter in their daily lives.

To build a more comprehensive medical protection portfolio, it is important to understand both the VHIS framework and the optional outpatient benefits that can be added. Whether it is a routine clinic consultation or post-surgery follow-up care, Bupa is committed to supporting customers by providing suitable coverage across a wide range of healthcare needs.

Hospital Benefit vs. Clinical Benefit : What’s the Difference?

Hospital benefit primarily covers expenses incurred during a hospital stay, including costs directly related to inpatient treatment. Clinical benefit, on the other hand, covers a broad range of clinic-based services such as general practitioner consultations, specialist visits, physiotherapy, traditional Chinese medicine, dental services, and diagnostic imaging.

Most employer provided group medical insurance plans include both hospital and clinical benefit and typically allow employees to use their medical card for cashless settlement at network providers. However, coverage limits may not always fully meet actual medical expenses, and individuals may be required to pay part of the consultation costs out of pocket.

It is important to note that VHIS includes a clinic related item known as “Pre and Post Confinement / Day Case Procedure Clinic Care.” This benefit only applies to: clinic consultations necessary before a hospital stay or day case procedure; emergency consultation charges; and follow up consultations provided or recommended in writing by the attending doctor after discharge or a day case procedure.

This benefit is not equivalent to comprehensive clinical coverage.

Bupa VHIS with Optional Clinical Benefit

Both Bupa My Flexi VHIS and Bupa Hero VHIS offer optional clinical benefit, allowing policyholders to enhance their medical protection based on their needs.

Bupa’s clinical benefit includes dedicated coverage for psychiatric and psychological outpatient treatments, reimbursing consultations related to mental, emotional, or behavioural conditions, as well as cognitive disorders such as Alzheimer’s disease and Parkinson’s disease.

The benefit also extends to a wide range of services, including:

• General practitioners and specialists
• Diagnostic imaging and laboratory tests
• Prescribed medication
• Physiotherapy
• Chiropractic care
• Traditional Chinese medicine
• Bone setting treatments

For added convenience, customers may also access video consultation services, enabling them to receive medical advice and treatment from home.

Cashless Service with a Medical Card

If the optional clinical benefit is selected, policyholders may use their Bupa medical card at designated network clinics and service providers to enjoy cashless settlement and full cover, subject to benefit limits and policy terms.

Important Notes
The product features listed above are for reference only. Please refer to the relevant product brochure and policy contract for full details. Coverage is subject to the terms and conditions of the policy.

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