Health Insurance Learning Hub
What is a Deductible?
When a policyholder purchases a health insurance product with a specified deductible, they are required to pay a designated amount (which can be paid by themselves or through another policy) before the insurance company compensates for the remaining eligible expenses.
Example of a Deductible
For instance, the Cigna VHIS Series - Flexi Plan offers up to five deductible options. For treatment in a semi-private room in Asia, the annual deductible options include HKD 0, HKD15,000, HKD25,000, HKD50,000, and HKD75,000, providing a variety of choices to meet different needs.
Let’s look at a few scenarios to understand how this works. Suppose a 35-year-old policyholder purchases a health insurance policy with a HKD $25,000 deductible and later requires hospitalization due to illness:
Scenario A
If the eligible medical expenses for the first hospitalization in the policy year are HKD $60,000, the policyholder pays the deductible of HKD25,000, and the insurance company will compensate the remaining HKD35,000.
If the policyholder is hospitalized again within the same policy year, they will not need to pay the deductible again and can receive full coverage, subject to other policy terms.
Scenario B
If the eligible medical expenses for the first hospitalization are HKD $20,000, the policyholder must pay the full amount, and the insurance company will not cover it. The remaining deductible for the policy year will be $5,000.
Scenario C
For subsequent claims, the same calculations apply. For instance, if the policyholder is hospitalized again within the same policy year with eligible medical expenses of HKD $30,000, after subtracting the remaining $5,000 deductible, the insurance company will cover the expense of $25,000.
Scenario D
In the new policy year, if the policyholder is hospitalized again with eligible medical expenses of HKD $20,000, since the deductible resets to $25,000, and the policyholder will need to pay the full amount of $20,000.
Who Should Consider Purchasing Health Insurance with a Deductible?
Generally, anyone can purchase health insurance with a deductible, but it is particularly suitable for two groups: those whose employers provide group health insurance or those who already have basic medical coverage and wish to add additional protection.
The Department of Health recommends that if individuals already have company health insurance, they can consider purchasing an additional voluntary health insurance product with a deductible tailored to their needs and budget, as the premiums are usually lower than those without a deductible. Should they need to make a claim, they can offset the deductible with the compensation from their company insurance. Even if they change jobs in the future and can no longer use the company insurance, they will still have the voluntary health insurance for coverage.
Know more: VHIS Explained: How to Buy VHIS With Deductible Options & Group Insurance
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Comprehensive coverage for the three major critical illnesses: cancer, stroke, and heart attack
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The Insurance Authority reminds everyone that the choice of health insurance varies by individual. The public should consider their coverage needs and balance their financial situation when choosing the appropriate health insurance plan. They may compare the following categories:
Benefit scope
Coverage model and amounts
Premium levels
Deductible options
Workers should consider purchasing suitable health insurance early to handle unexpected medical needs in the future. Cigna Healthcare's upgraded medical insurance can complement existing personal or group medical coverage, offering diverse deductible options. This plan provides comprehensive medical coverage, with premiums starting as low as just a few dollars per day, ensuring coverage up to HKD $1 million annually and renewable until the insured reaches 100 years old.
The content above is for reference only. Cigna Healthcare does not guarantee or represent the accuracy or completeness of the information provided. nor is it liable for any damages, compensation, costs, or other expenses arising from the content.
The insurance product information provided is directly from Cigna Healthcare' and does not encompass all the coverage details and characteristics of the insurance product. The conditions of specific insurance plans are governed by their respective policy terms. For details on product features, contents, terms, conditions, and exclusions, please visit the Cigna Healthcare website and refer to the relevant product brochures and policy terms. This information does not constitute an insurance contract or an offer, invitation, or inducement to enter into any insurance contract.