1 Subject to meeting requirements in the renewal provisions of policy terms and conditions and making payment of prevailing premium on each policy anniversary. Zurich reserves the right to amend premium, benefits and terms upon policy renewal.
Most affordable choice. No additional exclusion will be imposed due to a change in health conditions at time of renewal
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Enhanced benefit in addition to those covered in Standard Plan. You can further boost your core coverage by adding supplementary major medical benefit
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Higher benefit limit allows you to stay in a better ward with improved privacy
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Full coverage on major items of medical expenses. Up to HKD6,000,000 annual coverage at an attractive premium with different deductible options
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HealthFlexi - Essential Plan
(Flexi Plan)
VHIS Certification Number
F00044-01-000-02
F00044-01-001-02
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Plan highlight | |||||||||||
Plan level
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Standard | Essential | Advanced | Prestige | |||||||
Lifetime benefit limit
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No limit | No limit | No limit | HKD 25,000,000 | |||||||
Annual benefit limit
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HKD 420,000 | HKD 550,000 | HKD 750,000 | HKD 6,000,000 | |||||||
Territorial scope of cover
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Worldwide2 | Worldwide2 | Worldwide2 | Asia3/ Worldwide excluding the United States2(US) | |||||||
Room type restriction
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No limit | No limit | No limit | Standard semi-private | |||||||
Deductible options
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Not applicable | Not applicable | Not applicable | HKD 0 / HKD 60,000 / HKD 90,000 / HKD 150,000 | |||||||
Key benefit limit | |||||||||||
Room and board
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HKD 750 per day Maximum 180 days per policy year |
HKD 900 per day Maximum 180 days per policy year |
HKD 1,800 per day Maximum 180 days per policy year |
Actual cost | |||||||
Miscellaneous charges
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HKD14,000 per policy year | HKD 16,000 per policy year | HKD 24,000 per policy year | Actual cost | |||||||
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Actual cost | |||||||
Prescribed Non-surgical Cancer Treatments
Treatments covered here only include radiotherapy, chemotherapy, targeted therapy, immunotherapy and hormonal therapy.
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HKD 80,000 per policy Year | HKD 80,000 per policy Year | HKD 120,000 per policy Year | Actual cost | |||||||
Enhanced benefits
Please refer to the Certified Plans Benefit Summary for details
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Not applicable | Applicable | Applicable | Applicable | |||||||
Other benefits
Please refer to the Certified Plans Benefit Summary for details
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Not applicable | Applicable | Applicable | Applicable | |||||||
Estimated coverage4 | |||||||||||
HealthSure | HealthFlexi (Essential plan) | HealthFlexi (Essential Plan with SMM) | HealthFlexi (Advanced plan) | HealthFlexi (Advanced Plan with SMM) | HealthFlexi Plus | ||||||
Fever with hospitalization
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75%-85% | 85%-95% | 85%-95% | 85%-95% | 85%-95% | 100% | |||||
Cataract surgery (Day case)
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75%-85% | 80-90% | 85%-95% | 85%-95% | 85%-95% | 100% | |||||
Myomectomy
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65%-75% | 70%-80% | 85%-95% | 80%-90% | 85%-95% | 100% | |||||
Knee replacement
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60%-70% | 63%-73% | 83%-93% | 65%-75% | 85%-95% | 100% | |||||
Stage-two breast cancer
Estimated expenses: HKD 1,515,240
Stage-two breast cancer3
Diagnostic tests HKD 6,300
Operating theatre charge HKD 22,920
Doctor's fee HKD 52,930
Anesthetist's fee HKD 14,550
Hospital charges HKD 18,540
Radiotherapy HKD 100,000
Targeted Therapy HKD 300,000
Hormonal Therapy HKD 1,000,000
Estimated expenses HKD 1,515,240
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10%-20% | 10%-20% | 15%-25% | 15%-25% | 20%-30% | 99% |
Hide the Key benefit limit and Estimated coverage Key benefit limit and Estimated coverage | |||
Download Certified Plans benefit summary |
2Except psychiatric treatments.
3Except psychiatric treatments. Asia including Australia and New Zealand.
4 Estimated coverage is an estimation of claim amount under each Certified Plan for different conditions in accordance with Zurich's assessment. The level of severity, proposed medical treatment, and actual medical expenses vary for different medical cases. The estimated coverage is for reference only, and should not be construed as actual claim result of any cases. All benefits payable are subject to benefit limits of particular benefit items, please refer to 'Terms and Conditions' for details.
The information related to surgical costs is for reference only. The actual costs would vary depending on the complexity of each medical case and the difference in charges of individual doctors.
Most affordable choice. No additional exclusion will be imposed due to a change in health conditions at time of renewal
|
Enhanced benefit in addition to those covered in Standard Plan. You can further boost your core coverage by adding supplementary major medical benefit
|
Higher benefit limit allows you to stay in a better ward with improved privacy
|
Full coverage on major items of medical expenses. Up to HKD6,000,000 annual coverage at an attractive premium with different deductible options
|
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HealthSure
(Standard plan) |
HealthFlexi
(Flexi Plan) |
HealthFlexi
(Flexi Plan) |
HealthFlexi Plus
(Flexi Plan) |
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Plan highlight | Plan highlight | Plan highlight | Plan highlight | ||
Plan level Standard
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Plan level Essential
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Plan level Advanced
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Plan level Prestige
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Lifetime benefit limit No limit
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Lifetime benefit limit No limit
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Lifetime benefit limit No limit
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Lifetime benefit limit HKD 25,000,000
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Annual benefit limit HKD 420,000
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Annual benefit limit HKD 550,000
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Annual benefit limit HKD 750,000
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Annual benefit limit HKD 6,000,000
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Territorial scope of cover Worldwide2
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Territorial scope of cover Worldwide2
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Territorial scope of cover Worldwide2
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Territorial scope of cover Asia3/ Worldwide excluding the United States2
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Room type restriction No limit
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Room type restriction No limit
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Room type restriction No limit
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Room type restriction Standard semi-private
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Deductible options Not applicable
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Deductible options Not applicable
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Deductible options Not applicable
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Deductible options HKD 0 / HKD 60,000 / HKD 90,000 / HKD 150,000
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Key benefit limit | Key benefit limit | Key benefit limit | Key benefit limit | ||
Room and board HKD 750 per day
Maximum 180 days per policy year |
Room and board HKD 900 per day
Maximum 180 days per policy year |
Room and board HKD 1,800 per day
Maximum 180 days per policy year |
Room and board Actual cost
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Miscellaneous charges HKD14,000 per policy year
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Miscellaneous charges HKD 16,000 per policy year
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Miscellaneous charges HKD 24,000 per policy year
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Miscellaneous charges Actual cost
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Surgeon's fee: Complex HKD 50,000
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Surgeon's fee:: Complex HKD 54,000
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Surgeon's fee:: Complex HKD 80,000
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Surgeon's fee:: Complex Actual cost
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Major HKD 25,000
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Major HKD 27,000
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Major HKD 40,000
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Major Actual cost
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Intermediate HKD 12,500
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Intermediate HKD 13,500
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Intermediate HKD 20,000
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Intermediate Actual cost
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Minor HKD 5,000
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Minor HKD 5,750
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Minor HKD 8,000
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Minor Actual cost
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Prescribed Non-surgical Cancer Treatments HKD 80,000 per policy Year
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Prescribed Non-surgical Cancer Treatments HKD 80,000 per policy Year
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Prescribed Non-surgical Cancer Treatments HKD 120,000 per policy Year
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Prescribed Non-surgical Cancer Treatments Actual cost
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Enhanced benefits Not applicable
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Enhanced benefits Applicable
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Enhanced benefits Applicable
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Enhanced benefits Applicable
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Other benefits Not applicable
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Other benefits Applicable
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Other benefits Applicable
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Other benefits Applicable
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Estimated coverage4 | Estimated coverage4 | Estimated coverage4 | Estimated coverage4 | ||
HealthSure | HealthFlexi (Essential plan) |
HealthFlexi (Essential Plan with SMM) |
HealthFlexi (Advanced plan) |
HealthFlexi (Advanced Plan with SMM) |
HealthFlexi Plus |
Fever with hospitalization Estimated expenses: HKD 21,600 75%-85%
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Fever with hospitalization Estimated expenses: HKD 21,600 85%-95%
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Fever with hospitalization Estimated expenses: HKD 21,600 85%-95%
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Fever with hospitalization Estimated expenses: HKD 21,600 85%-95%
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Fever with hospitalization Estimated expenses: HKD 21,600 85%-95%
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Fever with hospitalization Estimated expenses: HKD 21,600 100%
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Cataract surgery (Day case) Estimated expenses: HKD 20,050 75%-85%
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Cataract surgery (Day case) Estimated expenses: HKD 20,050 80-90%
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Cataract surgery (Day case) Estimated expenses: HKD 20,050 85%-95%
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Cataract surgery (Day case) Estimated expenses: HKD 20,050 85%-95%
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Cataract surgery (Day case) Estimated expenses: HKD 20,050 85%-95%
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Cataract surgery (Day case) Estimated expenses: HKD 20,050 100%
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Myomectomy Estimated expenses: HKD 81,130 65%-75%
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Myomectomy Estimated expenses: HKD 81,130 70%-80%
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Myomectomy Estimated expenses: HKD 81,130 85%-95%
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Myomectomy Estimated expenses: HKD 81,130 80%-90%
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Myomectomy Estimated expenses: HKD 81,130 85%-95%
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Myomectomy Estimated expenses: HKD 81,130 100%
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Knee replacement Estimated expenses: HKD 150,040 60%-70%
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Knee replacement Estimated expenses: HKD 150,040 63%-73%
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Knee replacement Estimated expenses: HKD 150,040 83%-93%
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Knee replacement Estimated expenses: HKD 150,040 65%-75%
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Knee replacement Estimated expenses: HKD 150,040 85%-95%
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Knee replacement Estimated expenses: HKD 150,040 100%
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Stage-two breast cancer Estimated expenses: HKD 1,515,240 10%-20%
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Stage-two breast cancer Estimated expenses: HKD 1,515,240 10%-20%
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Stage-two breast cancer Estimated expenses: HKD 1,515,240 15%-25%
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Stage-two breast cancer Estimated expenses: HKD 1,515,240 15%-25%
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Stage-two breast cancer Estimated expenses: HKD 1,515,240 20%-30%
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Stage-two breast cancer Estimated expenses: HKD 1,515,240 99%
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Hide the Key benefit limit and Estimated coverageKey benefit limit and Estimated coverage |
Download Certified Plans benefit summary |
2Except psychiatric treatments.
3Except psychiatric treatments. Asia including Australia and New Zealand.
4 Estimated coverage is an estimation of claim amount under each Certified Plan for different conditions in accordance with Zurich's assessment. The level of severity, proposed medical treatment, and actual medical expenses vary for different medical cases. The estimated coverage is for reference only, and should not be construed as actual claim result of any cases. All benefits payable are subject to benefit limits of particular benefit items, please refer to 'Terms and Conditions' for details.
The information related to surgical costs is for reference only. The actual costs would vary depending on the complexity of each medical case and the difference in charges of individual doctors.
Fill in the claim form and submit it with all other supporting documents by post.
Please click
here for details
of claim procedure, forms and required documents.
You will receive an SMS and/ or email for acknowledgement.
We will process your claim as soon as possible and contact you for additional supporting documents if necessary.
After we have received all the required documents, you will receive the claim result through
SMS/email/mail within 5 business days.
We will reimburse the claim amount by cheque or depositing into your designated bank account according
to your preference.
1. What is Voluntary Health Insurance Scheme (VHIS)?
The Voluntary Health Insurance Scheme ("VHIS") is a policy initiative introduced by the Food and Health Bureau ("FHB") to regulate indemnity hospital insurance plans offered to individuals. The objectives of such initiative are to enhance the protection level of hospital insurance products, and to encourage the public to use private healthcare services when in need. The Certified Plans under VHIS can be divided into Standard Plans and Flexi Plans. Standard Plans provide standardized coverage; on top of the Standard Plan-equivalent coverage, Flexi Plans, provide higher benefit amount and more benefit items.
2. Why do we need the VHIS plans?
Medical expenses continue to increase over time, so individuals should plan for the medical protection needs of themselves and their family members as soon as possible. The VHIS Certified Plans are certified by FHB to fulfill a number of standard features with an objective to enhance consumer protection by standardizing policy terms and conditions (applicable to Standard Plans only). The Certified Plans under VHIS meet multiple standardized product features, including:
Tax deduction
Hong Kong taxpayer, who or whose spouse is the policyholder of a policy issued under a Certified Plan of VHIS, may claim tax deductions up to HKD 8,000 per insured person for the premiums paid in relation to the Certified Plan in each assessment year. The insured person of the Certified Plan should be the taxpayer or any of the specified relatives, which include the taxpayer's spouse and children1, and the taxpayer's or his/her spouse's grandparents2, parents3 and siblings3. There is no limit on the number of insured persons and the number of eligible policies4.
Premium transparency
Consumers can access or view the details of the premium schedules of all Certified Plans at the websites of the participating insurance companies and the official VHIS website.
Eligibility before aged 80; guaranteed renewal5 up to aged 100
VHIS plans provide guaranteed renewal up to the age of 100 years, regardless of any change in health conditions of the insured person. Also, the VHIS Standard Plans have no "lifetime benefit limit", and the benefits will not lapse until the insured person reaches the age of 100 years.
Coverage of unknown pre-existing conditions
Pre-existing conditions unknown to applicants are commonly excluded from benefit coverage in the existing indemnity hospital insurance plans available in the market. VHIS provides the following waiting period and reimbursement arrangement for pre-existing conditions:
First Policy Year | no coverage |
Second Policy Year | 25% reimbursement |
Third Policy Year | 50% reimbursement |
Fourth Policy Year onwards | full coverage |
1Children i) aged less than 18; ii) aged 18 to less than 25 receiving full-time
education; or iii) aged 18 or above but incapacitated for work by reason of physical or mental
disability
2Parents or grandparents i) aged less than 55 but eligible to claim an allowance under
the Government's Disability Allowance Scheme or ii) aged 55 or above.
3Brothers or sisters i) aged less than 18; ii) aged 18 to less than 25 receiving
full-time education or iii) aged 18 or above but incapacitated for work by reason of physical or
mental disability.
4Tax deduction for the qualifying premiums paid under VHIS policy (not including levy)
will be based on the premiums paid after deducting the premium discount (if any). Whether tax
deduction is allowable for the qualifying premiums paid under VHIS policy (not including levy) are
subject to the Inland Revenue Ordinance and the circumstances of the policy holder (as taxpayer)
and the insured person(s) (as specified relative(s)). Please refer to the website of the Inland
Revenue Department (IRD) or contact the IRD directly for any tax related enquiries. Zurich does
not provide tax and/or legal advice. You should consult independent tax and/or legal advisor if
needed.
5Subject to meeting requirements in the renewal provisions of policy terms and
conditions and making payment of prevailing premium on each policy anniversary. Zurich reserves
the right to amend premium, benefits and terms upon policy renewal.
3. How to calculate the tax deduction amount of VHIS plans?
The maximum amount that a taxpayer is eligible for claiming a tax deduction is HKD 8,000 per insured person in each assessment year. Hence, the tax deduction could be considered as discounts to VHIS plans.
The calculation of tax deduction is quite simple, and please refer to the formula as shown below:
Tax deduction amount = VHIS premium X tax rate
Assume VHIS premium is HKD 5,000 annually, and taking the standard tax rate at 15% as an example, the tax deduction amount equals = HKD 5,000 X 15% = HKD 750.
Tax deduction is also applicable to VHIS purchase for specified relatives (Refer to Question 2). Policyholder can apply for tax deduction for a maximum amount of HKD 8,000 per insured person for themselves or specified relatives. For example, a family of four is eligible to claim tax deduction up to HKD 32,000 per assessment year.
4. Can one split policy ownership with another person?
No. Zurich's underwriting practice allows one policy holder per policy.
5. How to choose between Standard Plan and Flexi Plan?
Standard Plans provide standardized basic coverage. If the claim reaches the coverage limit of any of the benefit item, there will be no extra medical benefits for buffer. On the other hand, Flexi Plans provide comprehensive and diversified medical coverage with more superior hospital insurance benefits.
Premiums of the two plans are different due to the variation in coverage and benefits. Flexi Plans provide better hospital benefits in general, but at a higher premium. You may consider choosing Flexi Plans to enhance your protection if budget allows. If your employer provides group medical insurance, which offers some levels of medical benefits and coverage, then the Flexi Plans with deductible options could act as a top-up cover and let you enjoy more comprehensive protection at a reasonable premium.
6. If you have already purchased medical insurance or are covered by your company's group medical insurance, why do you still need VHIS?
VHIS plans offer more comprehensive coverage than most of the existing hospital insurance plan in the market. Group medical insurance usually provides basic coverage and may not fully cover certain expensive medical expenses. You should also take into consideration the risk of absence of medical coverage during job transition or unemployment. By choosing the Flexi Plans with a deductible amount, which complements your existing group medical insurance, you could get comprehensive coverage at a reasonable premium.
7. Is/are newborn baby or parents over age of 70 years also eligible to purchase VHIS plans?
Hong Kong residents between the age of 15 days and 80 years are eligible to apply for Certified Plans. You could also enjoy tax deduction benefits if you purchase VHIS plans for specified relatives (refer to Question 2) and yourself, up to a maximum limit of HKD 8,000 for each insured person.
8. How to submit a claim and how long will it take to process?
Zurich strives to provide convenient and easy claim services. Simply take the following four steps to complete the claim process:
Step 1: Obtain all the required documents before discharged from hospital, complete the claim form and submit it together with all the necessary documents within 90 days after discharge from the hospital. The required documents include the originals of all receipts along with the proof of diagnosis, treatment category, treatment procedures, tests and/or services.
Step 2: You will receive an acknowledgment SMS and/or email to confirm that we have received your claim application.
Step 3: We will process your claim as quickly as possible, and we will contact you via email/ phone/ post to obtain other supporting document(s) if necessary.
Step 4: Upon receipt of your completed claim form and all required documents, we will conduct the claim assessment and notify you the claim result within five business days, through SMS, email or post. After the claim process is completed, we will reimburse the claim amount as soon as possible according to your selected payment method.
9. How to get more information about VHIS?
For more information about VHIS, you can visit the official website of VHIS provided by FHB https://www.vhis.gov.hk/en/; for tax deduction related information, you can visit the Inland Revenue Department website https://www.ird.gov.hk/eng/faq/vhis_qp.htm; and for matters related to regulations of insurance company, you can visit the Insurance Authority website https://www.ia.org.hk/en/index.html. You are reminded to seek independent professional advice if necessary.
Our customer service representatives are always ready to answer your queries regarding VHIS. If you have any questions, please feel free to call our customer service hotline at +852 2968 2288 or e-mail us at enquiry@hk.zurich.com.
If you are the existing policy holder of Indemnity Hospital Insurance Products ("IHIP Products1") before the implementation of VHIS (October 16, 2019), you will be entitled to a one-off, non-compulsory migration facilitation to HealthSure Voluntary Health Insurance Plan or HealthFlexi Plus Voluntary Health Insurance Plan upon renewal. Upon successful migration to one of our VHIS plans, the existing IHIP Product's coverage will be terminated.
For more information about the migration arrangement, please contact our hotline at +852 2903 9391.
1IHIP Products include CareMultiple Medical Insurance Plan, HealthMultiple Medical Insurance Plan, HassleFree Health Insurance Plan, HealthNoble Medical Insurance Plan, HealthAngel Medical Insurance Plan, HealthPlus Medical Insurance Plan and other applicable medical policies.
Key Exclusions
The following list is for reference only and it is not a full list of exclusions. Please refer to the Terms and Conditions of the respective plan for the complete list and details of exclusions.
Premium and terms and benefits adjustments
Cooling-off Period and Cancellation Right
You have the right to cancel the policy and obtain a refund of any premiums and any levy paid by giving written notice to us. Such notice must be signed by you and received directly by our office at 25-26/F, One Island East, 18 Westlands Road, Island East, Hong Kong within the cooling-off period i.e., 21 days immediately following the day of delivery of the policy or the cooling-off notice to you or your nominated representative (whichever is the earlier). After the cooling-off period, you can request cancellation of this policy by giving 30 days prior written notice to us, provided that there has been no benefit payment under this policy during the relevant policy year.
Termination of Policy
Other Important Information