Zurich VHIS Series

	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
	HealthSure (Standard plan) VHIS Certification Number S00024-01-000-02	HealthFlexi - Essential Plan (Flexi Plan) VHIS Certification Number F00044-01-000-02 F00044-01-001-02		HealthFlexi - Advanced Plan (Flexi Plan) VHIS Certification Number F00044-02-000-02 F00044-02-001-02		HealthFlexi Plus (Flexi Plan) VHIS Certification Number F00036-01-000-02 F00036-02-000-02 F00036-03-000-02 F00036-04-000-02 F00036-05-000-02 F00036-06-000-02 F00036-07-000-02 F00036-08-000-02
Plan highlight
Plan level	Standard	Essential		Advanced		Prestige
Lifetime benefit limit	No limit	No limit		No limit		HKD 25,000,000
Annual benefit limit	HKD 420,000	HKD 550,000		HKD 750,000		HKD 6,000,000
Territorial scope of cover	Worldwide²	Worldwide²		Worldwide²		Asia³/ Worldwide excluding the United States²(US)
Room type restriction	No limit	No limit		No limit		Standard semi-private
Deductible options	Not applicable	Not applicable		Not applicable		HKD 0 / HKD 60,000 / HKD 90,000 / HKD 150,000
Key benefit limit
Room and board	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	HKD14,000 per policy year	HKD 16,000 per policy year		HKD 24,000 per policy year		Actual cost
Surgeon's fee Per surgery, subject to surgical category for the surgery/procedure in the Schedule of Surgical Procedures Complex Major Intermediate Minor	HKD 50,000 HKD 25,000 HKD 12,500 HKD 5,000	HKD 54,000 HKD 27,000 HKD 13,500 HKD 5,750		HKD 80,000 HKD 40,000 HKD 20,000 HKD 8,000		Actual cost
Prescribed Non-surgical Cancer Treatments Treatments covered here only include radiotherapy, chemotherapy, targeted therapy, immunotherapy and hormonal therapy.	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	Not applicable	Applicable		Applicable		Applicable
Other benefits Please refer to the Certified Plans Benefit Summary for details	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 Estimated expenses: HKD 21,600 Fever with hospitalization³ Pediatrician fee HKD 7,020 Hospital charges (3 days inpatient stay) HKD 14,580 Estimated expenses HKD 21,600	75%-85%	85%-95%	85%-95%	85%-95%	85%-95%	100%
Cataract surgery (Day case) Estimated expenses: HKD 20,050 Cataract surgery (local anesthesia, day case)³ Operating theatre charge HKD 5,000 Doctor's fee HKD 12,000 Anesthetist's fee HKD 0 Hospital charges HKD 1,050 Estimated expenses HKD 18,050	75%-85%	80-90%	85%-95%	85%-95%	85%-95%	100%
Myomectomy Estimated expenses: HKD 81,130 Myomectomy³ Operating theatre charge HKD 19,060 Doctor's fee HKD 36,630 Anesthetist's fee HKD 9,980 Hospital charges HKD 15,460 Estimated expenses HKD 81,130	65%-75%	70%-80%	85%-95%	80%-90%	85%-95%	100%
Knee replacement Estimated expenses: HKD 150,040 Knee replacement³ Operating theatre charge HKD 56,820 Doctor's fee HKD 55,130 Anesthetist's fee HKD 16,360 Hospital charges HKD 21,730 Estimated expenses HKD 150,040	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	10%-20%	10%-20%	15%-25%	15%-25%	20%-30%	99%


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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.

⁵Source: Charges of Common Surgery of July 2019 – December 2019 from Union Hospital.

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
HealthSure (Standard plan)	HealthFlexi (Flexi Plan)		HealthFlexi (Flexi Plan)		HealthFlexi Plus (Flexi Plan)
Plan highlight	Plan highlight		Plan highlight		Plan highlight
Plan level Standard	Plan level Essential		Plan level Advanced		Plan level Prestige
Lifetime benefit limit No limit	Lifetime benefit limit No limit		Lifetime benefit limit No limit		Lifetime benefit limit HKD 25,000,000
Annual benefit limit HKD 420,000	Annual benefit limit HKD 550,000		Annual benefit limit HKD 750,000		Annual benefit limit HKD 6,000,000
Territorial scope of cover Worldwide²	Territorial scope of cover Worldwide²		Territorial scope of cover Worldwide²		Territorial scope of cover Asia³/ Worldwide excluding the United States²
Room type restriction No limit	Room type restriction No limit		Room type restriction No limit		Room type restriction Standard semi-private
Deductible options Not applicable	Deductible options Not applicable		Deductible options Not applicable		Deductible options HKD 0 / HKD 60,000 / HKD 90,000 / HKD 150,000
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
Miscellaneous charges HKD14,000 per policy year	Miscellaneous charges HKD 16,000 per policy year		Miscellaneous charges HKD 24,000 per policy year		Miscellaneous charges Actual cost
Surgeon's fee: Complex HKD 50,000	Surgeon's fee:: Complex HKD 54,000		Surgeon's fee:: Complex HKD 80,000		Surgeon's fee:: Complex Actual cost
Major HKD 25,000	Major HKD 27,000		Major HKD 40,000		Major Actual cost
Intermediate HKD 12,500	Intermediate HKD 13,500		Intermediate HKD 20,000		Intermediate Actual cost
Minor HKD 5,000	Minor HKD 5,750		Minor HKD 8,000		Minor Actual cost
Prescribed Non-surgical Cancer Treatments HKD 80,000 per policy Year	Prescribed Non-surgical Cancer Treatments HKD 80,000 per policy Year		Prescribed Non-surgical Cancer Treatments HKD 120,000 per policy Year		Prescribed Non-surgical Cancer Treatments Actual cost
Enhanced benefits Not applicable	Enhanced benefits Applicable		Enhanced benefits Applicable		Enhanced benefits Applicable
Other benefits Not applicable	Other benefits Applicable		Other benefits Applicable		Other benefits Applicable
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%	Fever with hospitalization Estimated expenses: HKD 21,600 85%-95%	Fever with hospitalization Estimated expenses: HKD 21,600 85%-95%	Fever with hospitalization Estimated expenses: HKD 21,600 85%-95%	Fever with hospitalization Estimated expenses: HKD 21,600 85%-95%	Fever with hospitalization Estimated expenses: HKD 21,600 100%
Cataract surgery (Day case) Estimated expenses: HKD 20,050 75%-85%	Cataract surgery (Day case) Estimated expenses: HKD 20,050 80-90%	Cataract surgery (Day case) Estimated expenses: HKD 20,050 85%-95%	Cataract surgery (Day case) Estimated expenses: HKD 20,050 85%-95%	Cataract surgery (Day case) Estimated expenses: HKD 20,050 85%-95%	Cataract surgery (Day case) Estimated expenses: HKD 20,050 100%
Myomectomy Estimated expenses: HKD 81,130 65%-75%	Myomectomy Estimated expenses: HKD 81,130 70%-80%	Myomectomy Estimated expenses: HKD 81,130 85%-95%	Myomectomy Estimated expenses: HKD 81,130 80%-90%	Myomectomy Estimated expenses: HKD 81,130 85%-95%	Myomectomy Estimated expenses: HKD 81,130 100%
Knee replacement Estimated expenses: HKD 150,040 60%-70%	Knee replacement Estimated expenses: HKD 150,040 63%-73%	Knee replacement Estimated expenses: HKD 150,040 83%-93%	Knee replacement Estimated expenses: HKD 150,040 65%-75%	Knee replacement Estimated expenses: HKD 150,040 85%-95%	Knee replacement Estimated expenses: HKD 150,040 100%
Stage-two breast cancer Estimated expenses: HKD 1,515,240 10%-20%	Stage-two breast cancer Estimated expenses: HKD 1,515,240 10%-20%	Stage-two breast cancer Estimated expenses: HKD 1,515,240 15%-25%	Stage-two breast cancer Estimated expenses: HKD 1,515,240 15%-25%	Stage-two breast cancer Estimated expenses: HKD 1,515,240 20%-30%	Stage-two breast cancer Estimated expenses: HKD 1,515,240 99%

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²Except psychiatric treatments.

³Except psychiatric treatments. Asia including Australia and New Zealand.

⁵Source: Charges of Common Surgery of July 2019 – December 2019 from Union Hospital.

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.

Case Study

John, a 70-year-old retired grandpa, recently found that his vision became blurry and saw glare under sunlight or strong lights. Sometimes, he even saw double or several ghost images. So, he went to see an ophthalmologist.

John was diagnosed with cataract in both eyes, which is common among the elderly. The ophthalmologist recommended John to undergo a surgery to remove the lens and replace them with an artificial lens. The procedure could be performed at a day surgery centre and did not require an overnight stay in a hospital. The medical expenses amounted to HKD20,050 in total. Fortunately, John's son purchased Zurich's HealthSure for his father years ago and the plan covered more than 90% of the medical expenses.

Expense items	Eligible medical expense (HKD)	Benefit limit of HealthSure (HKD)	HealthSure estimated coverage (HKD)
Pre-procedure out-patient consultation	1,000	580 per visit(max. 1 visit per confinement/day case procedure)	580
Surgeon's fee	12,000	12,500 (intermediate surgery)	12,000
Operating theatre charge	5,000	35% of surgeon's fee payable	4,200
Miscellaneous charges	1,050	14,000 per policy year	1,050
Post-procedure out-patient consultation	1,000	580 per visit(max. 3 visits per confinement/day case procedure)	580
Total	20,050		18,410

Brian, a 16-year-old student who loves playing football, recently suffered from injury in an inter-school football competition. He heard a popping sound during the injury and experienced a sudden knee pain that made him unable to continue with the game.He then went to see an orthopedic doctor. The doctor recommended him to undergo magnetic resonance imaging for diagnosis.

Brian was diagnosed with anterior cruciate ligament tear after undergoing diagnostic tests. A surgery to reconstruct the anterior cruciate ligament and post-surgery physiotherapy treatments were recommended. The medical expenses from diagnosis to recovery cost HKD111,660 in total. Luckily, Brian's mother purchased Zurich's HealthFlexi (Essential plan with SMM benefit) for Brian one year ago and the plan covered around 90% of the expenses.

Expense items	Eligible medical expense (HKD)	Benefit limit of HealthFlexi (Essential Plan) (HKD)	HealthFlexi (Essential Plan) Estimated Coverage (HKD)	HealthFlexi (Essential Plan with SMM) Estimated Coverage (HKD)
Pre-confinement treatment
Diagnostic imaging test (MRI)	5,500	20,000 per policy year (Subject to 30% coinsurance)	3,850	3,850
Pre-confinement outpatient consultation	1,000	580 per visit (max. 2 prior outpatient visit per confinement)	580	580
Confinement
Room and board	2,400 (800 x 3 days)	900 per day (max. 180 days per policy year)	2,400	2,400
Miscellaneous charges	5,950	16,000 per policy year	5,950	5,950
Attending doctor's visit fee	2,400 (800 x 3 days)	900 per day (max. 180 days per policy year)	2,400	2,400
Surgeon's fee	41,800	27,000 (major surgery)	27,000	27,000
Operating theatre charge	33,360	35% of surgeon's fee payable	9,450	9,450
Anesthetist's fee	13,750	35% of surgeon's fee payable	9,450	9,450
SMM benefit⁴	-	Remaining eligible expenses in excess of the benefit limits for Surgeon's fee,Operating theatre charge and Anesthetist's fee under basic benefit x 80% reimbursement percentage, subject to 120,000 aggregate annual limit for SMM	-	34,408
Post-confinement treatment
Physiotherapy session	5,500 (1,100 x 5 visits)	・Post-confinement out-patient care: 580 per visit (max. 3 visits) ・Post-confinement rehabilitative care: 10,000 per policy year	5,500	5,500
Total	111,660		66,580	100,988

Emily, aged 50, is an accountant. She found out that she had a painless lump in her breast and was diagnosed with stage-two breast cancer after undergoing diagnostic tests, including breast biopsy. Emily's attending doctor advised Emily to undergo mastectomy.

Emily had the surgery and stayed in a semi-private room for seven days. Later, she underwent radiotherapy, targeted therapy and hormonal therapy. The medical expenses totaled HKD 1,515,240, in which the cancer treatments account for 92% of the total expenses. Luckily, Emily has purchased HealthFlexi Plus (with no deductible) and the plan fully covered her medical expenses for her confinement and cancer treatments.

Expense items	Eligible medical expense (HKD)	Benefit limit of HealthFlexi Plus (HKD)	HealthFlexi Plus estimated coverage (HKD)
Pre-confinement treatment
Diagnostic tests (including Breast Biopsy)	6,300	1,600 per visit (max. 2 prior out-patient visit per confinement)	1,600
Confinement
Doctor's fee⁶	52,930	Actual cost	52,930
Operating theatre charge	22,920		22,920
Anesthetist's fee	14,550		14,550
Hospital charges⁷	18,540		18,540
Cancer treatment
Radiotherapy	100,000	Actual cost	100,000
Targeted Therapy	300,000		300,000
Hormonal therapy	1,000,000		1,000,000
Total	1,515,240		1,510,540

Kate is a successful businesswoman. Apart from busy working every day, she also needs to take care of her aged parents. Unfortunately, she passed out in office one day, and was diagnosed with severe uterine fibroids during checkup.

Due to the complexity of the medical and surgical conditions, the doctor estimated that she needed to be hospitalized for a week, and the medical expenses would amount to HKD 126,960. Luckily, Kate had purchased Zurich's HealthFlexi Plus with HKD 60,000 deductible to supplement the coverage from the group medical insurance provided by her employer. Kate could expect the deductible amount of HKD 60,000 to be covered by her employer's medical plan with the remaining HKD 66,960 covered by HealthFlexi Plus. Kate could choose to stay in a semi-private room at her trusted private hospital to receive treatment, while focusing her efforts on recovery. As a result, she did not need to worry about the medical expenses affecting the financial conditions of her family.

Expense items	Eligible medical expense (HKD)	Benefit limit of HealthFlexi Plus (HKD)	HealthFlexi Plus estimated coverage (HKD)
Doctor's fee⁶	60,500	Actual cost	Fully cover the actual costs of hospital and surgical charges after the HKD 60,000 deductible
Operating theatre charge	28,510
Anesthetist's fee	17,000
Hospital charges⁷	20,950
Total	126,960		66,960

Expense items	Eligible medical expense (HKD)	HealthSure estimated coverage (HKD)
Pre-procedure out-patient consultation	1,000	580
Surgeon's fee	12,000	12,000
Operating theatre charge	5,000	4,200
Miscellaneous charges	1,050	1,050
Post-procedure out-patient consultation	1,000	580
Total	20,050	18,410

Expense items	Eligible medical expense (HKD)	HealthFlexi (Essential Plan) Estimated Coverage (HKD)
Pre-confinement treatment
Diagnostic imaging test (MRI)	5,500	3,850
Pre-confinement outpatient consultation	1,000	580
Confinement
Room and board	2,400 (800 x 3 days)	2,400
Miscellaneous charges	5,950	5,950
Attending doctor's visit fee	2,400 (800 x 3 days)	2,400
Surgeon's fee	41,800	27,000
Operating theatre charge	33,360	9,450
Anesthetist's fee	13,750	9,450
SMM benefit⁴	-	34,408 (with SMM)
Post-confinement treatment
Physiotherapy session	5,500 (1,100 x 5 visits)	5,500
Total	111,660	100,988 (with SMM) 66,580 (without SMM)

Expense items	Eligible medical expense (HKD)	HealthFlexi Plus estimated coverage (HKD)
Pre-confinement treatment
Diagnostic tests (including Breast Biopsy)	6,300	1,600
Confinement
Doctor's fee⁶	52,930	52,930
Operating theatre charge	22,920	22,920
Anesthetist's fee	14,550	14,550
Hospital charges⁷	18,540	18,540
Cancer treatment
Radiotherapy	100,000	100,000
Targeted Therapy	300,000	300,000
Hormonal therapy	1,000,000	1,000,000
Total	1,515,240	1,510,540

Expense items	Eligible medical expense (HKD)	HealthFlexi Plus estimated coverage (HKD)
Doctor's fee⁶	60,500	Fully cover the actual costs of hospital and surgical charges after the HKD 60,000 deductible
Operating theatre charge	28,510
Anesthetist's fee	17,000
Hospital charges⁷	20,950
Total	126,960	66,960

Other information

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.

Zurich will not pay any benefits in relation to or arising from the following expenses.

Treatments, procedures, medications, tests or services which are not medically necessary.
Confinement solely for the purpose of diagnostic procedures or allied health services, including but not limited to physiotherapy, occupational therapy and speech therapy.
Human Immunodeficiency Virus ("HIV") and its related Disability, which is contracted or occurs before the policy effective date, except for sexual assault, medical assistance, organ transplant, blood transfusions or blood donation, or infection at birth.
Dependence, overdose or influence of drugs, alcohol, narcotics or similar drugs or agents, self-inflicted injuries or attempted suicide, illegal activity, or venereal and sexually transmitted disease or its sequelae.
Services for beautification or cosmetic purposes, unless necessitated by Injury caused by an Accident or correcting visual acuity or refractive errors that can be corrected by fitting of spectacles or contact lens, including but not limited to LASIK.
Prophylactic treatment or preventive care, including but not limited to general check-ups, routine tests, screening procedures for asymptomatic conditions.
Dental treatment and oral and maxillofacial procedures performed by a dentist except for emergency treatment and surgery during confinement arising from an accident.
Medical services and counselling services relating to maternity conditions and its complications, including but not limited to abortion or miscarriage; birth control or reversal of birth control.
Purchase of durable medical equipment or appliances including but not limited to wheelchairs, hearing aids, or over-the-counter drugs.
Traditional Chinese medicine treatment, including but not limited to herbal treatment, bone-setting and, acupuncture, and other forms of alternative treatment including but not limited to qigong, massage therapy and aromatherapy.
Experimental or unproven medical technology or procedure.
Congenital condition(s) which have manifested or been diagnosed before the insured person attained the age of eight (8) years.
Eligible expenses which have been reimbursed under any law, or medical program or insurance policy provided by any government, company or other third party.
War (declared or undeclared), civil war, invasion, acts of foreign enemies, hostilities, rebellion, revolution, insurrection, or military or usurped power.

Premium and terms and benefits adjustments

The premiums will vary depending on the attained age of the Insured Person, at each policy anniversary and are not guaranteed. We may adjust the premium upon renewal according to the prevailing standard premium schedule adopted by us on an overall portfolio basis. In addition, we will regularly review our products including revising the premium rates. When reviewing the premium rates, we will consider our claims experience, medical cost inflation, and other factors.
We may revise the terms and benefits of the plans on an overall portfolio basis at the time of policy renewal. We will provide you with a written notice of any revision upon renewal or before the end of the policy year.

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

The policy will end if -

you fail to pay the premium within thirty (30) days after the due date;
the Insured Person dies; or
the Company has ceased to have the requisite authorisation under the Insurance Ordinance to write or continue to write this Policy

Other Important Information

The information in this website is for reference only and does not constitute any part of the insurance contract. For full terms and conditions and exclusions, please refer to the policy document itself which shall prevail in case of inconsistency. Zurich Insurance Company Ltd reserves the right of final approval and decision.
You are reminded to seek independent professional advice if necessary.
Both English and Chinese versions are official versions and neither one shall prevail over the other. Any inconsistency shall be interpreted in favour of the Policy Holder.