3. What is the minimum insurance coverage offered by Certified Plans?
All Certified Plans must meet the following conditions or offer the following coverage:[1]
- Guaranteed renewal up to 100 years of age (without re-underwriting)
- No "lifetime benefit limit"
- 21-day cooling off period
- Premium transparency
- Coverage extended to:
- Unknown pre-existing conditions (will be partially covered in 2nd year (25%) and 3rd year (50%) after policy inception and fully covered (100%) afterwards)
- Treatment of congenital conditions which have manifested or been diagnosed since the age of 8 will be covered
- Day case procedures such as endoscopy conducted in day centres will be covered
- Prescribed diagnostic imaging tests such as Computed Tomography (CT scan), Magnetic Resonance Imaging (MRI scan) and Positron Emission Tomography (PET scan) conducted during hospital stay or in an outpatient setting will be covered, subject to 30% coinsurance
- Prescribed non-surgical cancer treatments such as radiotherapy, chemotherapy and targeted therapy will be covered
- Psychiatric inpatient treatments in local hospitals will be covered up to the limit of HK$30,000 per policy year
There are two types of Certified Plans: Standard Plan which is fixed in product design and adheres to the minimum complying requirements of VHIS, and Flexi Plan which must provide basic protection equivalent to Standard Plan coverage plus a flexible top-up protection to suit market needs subject to certain rules set out by the Food and Health Bureau.[2]
[1] https://www.vhis.gov.hk/en/about_us/scheme.html
[2] https://www.vhis.gov.hk/en/consumer_corner/list-plans.html
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