Children-Medical-Insurance-for-Age-6-to-11

As the school year commences in late August and early September, parents in Hong Kong, renowned for prioritising the education of their kids, have likely already prepared new uniforms, school bags, and supplies. However, with the school term also comes a spike in seasonal illnesses among children. That’s why securing robust health protection for your child, such as a comprehensive insurance plan, is just as important as preparing for their academics.

Parents who have already taken out health insurance for their kids can choose to visit private hospitals and file claims for eligible medical expenses. After living through the COVID-19 pandemic, many families are more proactive and willing to invest in better coverage. In this guide, we compare the premium and protection levels of "5-star" Voluntary Health Insurance Scheme (VHIS) Plans, considered among the best child insurance plans available in Hong Kong.

These “5-star” Voluntary Health Insurance Scheme (VHIS) plans earned a 10Life score of 9.5 or higher. This reflects their ability to cover the vast majority of medical expenses for 12 common illnesses and injuries, such as cancer and vascular diseases.¹. These plans are typically inflation-resistant, featuring no sub-limits and high annual benefit caps. For example, a common hospitalisation case for children due to high fever in a semi-private room could cost around HK$33,100, and all of the plans in this comparison would fully reimburse that amount².

As shown in Table 1, there are seven VHIS Plans at the semi-private room level offering annual premiums under HK$9,000 for kids aged 6 to 11 (before any promotional discounts). The most affordable option is AXA WiseGuard Pro Medical Insurance Plan (Enhance), with an average annual premium of HK$7,568. While some parents may still find this a steep cost, it's worth noting that premiums paid for qualifying VHIS plans for kids are tax-deductible, offering a practical way to offset part of the expense³.

Table 1: Premium Comparison – “5-Star” VHIS Plans (Semi-Private Room, HK$0 Deductible)

Some companies indeed provide group medical insurance for employees’ children, which might lead parents to think an additional plan is redundant. However, group coverage often comes with lower reimbursement limits and typically won’t offer full protection for more expensive treatments.

This is where deductible-based child insurance plans offer strong value. These plans generally have lower premiums while still providing full coverage once the deductible is met.

Take the Blue Cross Dynasty VHIS Plan (Worldwide) as an example. While the HK$0 deductible version has an annual premium of HK$13,596, the HK$20,000 deductible version costs just HK$4,361—a 68% reduction.

This article provides a high-level look at premiums for top-rated VHIS plans for kids, specifically at the semi-private room level. If you're looking to explore further, such as comparing different room types, detailed coverage breakdowns, or claim limits, you can use 10Life’s Comparison Tool to access in-depth comparisons.

Additional Notes:

10Life’s coverage estimates are based on common medical cases of varying severity and treatment types. These are matched against the benefit limits of each insurance product, with calculations performed by 10Life’s actuaries using typical medical costs in Hong Kong’s private  healthcare sector under normal circumstances. For details, please refer to the 10Life Medical Insurance Scoring Methodology. The estimated reimbursement rate for each medical case reflects how much the insurance is expected to cover based on average costs and is intended as a reference only. These figures have not been confirmed by the relevant insurance companies.

“Full coverage” refers to the insurer covering 100% of eligible medical and related expenses (after deductibles, if any), subject to applicable annual, lifetime, or per-condition policy limits, as well as other terms and conditions. Full coverage only applies to specific benefit items. Other benefits may still be capped by item-specific limits. All claims must meet the insurer’s definitions of “medically necessary” and “reasonable and customary” charges.

The maximum tax-deductible premium amount per insured person under VHIS is HK$8,000 per assessment year.

This article was compiled by 10Life using publicly available market data and is intended for general reference only. It does not account for individual needs or suitability and should not be taken as a sales recommendation. Please consult a licensed insurance advisor to determine the most appropriate coverage for your situation, and always refer to the insurer’s official documentation.

Premium information is accurate as of August 5, 2024, and does not include the levy collected by the Insurance Authority.

Beyond hospitalisation, what common types of medical services for children, such as specialist visits, vaccinations, or therapy, are typically covered or excluded by these VHIS plans?

VHIS plans for kids mainly cover inpatient care, such as hospital stays, surgery, and related treatments. However, they generally exclude outpatient services such as specialist visits, vaccinations, and developmental therapies like speech or occupational therapy. Some Flexi Plans may offer optional add-on riders for outpatient coverage, but this is not standard. Parents seeking more comprehensive health insurance for their kids may consider separate outpatient plans.

Does having a VHIS plan mean I can take my child to any doctor or hospital, or are there network limitations?

Most VHIS plans for children do not have network restrictions. You’re free to choose any licensed doctor or private hospital in Hong Kong, as long as the treatment is medically necessary and the charges are reasonable and customary. Some insurers offer preferred provider networks for faster claims or added services, but using them is optional. VHIS gives families flexibility to choose care that suits their child’s needs.