Employee Benefits – Health Insurance

You’ve carefully prepared your resume and researched the company and hiring manager before crafting the perfect cover letter. You hold your breath, hit the send button and then you wait. After what seems like an eternity, you get an email asking you to come in for an interview – this is good.

You put on your Sunday best and practice your firmest handshake. The interview is long but for you it seemed like it was over in a flash; the good news is that you got the job.

At this point, what usually happens is that employers will send you an employment contract and some paperwork. Buried within that pile of paperwork would be some documents that outline your employee benefits. That is if you’re lucky enough to have any. In Hong Kong, employers are only required to provide you with EC insurance which pays if you’re injured on the job.

We write a lot of content from an employer’s prospective but this time, we wanted to write something for the employees and job seekers out there. In a 3 part series, we’ll be going over 3 types of employee benefits: health insurance, disability insurance and life insurance.

Here are some things to keep in mind when evaluating a job offer’s health insurance clause.

Does your health insurance policy pay the hospital directly or are they just reimbursing you after the fact?

This is an important question that is often overlooked. In Hong Kong, it is very common for health insurance companies to reimburse the insured for expenses after the fact. This means you have to pay the hospital or medical service provider upfront and then save your receipts to claim reimbursement from the insurance company after.

Depending on the type of injury or illness you’re suffering, costs can be big and can negatively impact your personal cash flow. Payment can also be delayed if you forget to collect all of your receipts and invoices.

Different health insurers will have direct billing arrangements with some hospitals but not others. Know which ones have direct billing if this is a concern for you.

Is there full coverage for cancer as an outpatient?

According to the Hong Kong Department of Health, 31% of all deaths recorded in 2013 were due to cancer. While I don’t mean to scare you, the point I wanted to make was that cancer is a very common occurrence so you want to make sure you’re protected.

If your employer’s health insurance plan does not provide you will full cancer coverage, you might want to consider topping up your coverage as costs can quickly spiral out of control. Cancer treatments at private hospitals can cost around HK$1.3 million according to the Cancer Information Hong Kong Charity Foundation.

Is there worldwide coverage? Does it include travels to the US?

This is an important question, especially if you’re required to travel for work. If your health insurance coverage doesn’t extend to covering treatments while you’re outside of Hong Kong, you might need to consider purchasing some standalone travel insurance coverage.

The same applies if you have worldwide coverage but travels to the US are excluded due to high medical costs and exchange rates.

Does your health insurance cover pre-existing conditions?

Another important question if you suffer from chronic health conditions. Pre-existing conditions are not covered automatically and if they are covered, you might need to declare them.

Generally speaking, insurance companies will only cover pre-existing conditions if you can show that they’ve been under control for the last 6-8 months.

Do they provide dental coverage?

And last but certainly not least, you should know whether you have dental coverage, how much you have, and what is covered. While you may never need to use your health insurance coverage, you will surely need to use your dental coverage at least twice a year.

Other important considerations

Will your policy cover your spouse or children? What about your partner if you’re unmarried? What about same-sex partners?

  • Is there a wait period? Most policies will stipulate a wait period of 90 days from policy inception. During this period of time, you are not able to make any claims.
  • What’s your deductible? A deductible is the amount you have to pay when making a claim. If you had a HK$5,000 deductible and a HK$25,000 claim, the insurance company would only pay you HK$20,000.
  • Who pays? Sometimes your employer will cover the full cost, sometimes its 50-50 and other times, they will deduct the premiums straight from your paycheque.

If you find you do need some extra coverage or just need help reviewing the insurance clauses in your employment contract, get in touch with a Trusted Union insurance advisor. We’ll be happy to help.