Prudential VHIS Series
Are VHIS plans underwritten by the Hong Kong government?
No, the VHIS plans are underwritten by insurance companies. We (Prudential) offer PRUHealth CoreChoice Medical Plan as a Standard Plan; and PRUHealth FlexiChoice Medical Plan and PRUHealth VHIS VIP Plan as a Flexi Plans and these three plans are underwritten by Prudential Hong Kong Limited (“Prudential”).
Does the Hong Kong government subsidise the VHIS plan?
There is no subsidy from the Hong Kong government to insurance companies for VHIS. However, tax deduction will be offered to encourage more Hong Kong residents to make use of private healthcare services and recalibrate the public-private healthcare balance.
In general, is my application guaranteed to be accepted when I apply for a VHIS plan?
No. We underwrite new applications based on the life assured’s health and other related risk factors. We will decide whether to accept your application on standard terms, accept it with increased premium and/or exclusions, or reject the application.
The high-risk pool proposed in the health reform public consultation in 2014 is not yet established due to diverse views on the public funding. As a result, guaranteed acceptance is not featured in the current VHIS scheme1.
How can I find out if the plans have been certified by the government?
What is a pre-existing condition?
A pre-existing condition is any sickness, disease, injury, physical, mental or medical condition or physiological degradation, including congenital condition, that has existed prior to the effective date of a medical insurance and is commonly excluded from medical insurance. Under the minimum requirement of VHIS plans, partial coverage is provided for unknown pre-existing conditions in the 2nd and 3rd policy year, and full coverage from the 4th year onwards.
For some Flexi Plans, the waiting period for unknown preexisting conditions could be shorter than the minimum requirement. For details, you may refer to the product provisions:
Do VHIS plans have exclusions?
Yes, VHIS plans have exclusions. There are two types:
General exclusions – These are listed in the VHIS Certified Plan Policy Template and these exclusions are applicable to all policies of VHIS plans.
Case-based exclusion – During the underwriting, insurance companies are allowed to assess the proposed life assured’s health condition and other related risk factors. Insurance companies may impose an exclusion of a particular sickness or disease from the coverage of VHIS plans based on a pre-existing condition or risk factors affecting the insurability of the proposed life assured.
If I am not a Hong Kong resident, can I purchase a certified VHIS certified plan from Prudential?
Prudential's VHIS plans are specially designed for Hong Kong residents who can enjoy the tax deduction offered by the Hong Kong Government. For residents of other places, we have a wide range of medical insurance products that may suit their needs. Please contact your consultant or call our Customer Service Hotline at 2281 1333 for more details.
How are the premium rates of VHIS plan determined?
We will determine the premium rates on a portfolio basis based on several factors, such as our claims and persistency experience, medical price inflation and projected future medical costs and any applicable changes in benefit. The premium rates are not guaranteed and are yearly adjustable.
What are the underwriting factors?
When we receive your application, we will assess the risk based on the information you give us. This includes (but is not limited to) the proposed life assured’s occupation, their hobbies, where they live, as well as their traveling pattern and health condition. We use this to decide whether to accept your application on standard terms, accept it with increased premiums and/or exclusions or reject it. When we look at the life assured’s occupation, our underwriting decision depends on factors such as what their job involves, where they work and the nature of the business. When we look at where they live, the decision depends on factors such as the location of their home and how long they have lived there.
Do I need to undergo a medical examination for taking out a VHIS plan?
There are a number of questions in the application form to guide you to provide medical information for the proposed life assured. In order to have a precise decision, an additional questionnaire and/or a medical examination may be required for some cases.
You can add a VHIS certified plan to your existing life insurance policy anytime so that you can enjoy the tax deduction as soon as possible. We will pro-rata your premium for the first policy year but you will enjoy your plan’s coverage in full.
How to apply
For new application
Contact your consultant or make an appointment.
Complete the Financial Needs Analysis (FNA) to identify the most suitable plan
Send us the completed application form and pay your premiums
We will underwrite* your plan based on your application form and issue your policy.
* When we receive your application, we will assess the risk based on the information you give us. This includes (but is not limited to) the life assured’s occupation, their hobbies, where they live, as well as their traveling pattern and health condition. We use this to decide whether to accept your application on standard terms, accept it with increased premiums and/or exclusions or reject it. When we look at the life assured’s occupation, our underwriting decision depends on factors such as what their job involves, where they work and the nature of the business. When we look at where they live, the decision depends on factors such as the location of their home and how long they have lived there.
Migrate from an existing plan
Please visit the section "About Migration" for more details.
After your VHIS plan becomes effective
Can I change my mind after the VHIS plan becomes effective?
Yes, like other life insurance plans, you will have a 21-day cooling-off period. You may cancel your VHIS plan within 21 days with full premium refund (including levy).
Will an additional premium loading be imposed at renewal if I have made a claim under the VHIS plan?
Once your VHIS plan becomes effective, no additional premium loading and / or case-based exclusion will be imposed even if you have claimed under the plan. This practice is also applicable to other Prudential’s non-VHIS plans.
We have the right to review and adjust the plan’s premium rates for particular risk classes on each policy anniversary, but not for any individual customer. We may adjust premium rates on a portfolio basis because of several factors, such as our claims and persistency experience, medical price inflation, projected future medical costs and any applicable changes in benefit.
How can I make an enquiry about the VHIS plan?
If you have any enquiry, suggestion or complaint, please let us know the details by sending us an email, fax or post.
Customer Service Department
Mail: P.O. Box No. 28058, Gloucester Road Post Office, Hong Kong
Fax: +852 2977 1233
You may also file your complaint about the issues specific to VHIS including product availability, features of the certified plans and compliance with the relevant code of practice to VHIS Office of Food and Health Bureau; or issues about our general conduct or that of our intermediaries to the Insurance Authority; or any issues concerning claims for tax deduction to Inland Revenue Department.
Voluntary Health Insurance Scheme Office
Mail: Units 2902, Millennium City 6, 392 Kwun Tong Road, Kowloon, Hong Kong
Hotline: +852 2529 8900
Fax: +852 2529 8982
Mail: 19th Floor, 41 Heung Yip Road, Wong Chuk Hang, Hong Kong
Hotline: +852 3899 9983
Fax: +852 3753 3812
Inland Revenue Department
Mail: Revenue Tower, 5 Gloucester Road, Wan Chai, Hong Kong
Hotline: +852 187 8088
Fax: +852 2519 9316
If I am admitted in a public hospital, am I eligible to claim for the hospital bill?
Yes. Your hospitalisation in public hospital is covered under the VHIS plans, we will pay according to the provisions and benefit schedule of the plan.
If I do not submit the claimable amount estimate application to you for claimable amount estimation before I receive the surgical procedures, does it affect my claim?
No. Your claim would not be affected. Claimable amount estimate is a value-added service to give you peace of mind before receiving medical treatment.
How to appoint or change policyowner/ representative policyowner?
As a policyowners, you can apply to transfer the ownership of your plan to:
the life assured if they have reached 18 years of age;
the parent or guardian of the life assured if they are under 18 years of age
any person with a familial relationship with the life assured.
Below is how you can do so:
Sign the form by the existing policyowner(s) and the new policyowner(s)
Send us the completed form
We will send you a confirmation letter and issue a new policy schedule to the new policyowner(s) afterward.
Follow the same steps above should you wish to:
Remove someone as a policyowner
Appoint or change representatives policyowners
Note: If the policy has more than 1 policyowner, all the policyowners should choose one of the policyowners as a “Representative Policyowner”, while the rest are named as “Joint Policyowner(s)”. The Representative Policyowner and Joint Policyowner(s) are all eligible for the tax deduction.
About tax deduction
How can I know my qualifying VHIS premiums for my tax return?
VHIS policyowners will receive a proof of premium payment in April of every year or on other occasions, e.g. change of policyowner. The proof of premium payment contains the transactions of the qualifying VHIS premiums paid for your VHIS plan that you may need for your tax deduction arrangement.
Is every policyowner of the VHIS plan eligible to claim the tax deduction?
The issuance of this plan does not necessarily mean you are eligible for any tax deduction for the qualifying VHIS premiums you have paid for this plan. For further information on tax deduction under the VHIS, please contact the Inland Revenue Department. We cannot provide you with any tax advice. If you have doubts, you should seek professional advice.
Yes. If you are the policyowner of the VHIS plan of a relative specified in Inland Revenue Ordinance, Cap.112 of the Laws of Hong Kong, you are eligible to claim the tax deduction. Specified relatives include your spouse, children, and your/your spouse’s parents, grandparents and siblings. Please refer to the Inland Revenue Ordinance for the detailed conditions of specified relatives.
What is migration?
‘Existing customers’ of our designated medical plans will be entitled to a one-off migration to transfer their existing medical plan to a VHIS plan within 1 Apr 2019 – 31 Dec 2021. Migrating your plan may require underwriting; it varies by plan. Please contact your consultant or call our Customer Service Hotline at 2281 1333 for more details.
‘Existing customers’ are customers who are HKID cardholders, with their designated medical plan which takes effect
- on or before 1 Apr 2019 for migration to PRUHealth Core Choice Medical Plan or PRUHealth FlexiChoice Medical Plan;
- on or before 3 Sep 2020 for migration to PRUHealth VHIS VIP Plan; and
- in-force at the time of migration
What are the designated medical plans eligible for migration?
The following medical plans are eligible for migration:
PRUhealth medical plus
PRUhealth secure top-up plan
PRUmed better care plan
PRUmed care plan
PRUmed health care plan
PRUmed lifelong care plan
PRUmyhealth prestige medical plan
PRUparent medical care plan
Note: The above plans have to take effect on or before 1 Apr 2019 for migration to PRUHealth Core Choice Medical Plan or PRUHealth FlexiChoice Medical Plan; and on or before 3 Sep 2020 for migration to PRUHealth VHIS VIP Plan. We may underwrite the migration application whether to accept it on standard terms, accept it with premium loading and/or exclusions, or reject it.
View the leaflet for more details including migration arrangement.
Is my existing non-VHIS plan eligible for migration? What are the plans available for migration?
If your existing medical plan takes effect on or before 1 Apr 2019, you can elect to migrate to the following plans:
PRUHealth Chore Choice Medical Plan,
PRUHealth FlexiChoice Medical Plan, or
PRUHealth VHIS VIP Plan
If your existing medical plan takes effect after 1 Apr 2019 and on or before 3 Sep 2020, you can elect to migrate to PRUHealth VHIS VIP Plan.
Can I migrate my existing medical plan any time during a policy year?
Yes. You can migrate to a VHIS plan anytime during the migration period (1 Apr 2019 – 31 Dec 2021) so that you can enjoy the tax deduction as soon as possible.
About claimable amount estimate
What’s your claimable amount estimate?
You may ask the healthcare services provider and/or the attending registered doctor to give you an estimate of the fees in relation to non-emergency surgical procedures to be performed, so you know how much you may claim for. We will provide the claimable amount estimate and the estimated out-of-pocket expense based on the life assured's (the person covered by the plan) policy coverage. This claimable amount estimate facility is only applicable to VHIS products. The claimable amount estimate is for reference only. The actual amount you can claim and your actual out-of-pocket expense will be subject to the final amount on the invoice from healthcare services provider and in accordance with the policy’s terms and conditions.
How to apply for claimable amount estimate?
Through your consultant
Submit your request through your Consultant and get the estimated results immediately after the information is input in the system
Submit your application via:
- myPrudential, or
- email, or
- post, or
- Customer Service Center
We will let you know the result or status via SMS. You can find more details on the result at myPrudential or thru your consultant.
For more details, please visit our claims and support page.
About Policy Documents
For PRUHealth VHIS VIP Plan
- For new application or renewal from 5 Jan 2021
- Previous version
For new application or renewal from 5 Jan 2021
For effective date before 5 Jan 2021
For PRUHealth FlexiChoice Medical Plan
- For new application or renewal from 5 Jan 2021
- Previous version
For new application or renewal from 5 Jan 2021
For effective date or renewal from 3 Mar 2020 to 4 Jan 2021
For effective date or renewal before 3 Mar 2020