What does a VHIS policy actually pay in its first year? Recommendations, the 0% the official summaries leave out, the 12-item Standard Plan schedule and the three things a Flexi Plan may cut, 2026

TL;DR Every consumer-facing official summary begins at "25% in the second year". The contract does not: the policy template says the first Policy Year is "no coverage". It is four steps, 0/25/50/100, not the three of 25/50/100. And what that 25% is a percentage of differs between the Chinese and English texts — do not read it as 25% of the bill.

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#The first year is "no coverage", not "25%"

Section 4 of Part 6 of the policy template is the only place that says what happens in the first year [Note 1]:

Both consumer-facing official summaries begin at the second year. The VHIS website's scheme page says that all Certified Plans "will provide partial coverage of unknown pre-existing conditions in the second and third year after policy inception, at 25% and 50% respectively. Full coverage i.e. 100% will be provided from the fourth year onwards"; question 17 of the official FAQ likewise begins at the second and third years [Note 2].

Neither passage says that the first Policy Year is "no coverage". It is item 24 of the Code of Practice's interpretation list that gives the whole of it: for the Standard Plan the waiting period is set at three Policy Years, with reimbursement ratios of 0%, 25% and 50% for the first three; a shorter waiting period or higher reimbursement ratio is encouraged for Flexi Plans.

⚠️ In one sentence: it is four steps, 0/25/50/100, not the three of 25/50/100. In the first year after buying, an admission caused by a pre-existing condition you did not know of and could not reasonably have known of pays nothing under a Standard Plan.

Two details about the "Policy Year" both change how long you actually wait.

The first Policy Year can be shorter than 12 months, and the waiting period is not extended because of it. Section 4.16(b) of the Code of Practice states that the waiting period for unknown pre-existing conditions should not be affected — the insured person can enjoy 25% reimbursement for unknown pre-existing conditions immediately after renewing the first Policy Year, even where that first Policy Year lasted less than 12 months. So "three Policy Years" can in principle run out in under 36 months.

⚠️ On a transfer, which date the waiting period runs from depends on the terms. Section 3.4 of the Code of Practice sets out two forms: one in which the waiting period after migration is counted from the inception date of the existing policy, and one in which it runs from the new policy's effective date or an earlier date specified by the company [Note 3]. The difference can be a full three years, so ask which applies before signing a transfer.

A word on how "unknown" is defined. The definition in Part 8 of the policy template is any sickness, disease, injury, physical, mental or medical condition or physiological degradation, including a congenital condition, that existed before the policy issuance date or the policy effective date, whichever is earlier; and an ordinary prudent person is to be taken to have been reasonably aware of it where it has been diagnosed, where it has manifested clear and distinct signs or symptoms, or where medical advice or treatment has been sought, recommended or received [Note 4].

⚠️ That definition carries no look-back limit of any kind — what it says is "has existed prior to the policy issuance date or the policy effective date", with no number of years. So the "within 3 years before applying" formulations in circulation have no source in any of the official documents cited here.

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#What is the 25% a percentage of? The Chinese and English texts differ

The contract's Chinese text reads 「按保障限額賠償百分之二十五」, anchoring the proportion explicitly to the benefit limit. The English text on the same line reads only "25% reimbursement", without saying 25% of what.

⚠️ This is not a translation blemish that can be set aside, because both versions are official versions. Section 1 of Part 2 of the policy template states it:

These Terms and Benefits have been prepared in both English and Chinese. 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.

[Note 5]

Paragraph (9) of the template's preamble likewise acknowledges that the two languages are not word-for-word equivalents, and paragraph 8(a) of the introduction reserves to the Health Bureau the final right to interpret the Scheme Documents, including the right to determine the meaning of the rules in both English and Chinese versions and to resolve inconsistency between the two versions of the same document.

So this article's position is to quote each text as it stands, to merge neither, and to adjudicate for nobody. And one practical thing follows: do not write, and do not believe, "25% of the bill". The English text does not say that, and the Chinese text says something else.

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#Disclosed pre-existing conditions: 0/25/50/100 has nothing to do with them

The four-step table applies only to what you neither knew nor could reasonably have known.

The paragraph above that table in Section 4 of Part 6 deals with the other case: eligible expenses arising from pre-existing conditions notified to the company in the application, subject to any case-based exclusions, are payable in accordance with the terms and benefits; and the company may impose case-based exclusions by reason of a pre-existing condition or other factor affecting insurability notified in the application [Note 6].

Which is to say: a condition you knew of and declared when applying does not travel the 0/25/50/100 road. It may be subject to a case-based exclusion from the outset — and a case-based exclusion has no term, and does not disappear of itself in the fourth year.

In exchange, after the policy issuance date or the policy effective date the company has no right to impose any additional case-based exclusion, save for the limited circumstances in Section 4 of Part 4.

Premium loading and exclusions are themselves permitted: question 31 of the official FAQ states that they are allowed "provided that there are pre-existing health conditions or other health risks such as smoking habit, family medical history and occupational hazard".

⚠️ And there is one arrangement only a Flexi Plan may make. Question 32 of the official FAQ:

The said situation is permitted for Flexi Plans when the product design encompasses a higher benefit layer by default and a lower benefit layer for the known pre-existing conditions of the insured person, and all the benefits are subject to the minimum protection as benchmarked by the Standard Plan.

[Note 7]

The Standard Plan has no such layering — it has only two states, paid and case-based exclusion. So somebody comparing the two classes with a known condition is not asking one question but two: under a Standard Plan, has it been made a case-based exclusion; under a Flexi Plan, there is the further question whether it has been put in a lower layer.

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#The Standard Plan Benefit Schedule: 12 items, in full

This schedule is the spine of the whole scheme, because it is also the floor for Flexi Plans. The template says so at the head of the table: this Benefit Schedule applies to all certified Standard Plans and represents the minimum complying requirements for all certified Flexi Plans.

The table holds 12 benefit items (a)–(l), plus two rows of "other limits" — the annual benefit limit and the lifetime benefit limit — 14 rows in all, in the document's own wording.

The five notes, in full, in the source's own English [Note 8]. And benefit item (l), psychiatric treatments, carries a restriction the schedule itself does not state: it covers inpatient treatment in Hong Kong only. The schedule gives only an amount; the geographical restriction is in two other official texts — the VHIS website's scheme page, which reads "Psychiatric inpatient treatments in local hospitals", and question 12 of the official FAQ, which puts it beside the overall geographical scope and makes clear that it applies to both classes of plan [Note 9].

That is: the layer of basic protection equivalent to the Standard Plan is required to be global, with psychiatric treatment alone limited to Hong Kong — for Standard Plans and equally for the basic protection layer of Flexi Plans. It is not something a Flexi Plan has cut away; it is the scope of the benefit item itself.

One thing is not complete here, and that has to be said: item (f), the surgeon's fee, is determined by category in the Schedule of Surgical Procedures, and that schedule occupies pages 42 to 57 of the English text, covering 475 categorised procedures across 13 body-system groupings.

⚠️ This article does not reproduce the full Schedule of Surgical Procedures, and treats no extract from it as a complete list. To find whether a procedure is complex, major, intermediate or minor, you must open those 16 pages of the policy template and look. The template also has a catch-all: where a surgical procedure is not listed, the company may reasonably determine its categorisation with reference to fee schedules recognised by the Government gazette or by relevant regulators or medical bodies.

The lifetime benefit limit reading "Nil" is not an omission. Section 2.16 of the Compliance Rules: "Lifetime Benefit Limit is not allowed at plan level and for specific benefit items."

As for whether a Standard Plan may carry a deductible or coinsurance — it may, but within an extremely narrow range. Sections 2.14 and 2.15 of the Compliance Rules: a deductible is allowed for a Standard Plan only when it applies to Other Benefits; and coinsurance other than the 30% coinsurance for prescribed diagnostic imaging tests is only allowed for Other Benefits of the Standard Plan [Note 10].

So among the 12 items in this table, the only cost-sharing a Standard Plan may impose is the 30% coinsurance at item (i). There is no other.

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#Three things that are easy to misread, each of them written in the table itself

One, the units differ. Items (a), (c) and (e) are "per day" plus "maximum X days per Policy Year"; (b), (d), (i), (j) and (l) are "per Policy Year"; (f) is "per surgery"; and (k) is "per visit" plus "per Policy Year". Three kinds of unit in one table is where the arithmetic most often goes wrong.

Two, (g) and (h) are not fixed amounts but percentages, and the base of the percentage floats. Note (5) says it plainly: the 35% applies to "the Surgeon's fee actually payable or the benefit limit for the Surgeon's fee according to the surgical categorisation, whichever is the lower".

Three, note (1) forbids double counting. Eligible expenses incurred in respect of the same item shall not be recoverable under more than one benefit item in the table.

Two easily confused terms are worth separating, in the words of the glossary at Annex III of the Compliance Rules [Note 11]. A deductible is a fixed amount — "a fixed amount of eligible expenses that, in a Policy Year, the Policy Holder must pay before the Company reimburses the remaining eligible expenses". Coinsurance is a proportion — "a percentage of eligible expenses the Policy Holder must contribute after paying the Deductible (if any) in a Policy Year".

⚠️ Neither is the same as the part above the limit. The glossary says so itself: "For the avoidance of doubt, Coinsurance does not refer to any amount that the Policy Holder is required to pay if the actual expenses exceed the benefit limits of the Certified Plan." The part above the limit is a third thing, and every policy leaves it to you. Confusing these three is how the sum goes wrong.

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#A Flexi Plan may cut only three things

A Flexi Plan is not "another kind of product" but "a Standard Plan plus something extra" — and that is the pivot of the whole comparison.

Sections 1.5 and 1.6 of the Compliance Rules: a Standard Plan is virtually fixed in product design, save for minor allowable variations, and must offer terms and benefits equivalent to the minimum requirements of Certified Plans under the VHIS, namely Basic Benefits; a Flexi Plan must provide Enhanced Benefits in addition to the Basic Benefits, and its design must adhere to the "better-off principle", entailing terms and benefits that will bring more protection to the customers when compared with a Standard Plan while policy holders' entitlement to the Basic Benefits would not be adversely affected, save for the exceptions in Section 6.5 [Note 12].

Section 1.8 settles the relationship between the two in a three-row table:

⚠️ Note that Enhanced Benefits are "must not include" in the Standard Plan column — so the two are not "one with less and one with more" but mutually exclusive by definition.

Only three things may be cut [Note 13]:

The three upgrades that may not be adjusted under Section 6.3 are: unavailability of accommodation at the specified ward class due to ward or room shortage for emergency treatment; isolation reasons requiring a specific class of accommodation; and other reasons not involving personal preference of the policy holders or insured persons.

On the same principle, a deductible, coinsurance and a lifetime benefit limit (Compliance Rules 3.16, 3.17 and 3.18) may be applied only to Enhanced Benefits, Other Benefits, or the situation specified under Section 6.5.

⚠️ Section 6.5's special approval is not a fourth thing that may be cut; on the contrary, Compliance Rules 1.6 names it in terms as the exception — only with the Health Bureau's approval and on satisfying all six conditions of 6.5 may a deductible, coinsurance or a lifetime benefit limit be applied to the layer equivalent to the Standard Plan.

But note that the layer equivalent to a Standard Plan already carries a built-in geographical exception of its own: psychiatric treatment is limited to Hong Kong — a restriction both classes of plan carry, and not something a Flexi Plan has cut out under 6.2.

So as far as coverage goes, the only meaningful way to compare Flexi Plans is to compare what each adds and what each has cut in those three places — because the layer underneath is, as a matter of law, identical in every one of them.

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#What counts as an "Enhanced Benefit"

Section 4.2 of the Compliance Rules divides Enhanced Benefits in two [Note 14]. Type 1 is built on the Standard Plan framework and covers four things: higher benefit limits (for example supplementary major medical coverage); extra benefit items (for example expenses on a companion bed during confinement); reduction or removal of the 30% coinsurance for prescribed diagnostic imaging tests; and amendment to policy terms and benefits to the advantage of policy holders, such as reduction in the scope of general exclusions or a shorter waiting period for unknown pre-existing conditions.

Type 2 is prescribed by the Health Bureau and listed at Annex I, and there are 6 of them: donor benefit, emergency outpatient care, home nursing, hospice and palliative care, outpatient kidney dialysis, and rehabilitative care.

Annex I also sets an actuarial threshold: all the Enhanced Benefits (both those defined by principle and those prescribed in the Annex) together with the Basic Benefits must constitute at least 90% of the actuarially fair value of the Certified Plan on average terms across all ages and gender. The matching ceiling is at Annex II: all the Other Benefits (accidental death benefit, cash benefit, health check, dental and the rest of the 14 prescribed items) must not constitute more than 10% of the actuarially fair value on the same basis.

In one sentence: at least 90% of a Certified Plan's actuarially fair value must sit in the wider category of Basic Benefits plus Enhanced Benefits, and those six prescribed enhanced benefits are not themselves hospital or surgical cover; it is only Other Benefits that the 10% ceiling regulates. What the rule does is stop a product being sold on a pile of non-hospital sweeteners.

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#Who can buy: this distinction hangs on one side only

Coverage is wider under a Flexi Plan; but on whether you can buy at all, the protection is institutionally attached to the Standard Plan. That asymmetry appears on no "benefit comparison table", because it is not a benefit term.

Section 2.5 of the Code of Practice and its note 2: companies are required to consider applications for Certified Plans in relation to persons to be insured who are Hong Kong residents and aged between 15 days and 80 years, that requirement being capable of exemption for Certified Plans whose product design is targeted at particular age groups. Section 2.11 of the Compliance Rules: "Companies offering Standard Plan are required to consider applications in relation to persons to be insured who are Hong Kong residents, and aged between 15 days and 80 years. A Standard Plan is not allowed to target at particular age groups of customers." [Note 15]

The section immediately following, 2.12, opens a narrow exception, and it has nothing to do with the Basic Benefits: certain Other Benefits under a Standard Plan may target a particular age group subject to the Health Bureau's approval.

That is, the exception is available only to the optional Other Benefits part of a Standard Plan; the mandatory Basic Benefits layer is untouched by it.

The matching duties to supply and the exemptions from them are in Code of Practice sections 2.3, 2.4 and 2.17 [Note 16]:

⚠️ And throughout, "required to consider" is not "required to accept". Question 30 of the official FAQ: "The participating insurance companies may decline an application after a fair and reasonable underwriting process in accordance with the principles set out in the Code of Practice under VHIS."

So if you are older, or buying for the first time, remember that the plan you are entitled to have considered is the Standard Plan.

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#Section 6.5's special approval: two official documents describe different things

This is the most technical section, and the most practical for anyone choosing a Flexi Plan with a deductible — because two official documents list different conditions for the same exemption.

Section 6.5 of the Compliance Rules sets out six conditions [Note 17]; question 9 of the official FAQ, describing the same exemption, lists three.

The two do not match, and each contains something the other omits:

• The FAQ's (b) adds an absolute floor of HK$20 million that the Compliance Rules never state ("or 4 times of annual benefit limit, whichever is higher"); Compliance Rules 6.5(f) says only that the lifetime benefit limit "must be at least 4 times of the Annual Benefit Limit at plan level".
• The FAQ does not mention Compliance Rules 6.5(c) at all — the cap under which the out-of-pocket amount on all deductibles and coinsurance in a Policy Year must not exceed 3% of the annual benefit limit. That is a consumer protection which appears only in the Compliance Rules and not in the FAQ.
• The FAQ's (c) drops the "itemised Deductible and/or Coinsurance" half of 6.5(b).
• The FAQ does not mention 6.5(d): before the policy is in force you must be given an option for coverage without any deductible and coinsurance at plan level.
• And it runs the other way too: the paragraph immediately after question 9's three items states something Section 6.5 of the Compliance Rules nowhere says in terms — "As in the case of all Flexi Plans, the policyholders should be provided with the option to switch to the Standard Plan without re-underwriting upon policy renewal. This means that the policyholders of the Flexi Plans with exemption mentioned above can continue to enjoy protection under Standard Plan even if the lifetime benefit limit is reached." [Note 18] That sentence is about all Flexi Plans, not only those with a lifetime benefit limit.

Note that Compliance Rules 6.5(e) is about something else — switching, within the same product, to the option without deductible and coinsurance; the two cannot be substituted for one another.

On dates, the FAQ (reviewed 9 July 2026) is newer than the Compliance Rules (the version as at 1 July 2022). But the Compliance Rules are a Scheme Document and the instrument product certification rests on; paragraph 7 of the policy template's introduction says of supplementary material such as the FAQ that "such information will not form part of the Scheme Documents but will provide guidance on the interpretation and/or elaboration". This article reproduces both, dates each, and does not pick one for the Government.

⚠️ How to use this: if you are looking at a Flexi Plan with a plan-level deductible, the 3% cap at 6.5(c) and the two rights at 6.5(d) and (e) to move to a version without a deductible are things the FAQ alone will not tell you — you have to open the Compliance Rules. Conversely, "you should be able to switch to the Standard Plan without re-underwriting at renewal, and keep the Standard Plan layer even after exhausting a lifetime limit" is something the Compliance Rules alone will not tell you — you have to open question 9 of the FAQ. Read both.

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#A Certified Plan is not legislation — which is why nobody regulates the premium

To follow the difference between the three classes of product, the first thing to know is that VHIS is not a statute but a set of rules made by the Government which insurers join voluntarily. That structural fact explains almost every oddity that follows.

Paragraph 5 of the policy template's introduction lists the four Scheme Documents a product provider must comply with: the registration rules, the policy template, the product compliance rules, and the code of practice. Paragraph 6 then settles the character of the whole scheme in a sentence: "The Scheme Documents are non-statutory in nature. They should not supplant or conflict with any applicable statutes, laws, rules, regulations, codes or guidelines." [Note 19]

The only genuinely statutory gate is a pair of them — Compliance Rules 1.2(a) requires a Certified Plan to be a contract of insurance either falling within Class 2 (sickness) of Part 3 of Schedule 1 to the Insurance Ordinance (Chapter 41), providing benefits in the nature of indemnity against risk of loss attributable to sickness or infirmity, or combining long term business and additional business of the nature in relation to Class 2 (sickness) under paragraph 3 of Part 1 of Schedule 1 to the same Ordinance — that is, a medical rider attached to a life policy. And the only law ever actually made for VHIS is the tax deduction amendment of 2018. There is no "Voluntary Health Insurance Ordinance".

How do the rules bind an insurer, then? By contract. Paragraph 5 of the policy template states that the terms and benefits of all Certified Plans must be based on that template, and a product must be certified by the Health Bureau before it can be marketed as a Certified Plan. That is, the rules are enforced not through criminal liability but through "comply or you are not certified; not certified and you may not call it a Certified Plan, and there is no tax deduction either".

That structure directly explains why nobody regulates the premium. Question 24 of the official FAQ answers it flatly: "The Health Bureau does not regulate the premiums of Certified Plans. However, the participating insurance companies have to publish the premium schedules of their Certified Plans that facilitate comparison and the premium schedule of all Certified Plans of insurance companies can be accessed on the official VHIS website." [Note 20]

In one sentence: the Government regulates the terms, not the price; it substitutes "publish it so you can compare" for "set it". So when you see the same benefit schedule at premiums that differ twofold, that is not a loophole but the design.

Paragraph 7 of the introduction adds one more layer: the Health Bureau may clarify or elaborate through such forms as the FAQ, but that information "will not form part of the Scheme Documents but will provide guidance on the interpretation and/or elaboration". That sentence has already become important, in the Section 6.5 discussion above.

⚠️ For anyone who takes "government certified" to mean "government priced" or "government guaranteed": what the Government sets is the minimum terms, not the price, and not any obligation to insure you.

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#The two things cut from the 2014 proposal

Today's VHIS is a version of a 2014 proposal after two things were cut out; knowing what was cut explains why some people cannot buy, and why there is no "policy portability".

The origin is the two-stage public consultation on healthcare reform in 2008 and 2010. The Legislative Council brief of January 2015 records that the public had reservations about a mandatory scheme, so the Government instead proposed a voluntary, government-regulated private health insurance scheme.

The consultation document of December 2014 put forward 12 "minimum requirements" — the only government document ever to set out a numbered list. The seventh chapter of the Report on Consultation on Voluntary Health Insurance Scheme of January 2017 explains which two were deferred: because "guaranteed acceptance with a capped premium loading" and policy "portability" both depended on whether a high risk pool would be established, those two minimum requirements would be dealt with together with the high risk pool at a later stage [Note 21].

⚠️ That is, guaranteed acceptance and policy portability were both taken out in 2017 and have never been implemented. So buying a Certified Plan today carries no guarantee of acceptance, and changing company means underwriting again.

But "no guaranteed acceptance" does not mean the two classes have the same threshold — institutionally, the duty to "consider your application" is anchored on the Standard Plan side.

The same report also explains why non-certified products remain on the market: it recommended allowing underwriters to offer and sell individual hospital insurance products not meeting the minimum requirements, so as to serve the needs of some consumers; and for the avoidance of doubt, products not complying with VHIS requirements would not qualify for tax deduction.

Section 4.3 of the Research Brief of the Legislative Council Secretariat's Research Office, dated 3 July 2018, is the only official document found that raises doubts about the arrangement, and it makes three points: the regulatory mechanism is purely voluntary, and the non-complying policies already in the market remain "lightly regulated"; the minimum product requirements exclude the two major proposals of guaranteed renewal and policy portability, weakening the overall appeal; and third — the minimum requirements set for Certified Plans "are not entirely new proposals, as some of them are already found in existing individual health insurance products" [Note 22]. (That section has a fourth and fifth point, which this article does not quote.)

⚠️ For anyone holding an older medical policy bought before 2019 and wondering whether "the Government regulated it later, so does mine upgrade automatically": no — non-certified products may lawfully continue to be sold and renewed, and the VHIS rules do not reach back. But the third point in that same passage runs the other way: the assumption that "an old policy must be worse in every respect than a Certified Plan" has no official support either. The Research Brief does not say which requirements, nor how many old policies carry them. The only way to know whether yours does is to take your own terms and match them item by item against the benefit schedule above.

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#"Guaranteed renewal" has exceptions: a change of residence or occupation may trigger re-underwriting

The Government has itself listed what a Certified Plan adds. The press release of 29 March 2019 announcing full implementation lists five features [Note 23], of which item (i) is guaranteed renewal to the age of 100 irrespective of any change in the insured person's health condition, without re-underwriting.

That is the Government's own summary. The contract is not so absolute — the heading of Section 4 of Part 4 of the policy template says as much: "No re-underwriting except in limited circumstances".

The health layer of that protection is absolute:

While these Terms and Benefits are in force, the Company shall not have the right to re-underwrite these Terms and Benefits irrespective of any change in health conditions of the Insured Person after the Policy Issuance Date or the Policy Effective Date, whichever is the earlier.

So worsening health, a new diagnosis, an admission — none of them can be a reason to re-underwrite. On that the Government's summary is not wrong. But the same section then lists four circumstances in which the company does have the right [Note 24]:

Case (b) runs the other way too. The template sets two sub-paragraphs beneath it: at any time where the policy holder asks to unsubscribe additional benefits, or to switch to a plan providing downgraded or reduced benefits, the company has no right to re-underwrite, though it may accept or reject the request according to its prevailing practices; and if the request is rejected, or the result not accepted, the company still has no right to terminate or not to renew.

⚠️ Cases (c) and (d) are marked "[Optional]" in the template — that is, an individual product may adopt them or not, and only your own policy terms will tell you whether yours has. Each carries five preconditions: the company took the factor into account in underwriting before inception; it specifically informed the policy holder at the time of application that a change could lead to re-underwriting at renewal; it maintains underwriting practices showing unambiguously how such changes affect the result, readily accessible to the policy holder; the re-underwriting is carried out solely in respect of that change; and fifth, in the template's own blunt words — "The re-underwriting result may be more advantageous or adverse to the Policy Holder and the Insured Person."

Both paragraphs also place a duty on the policy holder: the company has the obligation to request the policy holder to inform it of any change in the insured person's place of residence — that is, whether at the renewal date it differs from that at the last renewal date — and after receiving the request the policy holder has the obligation to inform the company. The occupation paragraph is drawn the same way.

And what may follow an allowed re-underwriting is in paragraph (f) of the same section: "as a result of re-underwriting, these Terms and Benefits may be terminated, new Premium Loading may be applied, existing Premium Loading may be adjusted upwards or downwards, new Case-based Exclusion(s) may be applied, and existing Case-based Exclusion(s) may be revised or removed."

⚠️ So "you will never be underwritten again" is inaccurate. The accurate statement is three sentences: a change in health can never trigger re-underwriting; a change of residence or occupation may, depending on whether that policy adopted those two optional paragraphs; and once triggered, the template says the result "may be more advantageous or adverse".

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#The institutional differences between the three classes of product

The "traditional medical insurance" column reflects only what the official documents cited in this article support; those documents contain no survey of the actual terms of traditional products in the market.

⚠️ The cooling-off period applies to new policies only. After setting out the "not less than 21 days" condition, Section 2 of Part 2 of the policy template adds that the right of cancellation does not apply to renewal. The same section also provides that no refund can be made if a benefit payment has been made, is to be made or is impending. Note 7 to Section 4.14 of the Code of Practice makes clear that the exception includes renewal under the migration arrangement [Note 25].

That is: migrating or renewing from an old policy into a Certified Plan does not bring another 21 days in which to change your mind — the most practical point for anyone weighing whether to transfer.

Three things have to be stated, and none of them can be inferred from the table.

One, "guaranteed renewal" guarantees that the company cannot turn you out; it does not guarantee that you can afford it. Section 2 of Part 4 of the policy template also gives the company the right to adjust the standard premium for all policies of the same portfolio according to the premium schedule then in force; and Section 15(a) of Part 2 provides that the policy terminates automatically where premium remains unpaid after the grace period.

And "cannot turn you out" itself has a condition: the sentence in Section 1 of Part 4 begins with "Unless" [Note 26]. Where the company has merely ceased its VHIS registration while keeping its authorisation under the Insurance Ordinance, automatic renewal is still required; but where it has lost that authorisation, the protection of automatic renewal does not apply — and Section 15 of Part 2 lists that as one of the circumstances in which the policy terminates automatically.

Two, guaranteed acceptance does not exist. That requirement, proposed in 2014, was deferred in 2017 and has not been implemented since.

Three, traditional products vary enormously. An old policy from the 1990s may be more generous than a Standard Plan on some items and much worse on others. The official material cited here contains no survey of traditional products at all, so this article will not say what traditional medical insurance is "generally" like. To compare, you can only take your own policy terms and match them item by item against the benefit schedule above.

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#Premiums: what the Government has published, and what it does not regulate

The Government does not set premiums, but it has in fact published a cross-company summary of Standard Plan premiums — and many people do not know it exists, because it appears only as an Excel link at the foot of one page.

The document is called Summary of Standard Premium of VHIS Standard Plan (HKD), in separate files for female and male, stating within itself "as at 17 July 2026", covering every age from 0 to 100 across 30 VHIS product providers in 43 data columns (a company that prices a standalone policy and a rider separately, or splits by age band at application, occupies more than one column).

The table below gives, at selected ages, the lowest and highest published annual standard premium among all columns carrying a figure. Only the range is reported here; nothing is ranked and no company is named.

Each of the six rows above draws on 34 columns carrying a figure. That is fewer than 43 because some columns apply only to particular ages at application (some, for instance, take new business only at ages 60–69 or 65–70) and carry no figure at other ages. The figures are annual standard premiums and exclude the Insurance Authority levy.

⚠️ The table stops at 50, and that is deliberate. At 30, 40 and 50, every figure filled in falls within that column's own range of "age at application". By 60 the number of filled columns rises to 35, and among them is one whose "age at new application" reads 0-59 and whose "age at renewal" reads 60-99 — meaning that column's figure at 60 is a renewal price and not a price for new business. Taking the highest and lowest at 60 directly would mix renewal-only prices with new-business prices, so this article does not list them.

How to read these figures.

At the same age and on the same benefit schedule, the highest is roughly twice to two and a half times the lowest, with the male-at-30 cell ($1,620 to $4,104, about 2.53 times) a little above two and a half. That gap is not a gap in coverage — every certified Standard Plan uses the same benefit schedule. What differs is pricing.

⚠️ "The same age" is itself a trap. Section 4.10(b) of the Code of Practice requires each company to disclose its definition of "age" (age last birthday, age next birthday, or age nearest birthday). The summary itself shows columns reading "age nearest birthday 0-81", others "age next birthday 1-81", and others "0-80". Comparing across a row at "60" may not be comparing people born on the same day. Check each premium schedule's own age basis before choosing.

⚠️ The "70" cell in today's table is not what you will pay at 70. The summary's own notes to readers put it plainly: premiums are generally determined by age and adjusted on renewal, and the standard premiums shown in the premium schedule for ages higher than your current age may be adjusted by the time you reach those ages [Note 27].

The same notes also state what the table itself is: in no circumstances should it be construed as a recommendation by the Health Bureau of any particular insurance product or insurance company, and consumers should not rely on this table alone in choosing an insurance product.

As to what constrains increases, officials give two accounts and this article reproduces both: question 26 of the official FAQ says the rate of adjustment in your case "must equally apply to other customers within the same age-gender group of your insurance plan"; while the contractual language in Section 2 of Part 4 of the policy template is adjustment across all policies of the same portfolio, "portfolio" being defined in Part 8 as all policies of the same terms and conditions and benefit schedule as certified by the Government as a Certified Plan. They are not the same unit, and "portfolio" is the wider of the two. Both are current official texts, and this article records both without reconciling them.

This article publishes no premium table for Flexi Plans — their coverage differs from company to company, the Government has never issued a cross-company summary for them, and Section 4.10 of the Code of Practice requires only that each company disclose its own. Without a common basis, any cross-company table of Flexi Plan premiums would mean nothing.

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#A worked example: get the units right first

Everything here uses figures already quoted above, and it demonstrates the thing most often got wrong — the units.

Example one: a Standard Plan, 10 days in hospital (3 of them in intensive care) plus one "major" operation. Built from the benefit schedule's limits (these are per-item ceilings; what is actually paid depends on the actual eligible expenses).

⚠️ One thing first: the items below cannot simply be added into a total. Note (1) of the benefit schedule says that eligible expenses incurred in respect of the same item shall not be recoverable under more than one benefit item — of the 10 days, the 3 in intensive care cannot have the same expense paid once under (a) room and board and again under (e) intensive care. How it is apportioned depends on the policy terms; officials have published no worked example, and this article will not supply one.

Whatever is actually paid on those seven items counts towards the $420,000 per Policy Year annual limit for items (a)–(l); each item also has its own sub-ceiling, and both layers apply at once.

Three unit traps, each of which will throw the arithmetic out.

(b) miscellaneous charges is "$14,000 per Policy Year", not "$14,000 per admission". Two admissions in the same Policy Year share that $14,000 between them. Treating it as per-admission, as in the table above, overstates it.

The 35% at (g) and (h) is not necessarily worked on $25,000, and the base is not "what the doctor billed". Note (5) says it applies to the surgeon's fee actually payable or the categorised benefit limit, whichever is lower — that is the amount actually paid, not the amount on the doctor's invoice, and the two need not be equal. For instance: if the surgeon bills $18,000 (below the $25,000 limit for a "major" procedure) and the whole of it is eligible and paid in full under item (f), then the 35% is worked on $18,000 rather than $25,000, giving $6,300 rather than $8,750. If that $18,000 is not paid in full for some other reason, the amount actually paid is lower still, and the base for the 35% falls with it.

Note (1) forbids the same expense being paid under two items. That is why the table has no total. Adding rows (a) and (e) in full on your own spreadsheet is the commonest overstatement there is.

Example two: the 30% coinsurance on prescribed diagnostic imaging tests. Question 8(f)(iv) of the official FAQ gives its own worked example: on eligible expenses of $5,000, the policy holder bears 30%, that is $1,500, and the insurer pays 70%, that is $3,500.

⚠️ One thing the official example does not add: item (i) also carries a limit of $20,000 per Policy Year. So it has to be read in two steps — first whether the expense exceeds the annual limit, and then the coinsurance. If $20,000 has already been used in that Policy Year, the next such expense is not "70% paid" but "not paid"; the part above the limit is not coinsurance.

Example three: what the 3% cap in Section 6.5 comes to in money. Compliance Rules 6.5(c) works it out itself: an annual benefit limit of HK$5 million × 3% = HK$150,000, being the ceiling on all deductibles and coinsurance in that Policy Year (including the 30% coinsurance on prescribed diagnostic imaging tests). The higher the annual limit, the higher that cap in proportion — at HK$10 million it is HK$300,000.

⚠️ Note the unit: that 3% is a total out-of-pocket ceiling "per Policy Year", not "per admission". And it applies only to Flexi Plans specially approved by the Health Bureau and meeting all the conditions of 6.5.

Example four: the "25%" of the second Policy Year, which is not 25% of the bill. Taking the Chinese text's construction together with the benefit schedule: suppose that in the second Policy Year a pre-existing condition unknown at application leads to a claim under item (l), psychiatric treatments (which covers inpatient treatment in Hong Kong only). That item's limit is $30,000 per Policy Year, so on the Chinese text's construction the ceiling on reimbursement is $30,000 × 25% = $7,500.

The English text on the same line says only "25% reimbursement", without a base; read as 25% of the bill, a $50,000 invoice would give $12,500 — which is not the same as the $7,500 above. This article does not choose between them for the Government.

⚠️ And there is a further layer nobody official has answered: where a claim for a pre-existing condition unknown at application also involves a prescribed diagnostic imaging test carrying 30% coinsurance, whether the 25% is applied before or after the coinsurance is addressed in none of the official documents cited here. This article does not work it out either.

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#What to do next

1. Ask yourself first whether you will need it this year. For a pre-existing condition unknown at application, the first Policy Year under a Standard Plan is zero, not 25%.
2. Do not estimate the second year as "25% of the bill". The Chinese text anchors it to the benefit limit; the English text gives no base. Both are official versions.
3. A condition you already knew of at application travels a different road. The four-step table does not apply; the question is whether it has been made a case-based exclusion, and a case-based exclusion has no term.
4. When comparing Flexi Plans, compare only two things: what Enhanced Benefits it adds, and what it has cut in the three places — coverage outside Hong Kong, ward upgrades, and the healthcare provider network. The layer underneath is, as a matter of law, the same in every one.
5. If you are older or buying for the first time, remember that the plan you are entitled to have considered is the Standard Plan. But "required to consider" is not "required to accept".
6. Seeing a Flexi Plan sold on "high deductible, low premium", open Section 6.5 of the Compliance Rules and check the 3% cap and the two rights to move to a version without a deductible — the FAQ does not carry them.
7. Take any quotation to the official summary. There is a cross-company summary for Standard Plans; there is none for Flexi Plans, and there will not be.
8. Migrating from an old policy, ask two things first: from which date the waiting period runs, and note that there is no 21-day cooling-off period on a migration.

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#Frequently asked questions

How much is paid in the first year for a pre-existing condition I did not know about?

Section 4 of Part 6 of the policy template says the first Policy Year is "no coverage". Item 24 of the Code of Practice's interpretation list likewise gives reimbursement ratios of 0%, 25% and 50% for the first three Policy Years. Every consumer-facing official summary begins at the second year, which is the commonest source of the misunderstanding.

Is the "25% reimbursement" calculated on the bill or on the limit?

The Chinese text reads 「按保障限額賠償百分之二十五」, against the benefit limit; the English text on the same line reads only "25% reimbursement", with no base. Both versions are official and neither prevails; the template provides that any inconsistency is to be interpreted in favour of the policy holder, and the Health Bureau reserves the final right of interpretation. This article does not adjudicate, but do not read it as 25% of the bill.

If I declared a condition when I applied, is it paid in full after three years?

No. The 0/25/50/100 table is written only for what you neither knew nor could reasonably have known. A disclosed pre-existing condition is dealt with by the first paragraph of Section 4 of Part 6: it may be subject to a case-based exclusion and to premium loading (FAQ question 31), and a case-based exclusion has no term and does not disappear of itself in the fourth year.

How do the limit and the coinsurance work for prescribed diagnostic imaging tests under a Standard Plan?

Item (i) of the benefit schedule reads "$20,000 per Policy Year; subject to 30% Coinsurance". Read it in two steps: first whether the $20,000 annual limit has been used up in that Policy Year, then the 30% coinsurance. The part above the limit is not coinsurance.

How much a day is intensive care, and for how many days?

Item (e): $3,500 per day, maximum 25 days per Policy Year.

Does the Standard Plan Benefit Schedule have a "deposit" item?

No. The schedule has 12 benefit items (a)–(l) plus two rows of "other limits", all set out above, and none of them is a deposit of any kind.

Can that $30,000 of psychiatric treatment be used for an admission abroad?

No. The VHIS website's scheme page reads "Psychiatric inpatient treatments in local hospitals will be covered up to the limit of HK$30,000 per policy year"; and question 12 of the official FAQ states that the Standard Plan and the basic protection of Flexi Plans equivalent to it are required to provide global coverage, "except for psychiatric treatments that are limited to Hong Kong" — the same for both classes.

Migrating from an old policy into a Certified Plan, is there a 21-day cooling-off period?

No. After the 21-day condition, Section 2 of Part 2 of the policy template states that the right of cancellation does not apply to renewal; note 7 to Section 4.14 of the Code of Practice makes clear that the exception includes renewal under the migration arrangement. The same section also provides that no refund is made if a benefit payment has been made or is impending.

For which class of plan does the company have a duty to consider my application?

Code of Practice 2.5 and Compliance Rules 2.11 require applications to be considered from Hong Kong residents aged 15 days to 80 years, and that duty is anchored on the Standard Plan — a Standard Plan may not target particular age groups, and one must be available for new application throughout the company's registration (Code of Practice 2.3). A Flexi Plan may, with the Health Bureau's approval, target particular age or client groups and decline to consider others (2.17), and may cease receiving applications at any time (2.4). "Required to consider" is not "required to accept" (FAQ question 30).

Can a Flexi Plan pay less than a Standard Plan?

Only in three places: coverage outside Hong Kong (6.2), ward upgrades above the specified class (6.3, apart from three kinds of involuntary upgrade), and restrictions on healthcare service providers for the Enhanced Benefits part (6.4) — none of which may affect the Basic Benefits layer equivalent to the Standard Plan. The sole exception is a Flexi Plan specially approved by the Health Bureau and meeting all six conditions of Section 6.5: Compliance Rules 1.6 names 6.5 in terms as the exception to that principle, and only in that case may a deductible, coinsurance or a lifetime benefit limit be applied to this layer.

Is "guaranteed renewal to 100 without re-underwriting" absolute?

The health layer is absolute: a change in health condition cannot trigger re-underwriting. But the heading of Section 4 of Part 4 of the policy template is "No re-underwriting except in limited circumstances", and it lists four cases, of which a change of place of residence and a change of occupation are marked "[Optional]" — you have to see whether your own policy adopted them. Once triggered, paragraph (f) of that section allows the company to apply or increase premium loading, add case-based exclusions and even terminate the terms and benefits; the template itself says the result "may be more advantageous or adverse".

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#What this article does not state

• The Schedule of Surgical Procedures is treated here only in extract, and is not reproduced in full. Benefit item (f), the surgeon's fee, depends on categorisation in that schedule, which occupies 16 pages of the English text and covers 475 categorised items across 13 body-system groupings. This article gives only the category names and the method of calculation, and no extract from it should be treated as a complete list. To find which category a particular procedure falls into, the policy template itself must be consulted.
• This article reaches no conclusion on how many Certified Plans or products are in the market. Question 22 of the official FAQ (page reviewed 9 July 2026) says "As of 30 June 2026, there were 100 Certified Plans available in the market (including Standard Plan and Flexi Plans) which altogether offered 573 products"; while counting the register of Certified Plans item by item (the pages dated 17 July 2026) gives 33 Standard Plans plus 70 Flexi Plans, 103 products in all, with certification numbers of 33 + 546 = 579. The two do not agree and the Government has not published how the count is made. This site's VHIS Complete Guide sets out that difference and each denominator in full; this article notes only that the difference exists and adopts neither figure.
• Why the limits are set at $750, $14,000, $420,000 and the rest is something this article does not explain. The consultancy study the Government commissioned in 2018, Consultancy Study on the Benefit Limits of Standard Plan under the Voluntary Health Insurance Scheme with Premium and Impact Assessment (the document dated 28 September 2018), is the document that addresses that question; this article has confirmed only its existence and location and has not read its contents, and so states nothing about the reasoning behind the limits.
• This article gives no general account of the terms of traditional medical insurance. The official documents cited here contain no survey or statistics on traditional products in the market. The "traditional medical insurance" column of the comparison table reflects only what officials have stated in terms, and reads "no common rule" everywhere else. The only general official description of what existing products contain is the third point of section 4.3 of the Legislative Council Research Brief, quoted above; that sentence does not say which requirements, and gives no proportion or number.
• The order of the 25%/50% for unknown pre-existing conditions and the 30% coinsurance has no official statement. Neither the policy template, the Code of Practice, the Compliance Rules nor the official FAQ cited here addresses that combination.
• The premium range at 60 and above is not listed. The reason is in the premium section: from that age the figures in some filled columns of the summary are renewal prices rather than prices for new business, and taking the highest and lowest directly would mix the two.
• This article recommends no insurance company and no plan, and makes no recommendation on anyone's health or financial circumstances — those are for a licensed insurance intermediary and a doctor.

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#Notes: the official wording

Most of the documents here publish in both English and Chinese, and the English quoted below is the source's own. Where a source is cited by its Chinese edition, the rendering is ours and is marked as such, with the original set out alongside so it can be checked.

[Note 1] VHIS Certified Plan Policy Template (version as at 1 July 2022), Part 6 Section 4, in the source's English:

Eligible Expenses arising from Pre-existing Condition(s) that the Policy Holder and/or Insured Person was not aware and would not reasonably have been aware of at the time of submission of Application, including any updates of and changes to the required information (if so requested by the Company under Section 8 of Part 1), shall be payable in accordance with these Terms and Benefits, subject to the following waiting period and reimbursement arrangement – First Policy Year no coverage; Second Policy Year 25% reimbursement; Third Policy Year 50% reimbursement; Fourth Policy Year onwards full coverage.

The Chinese of the same line anchors the proportion to the benefit limit; the English does not.

[Note 2] The two consumer summaries. The VHIS website's scheme page (reviewed 27 July 2022):

Unknown pre-existing conditions — partial coverage will be provided in the second year (25%) and the third year (50%) after policy inception, and full coverage (100%) thereafter

Question 17 of the official FAQ:

According to the terms and conditions, all Certified Plans will provide partial coverage of unknown pre-existing conditions in the second and third year after policy inception, at 25% and 50% respectively. Full coverage i.e. 100% will be provided from the fourth year onwards.

Item 24 of the Code of Practice's interpretation list is the one that gives the whole of it:

Waiting Period for Unknown Pre-existing Conditions — A period after issuance of a VHIS policy during which the Policy Holder is not eligible for, partially or fully, benefit coverage of Pre-existing Conditions that the Policy Holder is not aware of and will not reasonably have been aware of. For the Standard Plan, the waiting period is set at three Policy Years, with reimbursement ratio at 0%, 25% and 50% for the first three Policy Years respectively. A shorter waiting period or higher reimbursement ratio is encouraged for Flexi Plans.

[Note 3] Code of Practice Section 4.16(b):

That the Waiting Period for Unknown Pre-existing Conditions should not be affected (i.e. the Insured Person can enjoy 25% reimbursement for unknown Pre-existing Conditions immediately after renewal of the first Policy Year even if it lasts for less than 12 months).

The two forms in Section 3.4: under the arrangement without re-underwriting, "the Waiting Period for Unknown Pre-existing Conditions under the policy terms and conditions of the plan after Migration is counted from the inception date of the existing IHIP policy"; under the arrangement with re-underwriting, it runs from the new policy's effective date or an earlier date specified by the company.

[Note 4] The definition in Part 8 of the policy template:

"Pre-existing Condition(s)" shall mean, in respect of the Insured Person, any Sickness, Disease, Injury, physical, mental or medical condition or physiological degradation, including Congenital Condition, that has existed prior to the Policy Issuance Date or the Policy Effective Date, whichever is the earlier. An ordinary prudent person shall be reasonably aware of a Pre-existing Condition, where - (a) it has been diagnosed; (b) it has manifested clear and distinct signs or symptoms; or (c) medical advice or treatment has been sought, recommended or received.

[Note 5] Policy template, Part 2 Section 1:

These Terms and Benefits have been prepared in both English and Chinese. 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.

Paragraph (9) of the template's preamble also acknowledges that, because Chinese and English are structured differently, the words, expressions and sentence structures used in one language version may not be exactly the same as in the other, and that a pragmatic rather than a literal approach has to be taken in translation so as to convey the meaning, purpose and intent of the template effectively and accurately. The English text's second Policy Year line reads only "25% reimbursement" (a rendering for explanation only: reimbursement of 25%; the English does not say 25% of what). And paragraph 8 of the introduction:

HHB reserves the final right to – (a) interpret the Scheme Documents, including the right to determine the meaning of the rules in both English and Chinese versions and to resolve inconsistency, if any, between the two versions of the same Scheme Document; and (b) grant exemption from compliance with part of the Scheme Documents under exceptional circumstances.

[Note 6] Disclosed pre-existing conditions, the first paragraph of Part 6 Section 4 of the policy template:

Eligible Expenses arising from any Pre-existing Condition(s) which was/were notified to the Company in the Application, subject to the Case-based Exclusion(s) (if any), shall be payable in accordance with these Terms and Benefits. The Company may impose Case-based Exclusion(s) to these Terms and Benefits by reason of a Pre-existing Condition or other factor that affects the insurability of the Insured Person notified to the Company in the Application and any subsequent information or document submitted to the Company for the purpose of the application, including any updates of and changes to such requisite information (if so requested by the Company under Section 8 of Part 1). After the Policy Issuance Date or the Policy Effective Date (whichever is the earlier), the Company shall not have the right to impose any additional Case-based Exclusion(s), save for the limited circumstances stated in Section 4 of Part 4.

[Note 7] Official FAQ question 31:

Is premium loading or exclusion of particular illnesses allowed? Yes, provided that there are pre-existing health conditions or other health risks such as smoking habit, family medical history and occupational hazard.

Question 32:

The said situation is permitted for Flexi Plans when the product design encompasses a higher benefit layer by default and a lower benefit layer for the known pre-existing conditions of the insured person, and all the benefits are subject to the minimum protection as benchmarked by the Standard Plan.

[Note 8] The notes to the Standard Plan Benefit Schedule, all five, in the source's English:

(1) Eligible Expenses incurred in respect of the same item shall not be recoverable under more than one benefit item in the table above. (2) The Company shall have the right to ask for proof of recommendation e.g. written referral or testifying statement on the claim form by the attending doctor or Registered Medical Practitioner. (3) Tests covered here only include computed tomography ("CT" scan), magnetic resonance imaging ("MRI" scan), positron emission tomography ("PET" scan), PET-CT combined and PET-MRI combined. (4) Treatments covered here only include radiotherapy, chemotherapy, targeted therapy, immunotherapy and hormonal therapy. (5) The percentage here applies to the Surgeon's fee actually payable or the benefit limit for the Surgeon's fee according to the surgical categorisation, whichever is the lower.

[Note 9] The geographical restriction on psychiatric treatment. The VHIS website's scheme page:

Psychiatric inpatient treatments in local hospitals will be covered up to the limit of HK$30,000 per policy year

Official FAQ question 12:

Can I choose hospitals and doctors outside Hong Kong? Yes. Top-up benefits of Flexi Plans may apply to certain geographical regions. Standard Plan and basic protection of Flexi Plans equivalent to Standard Plan are required to provide global coverage, except for psychiatric treatments that are limited to Hong Kong.

[Note 10] Compliance Rules Sections 2.14 and 2.15:

2.14 Deductible is allowed for Standard Plan only when it applies to Other Benefits. 2.15 Coinsurance other than the 30% Coinsurance for the prescribed diagnostic imaging tests is only allowed for Other Benefits of the Standard Plan.

Section 2.16: "Lifetime Benefit Limit is not allowed at plan level and for specific benefit items."

[Note 11] The glossary at Annex III of the Compliance Rules:

3. Coinsurance — A percentage of eligible expenses the Policy Holder must contribute after paying the Deductible (if any) in a Policy Year. For the avoidance of doubt, Coinsurance does not refer to any amount that the Policy Holder is required to pay if the actual expenses exceed the benefit limits of the Certified Plan. 4. Deductible — A fixed amount of eligible expenses that, in a Policy Year, the Policy Holder must pay before the Company reimburses the remaining eligible expenses.

[Note 12] Compliance Rules Sections 1.5 and 1.6:

1.5 A Standard Plan is virtually fixed in product design, save for minor allowable variations. It must offer terms and benefits equivalent to the minimum requirements of Certified Plans under the VHIS, namely Basic Benefits. 1.6 A Flexi Plan must provide Enhanced Benefits as defined in Section 4 in addition to the Basic Benefits. The concept of Flexi Plans is to promote product innovation and competition for more consumer choices. The design of Flexi Plans must adhere to the "better-off principle" entailing terms and benefits that will bring more protection to the customers when compared with a Standard Plan while Policy Holders' entitlement to the Basic Benefits would not be adversely affected, save for the exceptions in Section 6.5.

The consumer-language version, official FAQ question 21:

Standard Plan benchmarks the minimum complying requirements of VHIS. As the policy terms and benefits of Standard Plan are standardised, the Standard Plans offered by different insurance companies will be virtually the same (except for very limited minor allowable variations). Flexi Plans offer basic protection equivalent to Standard Plan coverage, plus a flexible top-up protection such as higher benefit amounts and wider benefit coverage, which vary from plan to plan and company to company.

[Note 13] Compliance Rules Section 6:

6.2 Flexi Plans may reduce benefit coverage for eligible medical expenses incurred in territories outside Hong Kong. However, the reduction must not apply to the Basic Benefits of the Flexi Plans, i.e. the coverage equivalent to the Standard Plan. 6.3 Flexi Plans with targeted ward class specified may adjust the payable benefits where a confinement involves the use of ward class higher than the class specified. However, the adjustment must not apply to the Basic Benefits of the Flexi Plans, i.e. the coverage equivalent to the Standard Plan — the three upgrades that may not be adjusted being "(i) unavailability of accommodation at the specified ward class due to ward or room shortage for emergency treatment; (ii) isolation reasons that require a specific class of accommodation; or (iii) other reasons not involving personal preference of the Policy Holders and/or the Insured Persons." 6.4 Enhanced Benefits under the Flexi Plans may be provided subject to restriction in the choice of healthcare service providers. However, the restriction must not apply to the Basic Benefits part of the Flexi Plans, i.e. the coverage equivalent to the Standard Plan.

Sections 3.16, 3.17 and 3.18:

3.16 Deductible is allowed for Flexi Plans at plan level and for specific benefit items only when it applies to – (a) Enhanced Benefits; (b) Other Benefits; or (c) situation specified under Section 6.5. 3.17 Coinsurance other than the 30% Coinsurance for prescribed diagnostic imaging tests is allowed for Flexi Plans at plan level and for specific benefit items only when it applies to – (a) Enhanced Benefits; (b) Other Benefits; or (c) situation specified under Section 6.5. 3.18 Lifetime Benefit Limit is not allowed at plan level and for specific benefit items, save for the exceptions in Section 6.5.

[Note 14] Compliance Rules Section 4.2, in full:

4.2 In principle, there are two defined types of Enhanced Benefits, the inclusion of either of which can qualify an IHIP as a Flexi Plan – (a) The first type of Enhanced Benefits is based on the Standard Plan framework (i.e. hospital and surgical benefits related) manifested by STC and SBS. It covers the following – (i) Higher benefit limits (e.g. supplementary major medical coverage); (ii) Extra benefit items (e.g. expenses on companion bed during confinement); (iii) Reduction or removal of Coinsurance for prescribed diagnostic imaging tests; and (iv) Amendment to policy terms and benefits to the advantage of Policy Holders, such as reduction in scope of general exclusions or shorter Waiting Period for Unknown Pre-existing Conditions; and (b) The second type of Enhanced Benefits is prescribed by HHB which are considered to have significant complementarity with the Standard Plan benefits. The prescribed benefits are listed under Annex I.

The Chinese text numbers the two as 第一類 and 第二類, and its item (iii) specifies the 30% coinsurance where the English says only "Coinsurance". Annex I's six prescribed enhanced benefits are donor benefit, emergency outpatient care, home nursing, hospice and palliative care, outpatient kidney dialysis, and rehabilitative care; and it adds:

All the Enhanced Benefits (including those defined in Section 4.2(a) and those prescribed in this Annex) together with the Basic Benefits must constitute at least 90% of the actuarially fair value of the Certified Plan on average terms across all ages and gender.

Annex II:

All the Other Benefits must not constitute more than 10% of the actuarially fair value of the Certified Plan on average terms across all ages and gender.

[Note 15] Code of Practice Section 2.5 and its note 2:

2.5 Companies are required to consider applications for Certified Plans in relation to persons to be insured who are – (a) Hong Kong residents1; and (b) aged between 15 days and 80 years 2. 2 This requirement may be exempted for the Certified Plans of which the product design is targeted at particular age groups, such as people in younger ages.

Compliance Rules Section 2.11:

Companies offering Standard Plan are required to consider applications in relation to persons to be insured who are Hong Kong residents 1, and aged between 15 days and 80 years. A Standard Plan is not allowed to target at particular age groups of customers.

Section 2.12:

2.12 Certain Other Benefits under a Standard Plan may target at a particular age group (e.g. younger age groups) subject to the approval by HHB. The targeted age group and the relevant product design must be specified in the application for product certification.

[Note 16] Code of Practice Sections 2.3, 2.4 and 2.17:

2.3 Companies are required to make available a Standard Plan duly certified by HHB for new application at all times when they are registered as a VHIS Provider. 2.4 Companies are allowed to offer Flexi Plans or not, and the number of Flexi Plan on offer is not restricted. After offering a certified Flexi Plan in the market, the Company concerned is allowed to cease receiving applications for such Flexi Plan at its discretion, but is required to continue to renew the policies issued under the Certified Plans according to the relevant requirements as stated in Part 4 of the VHIS Certified Plan Policy Template. 2.17 Subject to HHB's approval, Companies are allowed to offer Flexi Plans that are targeted at particular age groups (e.g. people in younger ages) or client groups (e.g. members of the same association). Under these circumstances, the Companies concerned are allowed not to consider applications from people not fitting the definition of the targeted age groups or client groups. Nevertheless, the Companies concerned are required to renew the policies issued under the Certified Plans according to the relevant requirements as stated in Part 4 of the VHIS Certified Plan Policy Template.

Official FAQ question 30:

The participating insurance companies may decline an application after a fair and reasonable underwriting process in accordance with the principles set out in the Code of Practice under VHIS.

[Note 17] Compliance Rules Section 6.5, all six conditions:

6.5 Subject to special approval by HHB, the restrictions in Section 3.16 to Section 3.18 for Flexi Plans can be partly relaxed to allow the application of Deductible, Coinsurance and/or Lifetime Benefit Limit to Basic Benefits at plan level (which are normally not allowed for both Standard Plan and Flexi Plans) provided that a Flexi Plan can fulfill the following conditions – (a) The Annual Benefit Limit is at least HK$5 million at plan level; (b) There is no itemised dollar benefit limits, itemised Deductible and/or Coinsurance applied for at least 10 of the 12 benefit items as prescribed under the Standard Plan framework (i.e. items (a) to (l) of the SBS); (c) The out-of-pocket amount on all the Deductible and Coinsurance instituted into the plan (including the Coinsurance for prescribed diagnostic imaging tests) per Policy Year must not exceed 3% of the Annual Benefit Limit (e.g. a maximum of HK$150,000 on all the Deductible and Coinsurance if the annual benefit limit is HK$5 million); (d) For the same product at policy inception, the Policy Holders must be given an option for coverage without any Deductible and Coinsurance at plan level; (e) After policy inception, the Policy Holders must be given at least one opportunity to switch, without any Re-underwriting, to coverage without any Deductible and Coinsurance of the same product at plan level. The timing of that switch can be specified in terms of an age, a year, or a time after certain Policy Years. The relevant details must be specified in the policy terms and conditions at policy inception; and (f) The Lifetime Benefit Limit must be at least 4 times of the Annual Benefit Limit at plan level.

Question 9 of the official FAQ (page reviewed 9 July 2026) lists three:

(a) The annual benefit limit must be at least HK$5 million; (b) The lifetime benefit limit must be at least HK$20 million or 4 times of annual benefit limit, whichever is higher; and (c) There must be no itemised dollar limit for at least 10 of the 12 standard benefit items (i.e. the benefit items prescribed under the Standard Plan framework).

[Note 18] The paragraph immediately following those three items in question 9:

As in the case of all Flexi Plans, the policyholders should be provided with the option to switch to the Standard Plan without re-underwriting upon policy renewal. This means that the policyholders of the Flexi Plans with exemption mentioned above can continue to enjoy protection under Standard Plan even if the lifetime benefit limit is reached.

[Note 19] Paragraph 6 of the policy template's introduction:

The Scheme Documents are non-statutory in nature. They should not supplant or conflict with any applicable statutes, laws, rules, regulations, codes or guidelines.

Compliance Rules Section 1.2(a)(ii): a contract which "combines long term business and additional business of the nature in relation to Class 2 (sickness) following paragraph 3 of Part 1 of Schedule 1 to the Insurance Ordinance (Chapter 41), for example by writing an insurance policy with both life and medical coverage or writing a medical insurance rider attached to and forming part of a life insurance policy". Paragraph 7 of the introduction: the Health Bureau may offer clarification or elaboration on certain parts of the Scheme Documents, say in the form of Frequently Asked Questions, and "such information will not form part of the Scheme Documents but will provide guidance on the interpretation and/or elaboration".

[Note 20] Official FAQ question 24 (reviewed 9 July 2026):

The Health Bureau does not regulate the premiums of Certified Plans. However, the participating insurance companies have to publish the premium schedules of their Certified Plans that facilitate comparison and the premium schedule of all Certified Plans of insurance companies can be accessed on the official VHIS website.

[Note 21] The seventh chapter of the Report on Consultation on Voluntary Health Insurance Scheme (January 2017), cited here in its Chinese edition. The renderings are ours:

7.7 We propose certain modifications to the "minimum requirements" originally proposed. Specifically, since the implementation of "guaranteed acceptance with a capped premium loading" and policy "portability" depends on whether a high risk pool is established, we propose that these two "minimum requirements" be dealt with at a later stage together with the high risk pool. (our translation from the Chinese original)

Chinese original:

7.7 我們提出對原建議的「最低要求」作出若干修訂。具體而言，由於實行「必定承保而附加保費率設有上限」及保單「自由行」，取決於是否設立高風險池，我們建議這兩項「最低要求」在較後階段才與高風險池一併處理。

7.4 […] We propose to allow underwriters to launch and sell in the market individual hospital insurance products that do not comply with the "minimum requirements", so as to meet the needs of some consumers. […] For the avoidance of doubt, products not complying with the requirements of the Voluntary Health Insurance Scheme will not receive tax concessions. (our translation from the Chinese original)

Chinese original:

7.4 […] 我們建議准許承保機構在市場推出和銷售不符合「最低要求」的個人住院保險產品，以滿足部分消費者的需要。[…] 為免生疑問，不符合自願醫保計劃規定的產品不會獲稅項寬減。

[Note 22] Section 4.3 of the Research Brief of the Legislative Council Secretariat's Research Office (3 July 2018), cited here in its Chinese edition. The rendering is ours:

First, the regulatory mechanism is purely voluntary and is confined to Certified Plans under the Voluntary Health Insurance Scheme. As for the non-complying policies already in the market, they remain "lightly regulated". Medical underwriters may still sell those products without facing the product limitations noted above. Secondly, following the completion of the public consultation in 2017, the minimum product requirements of the Voluntary Health Insurance Scheme do not include the two major high risk pool proposals of "guaranteed renewal" and policy "portability", weakening the scheme's overall attractiveness. Thirdly, the minimum requirements set for Certified Plans are not entirely new proposals, and some of them are already found in existing individual health insurance products. Together with the higher expected premiums of Certified Plans, this deepens doubts about the scheme's appeal to the public. (our translation from the Chinese original)

Chinese original:

首先，規管機制純屬自願性質，並只限於自願醫保下的認可產品。至於市場上現有不符合規定的保單，仍然"少有規管"。醫療承保機構仍可銷售這些產品，而毋須正視上文提及的產品局限。其次，在2017 年的公眾諮詢完成後，自願醫保的最低產品要求並無納入高風險池的"保證續保"和"保單自由行"兩大建議，削弱自願醫保的整體吸引力。第三，認可產品所訂的最低要求並非全新建議，當中部分要求早已見於現行個人醫保產品。加上認可產品的預計保費較高，亦令人加深自願醫保對公眾吸引力的疑慮。

[Note 23] The Government press release of 29 March 2019, cited here in its Chinese edition, listing all five features. The rendering is ours:

(i) guaranteed renewal to the age of 100 irrespective of any change in the insured person's health condition (without re-underwriting); (ii) no "lifetime benefit limit"; (iii) coverage extended to include pre-existing conditions unknown at application and day case procedures (including endoscopy) and the like; (iv) a taxpayer who buys a Certified Plan for himself and/or a specified relative and pays the premium on or after the first of April 2019 may claim a tax deduction for that premium; and (v) the premiums of Certified Plans are transparent, and consumers may consult the premium schedules on the VHIS website. (our translation from the Chinese original)

Chinese original:

（i）不論受保人的健康狀況是否改變均保證續保至100歲（不可重新核保）；（ii）不設「終身保障限額」；（iii）保障範圍擴大至涵蓋投保時未知的已有疾病和日間手術（包括內窺鏡）等；（iv）納稅人為自己及／或指明親屬購買認可產品，並在二○一九年四月一日或之後繳付保費，可就保費申請稅務扣除；及（v）認可產品的保費具透明度，消費者可於自願醫保網站查閱保費表。

The tax deduction cap comes from the press release of 1 March 2018: 「每年可作稅務扣減的保費上限為每名受保人8,000元」 — the annual cap on premiums eligible for tax deduction is that amount per insured person (our rendering).

[Note 24] Policy template Part 4 Section 4. The health layer:

While these Terms and Benefits are in force, the Company shall not have the right to re-underwrite these Terms and Benefits irrespective of any change in health conditions of the Insured Person after the Policy Issuance Date or the Policy Effective Date, whichever is the earlier.

The two sub-paragraphs beneath (b):

(i) However, at any time where the Policy Holder requests to unsubscribe the additional benefits (if any) in these Terms and Benefits, or switch to another insurance plan which provides downgrade or reduction of benefits, the Company shall not have the right to re-underwrite these Terms and Benefits but shall have the discretion to accept or reject the request according to its prevailing practices in handling similar requests; and (ii) The Company shall not have the right to terminate or not to Renew these Terms and Benefits if any of the aforesaid requests is rejected by the Company or the re-underwriting result is not accepted by the Policy Holder;

The fifth precondition in each of (c) and (d):

(v) The re-underwriting result may be more advantageous or adverse to the Policy Holder and the Insured Person.

Both paragraphs also place the duty to notify on the policy holder: the company "shall have the obligation to request the Policy Holder to inform the Company of any change in the Place of Residence of the Insured Person, which means that as at the Renewal Date his Place of Residence differs from that as at the last Renewal Date (or the Policy Effective Date in the event of first Renewal). After receiving the request, the Policy Holder shall have the obligation to inform the Company of such a change." The occupation paragraph is drawn the same way. Paragraph (e) substantially repeats the point that only the relevant factors may be considered and sets no new rule: "(e) if under the terms of this Part 4, the Company has the right, or is required, to re-underwrite these Terms and Benefits based on certain factors at Renewal, the Company shall, in accordance with the terms of this Part 4 and its prevailing underwriting guidelines, take into account only such relevant factors to carry out the re-underwriting". Paragraph (f):

(f) as a result of re-underwriting, these Terms and Benefits may be terminated, new Premium Loading may be applied, existing Premium Loading may be adjusted upwards or downwards, new Case-based Exclusion(s) may be applied, and existing Case-based Exclusion(s) may be revised or removed.

[Note 25] The cooling-off period. After the "not less than 21 days" condition, Section 2 of Part 2 of the policy template provides that the cancellation right does not apply to renewal, and that no refund can be made if a benefit payment has been made, is to be made or is impending. Code of Practice Section 4.15: "The cooling-off period lasts for 21 days (or longer if offered by Companies) after the Delivery of the policy or the cooling-off notice…". Note 7 to Section 4.14:

Except those offered for renewal, including renewal under the Migration arrangement stated in Section 3.4(a).

[Note 26] The opening of Section 1 of Part 4 of the policy template:

Unless the Company has ceased to have the requisite authorisation under the Insurance Ordinance to write these Terms and Benefits, or has ceased to maintain its registration with the Government as a VHIS provider, or the Policy Holder decides not to Renew these Terms and Benefits by giving the Company not less than [insert a period of not more than 30 days] days prior notice in writing in accordance with Section 3 of Part 2, Renewal shall be arranged automatically with the Terms and Benefits no less favourable than the latest version of the Standard Plan Terms and Benefits published by the Government at the time of Renewal…

Section 15 of Part 2 lists the circumstances in which the policy terminates automatically, including where the company ceases to have the requisite authorisation under the Insurance Ordinance to write or continue to write the policy.

[Note 27] The notes to readers of the Summary of Standard Premium of VHIS Standard Plan (HKD), cited here in its Chinese wording. The renderings are ours:

As with the medical insurance products commonly found in the market, the standard premium of a Standard Plan (and of Flexi Plans) is generally determined by age and adjusted upon renewal. This means that the standard premiums shown in the premium schedule for ages higher than your current age may be adjusted by the time you reach those ages. You should take this factor into account, since medical insurance is by nature a long-term protection. (our translation from the Chinese original)

Chinese original:

與市場上常見的醫療保險產品一樣，標準計劃（及靈活計劃）的標準保費通常按年齡釐定，並在續保時作出調整。這表示保費表中比閣下現時年齡較高的相應標準保費，於閣下達至該等年齡時可能會有調整。閣下應考慮此項因素，因為醫療保險本質上是一種長期保障。

In no circumstances should this table be construed as a recommendation by the Health Bureau to anyone of any particular insurance product (including any of its product features) or insurance company… While the Health Bureau endeavours to compile the annual standard premium figures of Standard Plans, it makes no representation or warranty, express or implied, as to the accuracy, validity or completeness of this table. Consumers should not rely on this table alone in choosing an insurance product. (our translation from the Chinese original)

Chinese original:

在任何情況下，本表不應被理解為醫務衞生局向任何人推薦任何特定的保險產品（包括其任何產品特點）或保險公司…儘管醫務衞生局致力編整標準計劃的年度標準保費數字，但並不代表對此表的準確性、有效性或完整性作出任何明示或默示的陳述或保證。消費者不應僅依賴此表選擇保險產品。

The two accounts of what constrains an increase: question 26 of the official FAQ says the rate of adjustment "must equally apply to other customers within the same age-gender group of your insurance plan"; the contractual language in Section 2 of Part 4 of the policy template is adjustment across all policies of the same portfolio, "Portfolio" being defined in Part 8 as "all policies of the same terms and conditions and the benefit schedule as certified by the Government as a Certified Plan under VHIS".

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Disclosure: GoodDoctor.hk has commercial referral relationships with some VHIS product providers. This article is an editorial compilation, recommends no insurance company and no plan, and constitutes neither regulated insurance advice nor medical advice. For comparisons of particular products and for decisions about buying, consult an insurance intermediary licensed by the Insurance Authority.

#Sources and dates checked

• The non-statutory character of the scheme, the four Scheme Documents, the whole Standard Plan Benefit Schedule and its five notes, the four-step waiting period for pre-existing conditions, disclosed pre-existing conditions and case-based exclusions (Part 6 Section 4, first paragraph), the definition of a pre-existing condition, the renewal provisions and the "Unless" exception in Part 4 Section 1(a), the cooling-off period not applying to renewal and no refund where a benefit has been paid (Part 2 Section 2), the circumstances of automatic termination (Part 2 Section 15), and the clause on the two language versions: VHIS Certified Plan Policy Template (version as at 1 July 2022), Health Bureau, Chinese text https://www.vhis.gov.hk/doc/tc/information_centre/c_standard_plan_template.pdf ; English text https://www.vhis.gov.hk/doc/en/information_centre/e_standard_plan_template.pdf (retrieved 1 August 2026)
• The definitions of Standard Plan and Flexi Plan, the comparison table at Section 1.8, the limits on deductible, coinsurance and lifetime benefit limit for Standard Plans (2.13–2.16), the limits for Flexi Plans (3.16–3.18), the definition of Enhanced Benefits (4.2), Annex I's six prescribed enhanced benefits and the 90% actuarially fair value threshold, Annex II's 10% ceiling, the reductions allowed under Section 6 and the six conditions of Section 6.5, the glossary definitions of "Coinsurance" and "Deductible" at Annex III, a Standard Plan not being allowed to target particular age groups and the duty to consider applications from Hong Kong residents aged 15 days to 80 years (2.11), and the contract classification under Class 2 (sickness) of the Insurance Ordinance (Chapter 41): Product Compliance Rules under the Voluntary Health Insurance Scheme (version as at 1 July 2022), Health Bureau, Chinese text https://www.vhis.gov.hk/doc/tc/information_centre/c_product_compliance_rules.pdf ; English text https://www.vhis.gov.hk/doc/en/information_centre/e_product_compliance_rules.pdf (retrieved 1 August 2026)
• The interpretation of the waiting period for unknown pre-existing conditions (0%/25%/50%), the treatment of a first Policy Year shorter than 12 months (4.16(b)), how the waiting period is counted on a transfer (3.4), the 21-day cooling-off period (4.15) and its exceptions for renewal and for renewal under the migration arrangement (note 7 to 4.14), the duty to consider applications from Hong Kong residents aged 15 days to 80 years and the exemption for age-targeted products (2.5 and note 2), a Standard Plan having to be available for new application at all times (2.3), Flexi Plans being optional and able to stop receiving applications (2.4), and Flexi Plans being able to target particular age or client groups and decline to consider others (2.17): Code of Practice for Insurance Companies under the Voluntary Health Insurance Scheme, Health Bureau, Chinese text https://www.vhis.gov.hk/doc/tc/information_centre/c_cop.pdf ; English text https://www.vhis.gov.hk/doc/en/information_centre/e_cop.pdf (retrieved 1 August 2026)
• Premiums not being regulated (question 24), the constraint on premium adjustment at renewal (question 26), the reimbursement ratios for unknown pre-existing conditions (question 17), the difference between Standard and Flexi Plans (question 21), the conditions for a Flexi Plan with a lifetime benefit limit and the paragraph that follows about switching to a Standard Plan without re-underwriting at renewal (question 9), the number of Certified Plans (question 22), the worked example of coinsurance on prescribed diagnostic imaging tests (Q8(f)(iv)), global basic protection with psychiatric treatment limited to Hong Kong (question 12), no guaranteed acceptance (question 30), premium loading and exclusions (question 31), and a lower benefit layer for known pre-existing conditions being permitted only for Flexi Plans (question 32): VHIS "Frequently Asked Questions", reviewed 9 July 2026, Chinese https://www.vhis.gov.hk/tc/consumer_corner/faqs.html ; English https://www.vhis.gov.hk/en/consumer_corner/faqs.html (retrieved 1 August 2026)
• The summary of "key product features of Certified Plans" (25% in the second year and 50% in the third; psychiatric inpatient treatments in local hospitals up to HK$30,000 per policy year): VHIS "The Scheme" page, reviewed 27 July 2022, https://www.vhis.gov.hk/tc/about_us/scheme.html (retrieved 1 August 2026)
• Cross-company annual standard premiums for Standard Plans, and the statements in the notes to readers about premiums being determined by age, adjusted at renewal, and not constituting a recommendation: Summary of Standard Premium of VHIS Standard Plan (HKD) (as at 17 July 2026; the file is bilingual), female https://www.vhis.gov.hk/doc/en/information_centre/Standard_Plan_Premium_Summary_Female.xlsx ; male https://www.vhis.gov.hk/doc/en/information_centre/Standard_Plan_Premium_Summary_Male.xlsx ; linked from https://www.vhis.gov.hk/tc/consumer_corner/list-plans.html (retrieved 1 August 2026)
• The dates of the register of Certified Plans pages (17 July 2026): https://www.vhis.gov.hk/tc/consumer_corner/standard-plan.html and https://www.vhis.gov.hk/tc/consumer_corner/flexi-plan.html (retrieved 1 August 2026)
• The five standardised features of Certified Plans (full implementation): Government press release, "Voluntary Health Insurance Scheme to be fully implemented next Monday", 29 March 2019, https://www.info.gov.hk/gia/general/201903/29/P2019032900568.htm (retrieved 1 August 2026)
• The tax deduction cap of $8,000 per insured person a year, and the policy problem statement about hospital insurance products with lower benefit amounts or narrower coverage: Government press release, "Government announces details of Voluntary Health Insurance Scheme", 1 March 2018, https://www.info.gov.hk/gia/general/201803/01/P2018030100434.htm (retrieved 1 August 2026)
• The deferral of "guaranteed acceptance with a capped premium loading" and policy "portability" (7.7); and the allowance of products not meeting the minimum requirements and their exclusion from tax concessions (7.4): Report on Consultation on Voluntary Health Insurance Scheme, Food and Health Bureau, January 2017, https://www.vhis.gov.hk/doc/tc/information_centre/VHIS_full_report.pdf (retrieved 1 August 2026)
• The scheme's origin in the two-stage public consultations on healthcare reform of 2008 and 2010, and the public's reservations about a mandatory scheme: Legislative Council brief, Voluntary Health Insurance Scheme (file reference FH CR 4/1/3822/13 Pt.4), submitted to the Panel on Health Services on 13 January 2015, https://www.legco.gov.hk/yr14-15/chinese/panels/hs/papers/hs20150113-fhcr41382213pt4-c.pdf (retrieved 1 August 2026)
• The non-complying policies in the market remaining "lightly regulated", the two high risk pool requirements not being included, and the minimum requirements for Certified Plans being "not entirely new proposals, as some of them are already found in existing individual health insurance products" (the third point of section 4.3): Legislative Council Secretariat Research Office, Health insurance for individuals in Hong Kong, Research Brief Issue No. 3 2017–2018, 3 July 2018, https://www.legco.gov.hk/research-publications/chinese/1718rb03-health-insurance-for-individuals-in-hong-kong-20180703-c.pdf (retrieved 1 August 2026)
• The document containing the reasoning behind the Standard Plan benefit limits (this article confirms only its existence and does not cite its contents): Consultancy Study on the Benefit Limits of Standard Plan under the Voluntary Health Insurance Scheme with Premium and Impact Assessment — Executive Summary, 28 September 2018, https://www.vhis.gov.hk/doc/en/information_centre/vhis_study2018_es3.pdf (retrieved 1 August 2026)

This article was written from the official documents above; information as at 1 August 2026. It is general information, and is neither medical advice nor regulated insurance advice.

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#Further reading

• On this platform: VHIS Complete Guide 2026
• On this platform: Is VHIS worth buying? Can people over 60 still be insured?
• On this platform: How do you apply for a medical fee waiver?
• The VHIS Standard Plan policy template: vhis.gov.hk
• Insurance Authority consumer education: ia.org.hk