24 October 2016
Patients are getting less from their insurance coverage as the cost of medical care goes up. Photo: Bloomberg
Patients are getting less from their insurance coverage as the cost of medical care goes up. Photo: Bloomberg

Patients get less from medical insurance as hospital fees rise

The reimbursement ratio for medical insurance claims has dropped to 78 percent in 2013 from 80 percent in 2012, according to the latest figures from the Hong Kong Federation of Insurers (HKFI).

Meanwhile, the average annual medical insurance premium rose 5.9 percent to HK$3,814 in 2013, from HK$3,600 in 2012, Ming Pao Daily reported on Friday, citing HKFI data. 

The figure further rose by 1.9 percent to HK$3,886 in 2014.

Despite the increase in premiums, the reimbursement ratio has been trending downwards, the report said.

The survey also found that medical expenses have gone up in 2013.

A medical case at a first-class bed in a private hospital cost HK$75,000, up 10 percent from the previous year.

The charge for a second-class bed rose 9 percent to HK$38,000, while that for a third-class bed increased 7 percent to HK$31,000 during the period.

Cost of minor surgeries in private clinics also went up 8 percnt to HK$5,251 per case.

Terry Tsang, chairman of the HKFI’s Medical Insurance Association, said the increase in medical fees has inevitably dragged down the reimbursement ratio, while the amount of coverage remains unchanged.

Tsang urged policyholders to review their benefit levels regularly to ensure the coverage is sufficient to cover rising medical fees.

Legislator Kwok Ka-ki said medical insurance policy holders find themselves in a passive position, where their coverage is determined by insurance companies and medical fees determined by private hospitals.

It is hard for patients to plan and gauge their medical outlays as there are no regulations governing private hospital fees.

Kwok feared that citizens will face even higher premiums when the government rolls out the proposed voluntary medical insurance scheme.

Tim Pang Hung-cheong, of the Society for Community Organization, a non-governmental organization, said patients can only accept that their medical insurance coverage is shrinking as medical fees are on the rise.

Anthony Lee, chairman of the Hong Kong Private Hospitals Association, said the rise in medical fees in private hospitals is mainly due to rising salaries.

Lee believes medical fees will continue to rise by around 10 percent every year.

Insurance companies are charging commissions that are too high, he said, adding that he hopes the introduction of the voluntary medical insurance scheme will help bring down charges.

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