What are the differences between “Deductibles” and “Co-insurance”?

  • Updated

Both are medical costs that the insured must pay when filing claims from the insurance company. Their main difference lies in the calculation methods:

"Co-insurance" - Calculated based on individual protection items and percentages, shared between the insured and the insurance company.

Assume the insured must bear 20% co-insurance for a claim item, with medical costs of HK$120,000: 
Compensation provided by the insurance company = HK$120,000 X 80% = HK$96,000
Costs paid by the insured = HK$120,000 X 20% = HK$24,000

"Deductible" - Calculated per policy year, the insured must bear a certain amount before the insurance company compensates the remaining medical expenses according to the plan’s coverage limit.

Assuming the insured has opt for BowtiePink with a HK$20,000 deductible, while the total hospital medical expenses are HK$70,000, Bowtie will compensate would be [Total Medical Expenses – Deductible], which is HK$70,000 – HK$20,000 = HK$50,000.

Bowtie Pink only offers deductible options (choices of HK$80,000, HK$50,000, HK$20,000, or HK$0) with no co-insurance. Whereas Bowtie VHIS Standard and Flexi have co-insurance but no deductible:

Bowtie VHIS Standard

  • Prescribed diagnostic imaging tests including CT, MRI, and PET scans: 30% co-insurance^

Bowtie VHIS Flexi

  • Prescribed diagnostic imaging tests including CT, MRI, and PET scans: 30% co-insurance^
  • Supplementary Major Medical (SMM): 20% co-insurance*

^The reimbursement is subject to the "Benefit Limit" of the Bowtie VHIS Standard Plan or Flexi Plan.
*The reimbursement is Subject to the maximum coverage limit of Bowtie VHIS Flexi Plan's "Supplementary Major Medical" coverage.