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.