Does Bowtie VHIS have any ward class restrictions?

  • Updated

Individual Bowtie VHIS plans adjust coverage based on the ward class, so we recommend you choose a plan that best suits your hospitalization needs.

If the insured person is assigned to a higher room type due to reasons beyond their or the policyholder's control, such as limited room availability or the need for isolation, and can provide written proof from the hospital, their claim will not be affected.

The Basic benefits of Bowtie VHIS Standard and Bowtie VHIS Flexi both offer the coverage without ward class restrictions, but the Supplementary Major Medical (SMM) under Bowtie VHIS Flexi has an adjustment factor on the rate of compensation according to the ward class that the insured admitted to during hospitalization. Details are as follows:

SMM Adjustment Factors / Compensation Ratio    
Ward Class Occupied by the Insured Bowtie VHIS Flexi Regular Plan Bowtie VHIS Flexi Plus Plan
Ward

100%

100%
Semi Private

50%

100%
Private

25%

50%
Above Standard Private

25%

25%

While BowtiePink VHIS has various adjustment factors/compensation ratios depending on the ward class section:

SMM Adjustment Factors / Compensation Ratio      
Ward Class Occupied by the Insured Bowtie Pink VHIS (Ward) Bowtie Pink VHIS (Semi Private) Bowtie Pink VHIS (Private)
Ward 100% 100% 100%
Semi Private 50% 100% 100%
Private 25% 50% 100%
Above Standard Private 25% 25%

50%

Example: If you have the Bowtie Pink VHIS (Ward Room - Deductible HK$80,000) but are admitted to a semi-private room during treatment, and your eligible medical expenses total HK$100,000, you will only be reimbursed HK$50,000.