Medical claims paid by Hong Kong insurers could double within a decade, according to findings released Tuesday [1].
This trend suggests a potential crisis in the affordability of private health insurance for both employees and employers, as the cost of care increases.
Total medical claims rose by over 60 per cent between 2019 and 2023 [3]. Total reimbursements reached HK$17.73 billion in 2023 [1], compared to HK$10.99 billion in 2019 [2].
According to the report, the increase is driven largely by a surge in inpatient bills, particularly for day procedures. These costs are putting pressure on the insurance sector's sustainability.
"If such an increase continues at the same rate, it will raise serious concerns about the affordability of private health insurance for both employers and...", the South China Morning Post said [4].
Industry experts suggest that these rising costs are a result of shifting healthcare delivery models and changing patient preferences. The regulator is now reviewing the affordability of private health insurance to ensure the same level of access to care.
As the insurance sector manages these rising costs, the balance between premium increases and patient access to medical services remains a critical point of focus for the city's healthcare system.
“Medical claims paid by Hong Kong insurers could double within a decade”
The surge in medical claims reflects a broader systemic pressure on Hong Kong's private healthcare market. If insurers cannot stabilize costs, premiums are likely to rise significantly, potentially pushing many policyholders out of the market or increasing the burden on the public healthcare system. This creates a long-term sustainability risk for the private insurance model in Hong Kong.
