What the VHIS Standard Plan does not cover: pregnancy, Chinese medicine, chiropractic, outpatient and second opinions
The VHIS Standard Plan covers eligible expenses related to hospitalisation and day surgery (Health Bureau VHIS Certified Plan policy template, 1 July 2022 version). Part 7, "General Exclusions", lists what it does not cover, including obstetric conditions (pregnancy, childbirth, miscarriage) and traditional Chinese medicine; dental, vision correction and preventive check-ups are also excluded. Purely outpatient services, such as a chiropractor's fee or an outpatient second-opinion fee, are outside the hospitalisation or day-surgery scope. An individual policy follows its own terms.
What does the Standard Plan generally not cover?
The table below summarises the Standard Plan's exclusions from Part 7, "General Exclusions", of the policy template (Health Bureau VHIS Certified Plan policy template, 1 July 2022 version). A Flexi Plan may add cover above the minimum requirements, but the terms of the policy you buy govern.
| Item | Standard Plan (policy template, Part 7) |
|---|---|
| Diagnosis of pregnancy, childbirth, abortion or miscarriage; birth control or reversal; infertility (IVF or artificial conception) | Not covered (§8, obstetric conditions) |
| Traditional Chinese medicine: herbal medicine, bone-setting, acupuncture, acupressure and tui na, and alternative therapies | Not covered (§10) |
| Dental treatment and oral-maxillofacial surgery by a dentist | Not covered (§7; except emergency treatment and surgery during a hospital stay due to an accident; follow-up dental after discharge is not covered) |
| Vision correction or refractive error services, including laser refractive surgery (LASIK) | Not covered (§7) |
| Preventive treatment and care: asymptomatic general body check-ups, routine tests or screening, vaccination, health supplements | Not covered (§6) |
| Hospitalisation purely to receive a diagnostic procedure or allied-health services (physiotherapy, occupational or speech therapy) | Not covered (§2; except a medically necessary diagnosis on a registered doctor's advice, or treatment that cannot effectively be done as a day case) |
Why aren't chiropractic and outpatient fees covered?
The Standard Plan covers eligible expenses related to hospitalisation and day surgery, so purely outpatient services (for example an ordinary chiropractor's fee, or a general or specialist outpatient consultation fee) generally fall outside it — not because each is named, but because they are not hospitalisation or day-surgery cover. A Flexi Plan or an individual policy may add outpatient cover, but the terms of your policy govern. How payment and cashless pre-authorisation work when using insurance for a private specialist is in using medical insurance for a private specialist.
Are a second opinion's consultation fee and re-tests covered?
If a second opinion is an outpatient consultation, the fee generally falls outside the Standard Plan's hospitalisation or day-surgery cover; if the second opinion then leads to hospitalisation or day surgery within the covered scope, that part can be handled under the policy terms. Whether the consultation fee and re-tests are counted separately or together follows your policy terms — check with the insurer or intermediary.
I saw a doctor and had tests earlier, and only later was diagnosed — can I claim?
Asymptomatic general check-ups, routine tests or screening are general exclusions (policy template §6). After diagnosis, eligible expenses related to hospitalisation or day surgery (and prescribed non-surgical cancer treatment) can be covered under the Standard Plan. Whether the earlier purely outpatient consultation and tests can be claimed depends on whether they meet the cover definition and on your policy's terms; the policy governs, so check with the insurer or intermediary.
Frequently asked questions
Does VHIS cover pregnancy and childbirth?
Obstetric conditions such as pregnancy, childbirth, abortion or miscarriage and their complications are general exclusions of the Standard Plan (Health Bureau VHIS Certified Plan policy template, 1 July 2022 version, Part 7 §8); an individual policy or Flexi Plan follows its own terms.
Can I claim for Chinese medicine or bone-setting?
Traditional Chinese medicine, including herbal medicine, bone-setting, acupuncture, acupressure and tui na, is a general exclusion of the Standard Plan (policy template, Part 7 §10). Separately, VHIS will cover inpatient services at the Chinese Medicine Hospital, with insurers aiming to roll out "Certified Products (Chinese Medicine)" from March 2027 (VHIS website, 2026).