Wide Variation in the Check-up Items and Fees of Medical Check-up Service for Elderly Online Purchases Come with Many Restrictions

17 June 2019
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Wide Variation in the Check-up Items and Fees of  Medical Check-up Service for Elderly Online Purchases Come with Many Restrictions As health awareness among the elderly has raised in recent years, many conduct regular annual medical check-ups for early detection of disease and undergo suitable treatment. This has spawned a burgeoning market for medical check-up services with some of which are purportedly designed for the elderly. But consumers should be aware that these plans differ significantly in the number and items of the health checks they cover, as well as the charges and discounts. In some cases, the price of check-up plan may seem competitive, just because certain basic items were included as optional items at an additional charge or in contrast, optional check-up items were included as set packages, consumers are reminded to compare check-up plans carefully. Besides, consumers should note that selection of these check-up plans were without professional advice from doctors based on an individual’s health and certain test reports are not evaluated or interpreted by doctors, raising concerns about accuracy.

A comprehensive health check should cover medical history, a health risk assessment, a physical examination, and appropriate tests. The investigation should preferably be conducted by a doctor, so that the health check test items could be customised, based on the consumer’s specific medical condition.  Many consumers are drawn to direct online purchases, because of the greater convenience and benefits. But online platforms usually demand pre-payments, so consumers must read the terms and conditions carefully, paying particular attention to the expiry date, and the conditions for alterations or cancellations. 

Included in the survey were 12 service providers offering 19 medical check-up plans for the elderly – 9 private companies, 2 private hospitals and 1 non-profit organisation – with prices ranging from $460 to $7,740, a difference of more than 16 times. 6 service providers offered a discount to their clients: for example a discount from 10% to 60%, or a rebate of $200 for Senior Citizen Card holders. Only 10 of the 19 plans could be paid by Health Care Vouchers (HCVs), among which 1 required a doctor referral, and 1 would not accept HCV as membership fee payment. Before joining a plan, elderly consumers should ask about restrictions in the use of HCVs.

The medical check-ups for elderly normally include blood tests, tests on kidney and liver function, faeces and urine, and a test for osteoporosis. The cost of some plans appeared to be relatively low, but closer examination revealed that some of the relevant check-up items were missing from the basic plans, but were available as optional or additional surcharge items. In the survey, 2 service providers offered osteoporosis test as additional surcharge item, and charged an extra fee at $750 or $1,160 for bone density measurement.

Consumers should also note that even for similar check-up items, there may be differences in the methodology used and the complexity of the examination. For instance, some plans use “Quantitative Ultrasound (QUS)” for the osteoporosis test to assess the risk of bone fractures. This test is for screening purposes and is not suitable for diagnosis. For older people who have been identified as being high risk of bone fractures, they should consult a doctor for a “Dual Energy X-ray Absorptiometry (DEXA)” examination.

A proper medical check-up service should have a doctor follow up the whole process. However, 6 service providers stated should elderly needed to consult a doctor for a suitable check-up plan, they have to arrange it at their own expense; it costs from $210 to $650. If elderly decide to enrol in a check-up plan, 3 service providers will waive the consultation fee. The survey found 5 out of 12 service providers delegated the responsibility for the medical check-up to nurses or health assistants, which is a rather unsatisfactory practice.

As a medical check-up can produce “false negatives” or “false positive” results, they cannot be relied on for 100% accuracy. Therefore, medical test reports should be evaluated and interpreted by doctors to get professional advice on the necessary treatment. But this may not be the case, 1 service provider levied a surcharge of $350 to $600 for a request to change from a registered nurse to a doctor for the test evaluation. Another service provider flatly stated that it could provide only a registered nurse or other health staff for the task.

In the survey, 6 service providers allowed their clients to receive the medical reports in person or over the phone. While the latter is more convenient, consumers should ensure the personnel giving the reports are suitably qualified. Moreover, 7 service providers set an expiry date for report collection and consultation, ranging from 2 to 12 months after the check-up. If the reports are not claimed by the expiry date, they may be destroyed. One service provider charged an extra doctor’s consultation fee of $210 after 60 days from the date of the medical check-up.

Apart from making a medical check-up reservation in person or over the phone, 6 private service providers sold their medical check-up plans through their company website and/or other online shopping platforms. But plans purchased online are generally valid for only a certain period of time upon confirmation of payment. 5 service providers allowed booking in 3 to 12 months; 3 of them required booking 1 month in advance; and 1 required advance booking within 6 months. Consumers should pay particular attention to the conditions regarding the expiry date and advance appointments to avoid monetary loss.

With online purchases, there are many restrictions if consumers want to change any check items. 1 service provider asked for a doctor’s referral; 1 allowed consumers to change on the day of the check-up or 1 working day before the check-up; and 3 others would not accept any alterations. For changes in an online purchased service, only 2 service providers allowed an upgrade to a higher priced plan, which the price difference to be borne by consumers, and 1 service provider allowed a paid plan to be transferred to someone else. If a customer wanted to cancel a check-up service purchased online, 2 service providers offered a full refund, or refunded 3% of the payment or $250, whichever was higher.

More tips for elderly and their family members when choosing medical check-up services are as follows:

- More check-up items are not necessarily better. A doctor’s consultation should be sought to suggest the test items based on the elderly’s health condition and risk assessment, coupled with a clinical evaluation;

- Consumers intend to be funded by HCVs should first check whether the service provider has any restrictions on their use. The fees for plans purchased through the company website and/or other online platforms are required to settled online, barring the use of HCVs;

- Whenever possible, elderly should be accompanied by relatives or friends to receive the test report and, to make enquiries on their behalf as appropriate, to ensure a correct understanding of their medical condition and to seek appropriate treatment if needed; 

- Before buying a plan online, consumers should read the terms and conditions in detail, make sure they understand clearly if the expiry date is calculated from the date when the advance booking is made or from the date of the check-up, if the medical check-up plan purchased is transferable to someone else, under what conditions test items can be added or altered. Consumers should retain all payment receipts for records should the need arise in the future to seek redress.  

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