AXA Smart Medicare is a Flexi Plan certified under the Voluntary Health Insurance Scheme, certification number F00017-03-001-04. It entitles the insured to a private room and covers treatment worldwide.
| Age | Annual premium |
|---|---|
| 30 | HK$21,529 |
| 45 | HK$33,761 |
| 60 | HK$58,181 |
| 75 | HK$113,169 |
Female non-smoker, the plan currency, before levy. Age is the only thing that changes down this table; it is the plan's own filed schedule, not a quotation.
| Room | Private |
|---|---|
| Geographical cover | worldwide |
| Annual limit | HK$420,000 |
| Lifetime limit | None |
| Room and board | HK$4,500 |
| Hospital charges | HK$35,000 |
| Doctor's visits | HK$4,500 |
| Specialist fees | HK$10,000 |
| Intensive care | HK$8,000 |
| Surgeon's fee | HK$160,000 |
| Anaesthetist | As stated in the schedule |
| Operating theatre | As stated in the schedule |
| Diagnostic imaging | HK$30,000 |
| Non-surgical cancer treatment | HK$80,000 |
| Outpatient before and after | HK$7,000 |
| Psychiatric treatment | HK$30,000 |
Also includes outpatient general, dental, kidney dialysis, a death benefit.
Read from the certified Terms and Benefits. Each page link opens that page of the filed document. Fields the document does not state are left out.
| Guaranteed renewal to age | 100 p.13 |
|---|---|
| Pre-existing conditions unknown at application | 0% year 1, 25% year 2, 50% year 3, 100% from year 4 p.23 |
| Waiting period | none |
| Cancellation and refund | full refund if cancelled within 21-day cooling-off period; no refund after cooling-off period if benefits have been paid p.4 |
| Switching from another plan | can switch to another plan with upgrade/addition of benefits (re-underwriting limited to new benefits); can switch to another plan with downgrade/reduction of benefits (no re-underwriting, but company discretion to accept/reject) p.15 |
| Room class | not restricted p.18 |
| If a higher room is used | not applicable p.18 |
| Geographical cover | worldwide p.18 |
| Psychiatric treatment area | Hong Kong only p.22 |
| Emergency treatment abroad | covered worldwide p.18 |
| Full cover on core benefits | no p.40 |
| Annual limit | unlimited (individual benefit items are capped; supplementary major medical has an aggregate annual limit of HKD 420,000) p.41 |
| Lifetime limit | none p.18 |
| Coinsurance | 30% for Prescribed Diagnostic Imaging Tests; 20% for Supplementary Major Medical p.40 |
| Pre-admission outpatient | 1 visit per confinement/day case procedure, HKD 980 per visit, up to HKD 7,000 per Policy Year p.40 |
| Post-discharge outpatient | 3 visits per confinement/day case procedure within 90 days, HKD 980 per visit, up to HKD 7,000 per Policy Year p.40 |
| General outpatient | none |
| Psychiatric treatment | HKD 30,000 per Policy Year p.40 |
| Diagnostic imaging coinsurance | 30% p.40 |
| Non-surgical cancer treatment | HKD 80,000 per Policy Year p.40 |
| Kidney dialysis | HKD 200,000 per Policy Year p.40 |
| Day case procedures | covered as in-patient for relevant benefits, subject to individual benefit limits p.19 |
| Home nursing | none |
| Hospice care | none p.29 |
| Chinese medicine | none p.26 |
| Physiotherapy | covered during confinement under miscellaneous charges; covered for follow-up outpatient visits post-confinement/day case procedure under pre- and post-confinement outpatient care p.20 |
| Congenital conditions | covered from age 8 p.26 |
| Pregnancy complications | none p.26 |
| Emergency dental | covered for emergency treatment and surgery during confinement arising from an accident p.26 |
| Hospital cash | none |
| Companion bed | none |
| Second medical opinion | not stated |
| Direct billing and pre-authorisation | pre-authorisation for claimable amount estimate is available p.17 |
| No-claim discount | 15% of annual premium if no benefit paid for 3 preceding policy years p.37 |
| Exclusions beyond the VHIS standard list | Hair Mineral Analysis (HMA); purchase of durable medical equipment or appliances; traditional Chinese medicine treatment and other alternative treatments p.25 |
At a constant age of 45, AXA has filed 3 schedule changes on this plan since 2021, an average of +2.3% a year, taking the premium from HK$29,040 to HK$33,761.
| Year | Change |
|---|---|
| 2022 | no change |
| 2023 | no change |
| 2024 | +6.0% |
| 2025 | +4.5% |
| 2026 | +5.0% |
A record of what has been filed, not a forecast of what you will pay.
| Option | Room | Deductible | Annual limit |
|---|---|---|---|
| Premier with SMM (HKD) | None | No annual limit (items (a)-(l) & Enhanced Benefits); SMM aggregate HKD 420,000 per Policy Year | |
| Premier with SMM (HKD) | None | No annual limit (items (a)-(l) & Enhanced Benefits); SMM aggregate HKD 420,000 per Policy Year |
Private hospitals publish what they billed for common operations. These pages take those bills and work out what a plan pays of them.
Every procedure with published bills
The certified plan document as filed, on the Health Bureau's VHIS site.