AXA Smart Medicare is a Flexi Plan certified under the Voluntary Health Insurance Scheme, certification number F00017-04-001-04. It entitles the insured to a ward room and covers treatment worldwide.
| Age | Annual premium |
|---|---|
| 30 | HK$636 |
| 45 | HK$1,009 |
| 60 | HK$1,775 |
| 75 | HK$3,615 |
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 | Ward |
|---|---|
| Geographical cover | worldwide |
| Annual limit | HK$14,500 |
| Lifetime limit | None |
| Room and board | HK$100 |
| Hospital charges | HK$1,820 |
| Doctor's visits | HK$98 |
| Specialist fees | HK$560 |
| Intensive care | HK$455 |
| Surgeon's fee | HK$6,495 |
| Anaesthetist | As stated in the schedule |
| Operating theatre | As stated in the schedule |
| Diagnostic imaging | HK$2,598 |
| Non-surgical cancer treatment | HK$10,390 |
| Outpatient before and after | HK$390 |
| Psychiatric treatment | HK$3,898 |
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 | First Policy Year no coverage, Second Policy Year 25% reimbursement, Third Policy Year 50% reimbursement, Fourth Policy Year onwards full coverage p.23 |
| Waiting period | none |
| Cancellation and refund | full refund within 21-day cooling-off period; no refund after cooling-off period for policyholder cancellation p.4 |
| Switching from another plan | possible to switch to another plan with upgrade or addition of benefits, subject to re-underwriting for the upgrade/addition p.15 |
| Room class | not restricted p.18 |
| If a higher room is used | not applicable as room class is not restricted p.18 |
| Geographical cover | worldwide, except for psychiatric treatment and medical negligence benefit p.18 |
| Psychiatric treatment area | Hong Kong only p.22 |
| Emergency treatment abroad | covered worldwide p.18 |
| Full cover on core benefits | no p.1 |
| Annual limit | unlimited p.41 |
| Lifetime limit | unlimited p.41 |
| Deductible options | none |
| How the deductible applies | none |
| Coinsurance | 30% for Prescribed Diagnostic Imaging Tests; 20% for supplementary major medical p.40 |
| Pre-admission outpatient | 1 prior outpatient visit or Emergency consultation per Confinement/Day Case Procedure, $76 per visit, up to $390 per Policy Year p.40 |
| Post-discharge outpatient | 3 follow-up outpatient visits per Confinement/Day Case Procedure (within 90 days after discharge), $76 per visit, up to $390 per Policy Year p.40 |
| General outpatient | none |
| Psychiatric treatment | HKD3,898 per Policy Year p.40 |
| Diagnostic imaging coinsurance | 30% p.40 |
| Non-surgical cancer treatment | HKD10,390 per Policy Year p.40 |
| Kidney dialysis | Outpatient kidney dialysis HKD6,495 per Policy Year p.40 |
| Day case procedures | covered as in-patient, subject to respective benefit limits p.19 |
| Home nursing | none p.29 |
| Hospice care | none p.29 |
| Chinese medicine | none p.26 |
| Physiotherapy | covered during Confinement under Miscellaneous charges; covered as follow-up outpatient visit after Confinement/Day Case Procedure p.20 |
| Congenital conditions | covered if manifested or diagnosed after age 8 p.26 |
| Pregnancy complications | none p.26 |
| Emergency dental | covered for injury caused by an Accident, up to HKD650 p.40 |
| Hospital cash | none |
| Companion bed | none |
| Second medical opinion | none |
| Direct billing and pre-authorisation | none |
| No-claim discount | 15% of annual premium if no benefit paid in the preceding 3 Policy Years p.42 |
| Exclusions beyond the VHIS standard list | dependence, overdose or influence of drugs, alcohol, narcotics or similar drugs or agents; venereal and sexually transmitted disease or its sequelae; Hair Mineral Analysis (HMA); immunisation or health supplements; birth control or reversal of birth control; sterilisation or sex reassignment of either sex; sexual dysfunction; purchase of durable medical equipment or appliances; traditional Chinese medicine treatment and other forms of alternative treatment p.25 |
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.