AXA Smart Medicare is a Flexi Plan certified under the Voluntary Health Insurance Scheme, certification number F00018-01-001-03. It entitles the insured to a ward room and covers treatment worldwide.
| Age | Annual premium |
|---|---|
| 30 | HK$5,187 |
| 45 | HK$8,173 |
| 60 | HK$14,298 |
| 75 | HK$29,016 |
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$116,000 |
| Lifetime limit | None |
| Room and board | HK$800 |
| Hospital charges | HK$14,000 |
| Doctor's visits | HK$750 |
| Specialist fees | HK$4,300 |
| Intensive care | HK$3,500 |
| Surgeon's fee | HK$50,000 |
| Anaesthetist | As stated in the schedule |
| Operating theatre | As stated in the schedule |
| Diagnostic imaging | HK$20,000 |
| Non-surgical cancer treatment | HK$80,000 |
| Outpatient before and after | HK$3,000 |
| 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 p.23 |
| Cancellation and refund | full refund within 21-day cooling-off period if no benefit paid; no refund after cooling-off period p.4 |
| Switching from another plan | re-underwriting for upgrade of benefits; discretion to accept/reject for downgrade of benefits p.15 |
| Room class | not restricted p.18 |
| Geographical cover | worldwide excluding 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.44 |
| Annual limit | unlimited p.45 |
| Lifetime limit | none p.18 |
| Deductible options | none |
| Coinsurance | none |
| Pre-admission outpatient | 1 visit per confinement/day case procedure, up to HKD3,000 per policy year p.44 |
| Post-discharge outpatient | 3 visits within 90 days after discharge/day case procedure, up to HKD3,000 per policy year p.44 |
| General outpatient | none |
| Psychiatric treatment | HKD30,000 per policy year p.44 |
| Diagnostic imaging coinsurance | 30% p.44 |
| Non-surgical cancer treatment | HKD80,000 per policy year p.44 |
| Kidney dialysis | HKD50,000 per policy year p.44 |
| Day case procedures | covered as in-patient, subject to individual benefit limits p.19 |
| Home nursing | none |
| Hospice care | none p.29 |
| Chinese medicine | none p.26 |
| Physiotherapy | covered during confinement or as follow-up to confinement/day case procedure, subject to limits of miscellaneous charges and pre/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 | not stated |
| No-claim discount | 15% of annual premium if no claim made in preceding 3 policy years p.39 |
| Exclusions beyond the VHIS standard list | purchase of durable medical equipment or appliances; traditional Chinese medicine treatment and other forms of alternative treatment 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$7,039 to HK$8,173.
| Year | Change |
|---|---|
| 2022 | no change |
| 2023 | no change |
| 2024 | +5.9% |
| 2025 | +4.5% |
| 2026 | +4.9% |
A record of what has been filed, not a forecast of what you will pay.
| Option | Room | Deductible | Annual limit |
|---|---|---|---|
| Regular with SMM (HKD) | None | No annual limit (items (a)-(l) & Enhanced Benefits); SMM aggregate HKD 116,000 per Policy Year | |
| Regular with SMM (HKD) | None | No annual limit (items (a)-(l) & Enhanced Benefits); SMM aggregate HKD 116,000 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.