AXA Smart Medicare is a Flexi Plan certified under the Voluntary Health Insurance Scheme, certification number F00018-04-001-03. 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 | 0% year 1, 25% year 2, 50% year 3, 100% from year 4 p.23 |
| Cancellation and refund | Full refund within 21-day cooling-off period if no claim; pro-rata refund if terminated due to death or company ceasing authorization p.4 |
| Switching from another plan | Possible to switch to another plan, re-underwriting applies for upgrade or additional 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, subject to benefit limits p.18 |
| Full cover on core benefits | no p.41 |
| Annual limit | unlimited p.41 |
| Lifetime limit | none p.18 |
| Deductible options | none |
| Coinsurance | 30% for Prescribed Diagnostic Imaging Tests; 20% for supplementary major medical p.41 |
| Pre-admission outpatient | 1 visit prior to confinement/day case procedure, USD76 per visit, up to USD390 per Policy Year p.41 |
| Post-discharge outpatient | 3 visits within 90 days after discharge/day case procedure, USD76 per visit, up to USD390 per Policy Year p.41 |
| General outpatient | none |
| Psychiatric treatment | USD3,898 per Policy Year p.41 |
| Diagnostic imaging coinsurance | 30% p.41 |
| Non-surgical cancer treatment | USD10,390 per Policy Year p.41 |
| Kidney dialysis | Covered, USD6,495 per Policy Year p.41 |
| Day case procedures | Covered as in-patient for relevant benefits, subject to limits per item p.19 |
| Home nursing | none |
| Hospice care | none p.29 |
| Chinese medicine | none p.26 |
| Physiotherapy | Covered during confinement or as follow-up outpatient care related to confinement/day case procedure, subject to limits 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.42 |
| Exclusions beyond the VHIS standard list | purchase of durable medical equipment or appliances; traditional Chinese medicine treatment and other alternative treatments 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.