AXA Smart Medicare is a Flexi Plan certified under the Voluntary Health Insurance Scheme, certification number F00018-05-000-03. It entitles the insured to a semi-private room and covers treatment worldwide.
| Age | Annual premium |
|---|---|
| 30 | HK$923 |
| 45 | HK$1,540 |
| 60 | HK$2,461 |
| 75 | HK$4,980 |
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 | Semi-private |
|---|---|
| Geographical cover | worldwide |
| Annual limit | None |
| Lifetime limit | None |
| Room and board | HK$200 |
| Hospital charges | HK$2,500 |
| Doctor's visits | HK$190 |
| Specialist fees | HK$650 |
| Intensive care | HK$650 |
| Surgeon's fee | HK$10,390 |
| Anaesthetist | As stated in the schedule |
| Operating theatre | As stated in the schedule |
| Diagnostic imaging | HK$3,125 |
| Non-surgical cancer treatment | HK$10,390 |
| Outpatient before and after | HK$650 |
| 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 |
| Waiting period | none |
| Cancellation and refund | full refund if cancelled within 21-day cooling-off period, no refund if benefit paid p.4 |
| Switching from another plan | allowed, re-underwriting for upgrades, discretion for downgrades p.15 |
| Room class | not restricted p.19 |
| If a higher room is used | not applicable p.19 |
| Geographical cover | worldwide excluding psychiatric treatment and medical negligence benefit p.18 |
| Psychiatric treatment area | Hong Kong only p.18 |
| Emergency treatment abroad | covered worldwide p.18 |
| Full cover on core benefits | partial p.40 |
| Annual limit | unlimited p.45 |
| Lifetime limit | none p.45 |
| Deductible options | none |
| How the deductible applies | per policy year p.28 |
| Coinsurance | 20% for supplementary major medical, 30% for Prescribed Diagnostic Imaging Tests p.40 |
| Pre-admission outpatient | 1 visit per confinement/day case procedure, USD98 per visit, up to USD650 per Policy Year p.44 |
| Post-discharge outpatient | 3 visits per confinement/day case procedure within 90 days, USD98 per visit, up to USD650 per Policy Year p.44 |
| General outpatient | none |
| Psychiatric treatment | USD3,898 per Policy Year p.44 |
| Diagnostic imaging coinsurance | 30% p.44 |
| Non-surgical cancer treatment | USD10,390 per Policy Year p.44 |
| Kidney dialysis | covered, USD12,500 per Policy Year p.44 |
| Day case procedures | covered as in-patient, subject to benefit limits p.19 |
| Home nursing | none |
| Hospice care | none p.29 |
| Chinese medicine | none p.25 |
| Physiotherapy | covered during confinement and post-discharge outpatient care, subject to limits of miscellaneous charges and pre/post-confinement outpatient care p.20 |
| Congenital conditions | covered if manifested or diagnosed after age 8 p.25 |
| Pregnancy complications | none p.25 |
| Emergency dental | covered for emergency treatment and surgery during confinement arising from an accident p.25 |
| 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 for 3 consecutive policy years p.38 |
| 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; expenses reimbursed by other parties 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.