VHIS Hong Kong
AXA · F00018-05-001-03

AXA Smart Medicare

AXA Smart Medicare is a Flexi Plan certified under the Voluntary Health Insurance Scheme, certification number F00018-05-001-03. It entitles the insured to a semi-private room and covers treatment worldwide.

Premium by age, current schedule

AgeAnnual premium
30HK$1,357
45HK$2,138
60HK$3,652
75HK$7,024

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.

What it pays

RoomSemi-private
Geographical coverworldwide
Annual limitHK$22,500
Lifetime limitNone
Room and boardHK$200
Hospital chargesHK$2,500
Doctor's visitsHK$190
Specialist feesHK$650
Intensive careHK$650
Surgeon's feeHK$10,390
AnaesthetistAs stated in the schedule
Operating theatreAs stated in the schedule
Diagnostic imagingHK$3,125
Non-surgical cancer treatmentHK$10,390
Outpatient before and afterHK$650
Psychiatric treatmentHK$3,898

Also includes outpatient general, dental, kidney dialysis, a death benefit.

What the plan document states

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 age100 p.13
Pre-existing conditions unknown at application0% year 1, 25% year 2, 50% year 3, 100% from year 4 p.23
Waiting periodnone
Cancellation and refundFull refund within 21-day cooling-off period if no benefit paid; after cooling-off, cancellation with 30 days notice if no benefit paid in current policy year p.4
Switching from another planSwitching to another plan with upgrade or addition of benefits is subject to re-underwriting for the upgraded/additional benefits p.15
Room classnot restricted p.18
If a higher room is usednot applicable as choice of ward class is not restricted p.18
Geographical coverworldwide excluding psychiatric treatment and medical negligence benefit p.18
Psychiatric treatment areaHong Kong only p.22
Emergency treatment abroadCovered worldwide, Emergency outpatient treatment for Accident up to $1,250 per Policy Year p.18
Full cover on core benefitspartial p.42
Annual limitNil p.42
Lifetime limitnone p.18
Deductible optionsnot stated
How the deductible appliesper Policy Year p.28
Coinsurance20% for supplementary major medical, 30% for Prescribed Diagnostic Imaging Tests p.42
Pre-admission outpatient1 visit per Confinement/Day Case Procedure, up to $650 per Policy Year p.42
Post-discharge outpatient3 visits within 90 days after discharge/procedure, up to $650 per Policy Year p.42
General outpatientnone
Psychiatric treatment$3,898 per Policy Year p.42
Diagnostic imaging coinsurance30% p.42
Non-surgical cancer treatment$10,390 per Policy Year p.42
Kidney dialysis$12,500 per Policy Year p.42
Day case proceduresCovered as in-patient, subject to individual benefit limits p.19
Home nursingnone
Hospice carenone p.29
Chinese medicinenone p.25
PhysiotherapyCovered during Confinement and as part of post-discharge outpatient care, subject to respective limits p.20
Congenital conditionsCovered from age 8 if not manifested or diagnosed before p.26
Pregnancy complicationsnone p.25
Emergency dentalCovered for Emergency Treatment and surgery during Confinement arising from an Accident p.25
Hospital cashnone
Companion bednone
Second medical opinionnot stated
Direct billing and pre-authorisationPre-authorisation for claimable amount estimate is available p.17
No-claim discount15% of annual premium if no claim made in the preceding 3 policy years p.42
Exclusions beyond the VHIS standard listdependence, overdose or influence of drugs, alcohol, narcotics or similar drugs or agents; venereal and sexually transmitted disease or its sequelae; Hair Mineral Analysis (HMA); purchase of durable medical equipment or appliances p.24

What a claim on this plan would look like

Private hospitals publish what they billed for common operations. These pages take those bills and work out what a plan pays of them.

Colonoscopy with or without polypectomyHK$21,098 to HK$54,834 depending on the hospital
ColposcopyHK$23,320 to HK$43,971 depending on the hospital
Trigger finger releaseHK$25,622 to HK$58,423 depending on the hospital
Cystoscopy with or without biopsyHK$23,116 to HK$62,569 depending on the hospital
CircumcisionHK$25,841 to HK$55,602 depending on the hospital
Gastroscopy with or without polypectomyHK$18,484 to HK$72,307 depending on the hospital

Every procedure with published bills

The certified plan document as filed, on the Health Bureau's VHIS site.

Price this plan for your age

Premiums are annual, in the plan currency, before the Insurance Authority levy, taken from the Standard Premium Schedules filed with the Health Bureau. Rate records come from every schedule archived on data.gov.hk since March 2021 and are a track record, not a forecast. Information only, not regulated advice.

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