Chow Tai Fook ''TopCare'' Medical Insurance Plan is a Flexi Plan certified under the Voluntary Health Insurance Scheme, certification number F00037-02-000-03. It entitles the insured to a ward room and covers treatment worldwide.
| Age | Annual premium |
|---|---|
| 30 | HK$8,567 |
| 45 | HK$13,773 |
| 60 | HK$20,398 |
| 75 | HK$39,361 |
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 | None |
| Lifetime limit | None |
| Room and board | HK$1,200 |
| Hospital charges | HK$16,000 |
| Doctor's visits | HK$950 |
| Specialist fees | HK$6,000 |
| Intensive care | HK$6,000 |
| Surgeon's fee | HK$70,000 |
| Anaesthetist | As stated in the schedule |
| Operating theatre | As stated in the schedule |
| Diagnostic imaging | HK$25,000 |
| Non-surgical cancer treatment | HK$120,000 |
| Outpatient before and after | HK$5,000 |
| Psychiatric treatment | HK$50,000 |
Also includes outpatient general, dental, maternity, chinese medicine, home nursing, a companion bed, hospital cash, rehabilitation, hospice care, 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 | 128 p.2 |
|---|---|
| Pre-existing conditions unknown at application | 0% for first 30 days of Policy Year 1, 100% from 31st day of Policy Year 1 onwards p.20 |
| Waiting period | 12 months for pregnancy complications p.40 |
| Cancellation and refund | Full refund within 21-day cooling-off period if no claim; after cooling-off, cancellation with 30 days' notice if no claim in policy year p.2 |
| Switching from another plan | Possible to switch to another plan, re-underwriting limited to upgraded/additional benefits p.2 |
| Room class | Ward p.46 |
| If a higher room is used | 50% coinsurance for Semi-Private Room, 75% coinsurance for Standard Private Room or above, under major medical benefit p.42 |
| Geographical cover | Worldwide, except for psychiatric treatment p.20 |
| Psychiatric treatment area | Hong Kong only p.20 |
| Emergency treatment abroad | Covered worldwide, subject to general limits p.20 |
| Full cover on core benefits | no p.46 |
| Annual limit | Unlimited p.49 |
| Lifetime limit | none p.20 |
| Deductible options | none |
| Coinsurance | none (30% for Prescribed Diagnostic Imaging Tests during Confinement, 20% for Prescribed Diagnostic Imaging Tests as Day Patient, 15% for Major Medical Benefit) p.46 |
| Pre-admission outpatient | 1 visit per Confinement/Day Case Procedure, HKD 800 per visit, up to HKD 5,000 per Policy Year p.46 |
| Post-discharge outpatient | 6 visits within 90 days after discharge/Day Case Procedure, HKD 800 per visit, up to HKD 5,000 per Policy Year p.46 |
| General outpatient | none |
| Psychiatric treatment | HKD 50,000 per Policy Year p.46 |
| Diagnostic imaging coinsurance | 30% during Confinement, 20% as Day Patient p.46 |
| Non-surgical cancer treatment | HKD 120,000 per Policy Year (basic) + HKD 120,000 per 6-year Benefit Period (top-up) p.46 |
| Kidney dialysis | HKD 50,000 per Policy Year p.47 |
| Day case procedures | Covered as in-patient for various benefits; cash allowance of HKD 800 per Day Case Procedure, once per Policy Year p.46 |
| Home nursing | HKD 800 per visit, 1 visit per day within 90 days after discharge/Day Case Procedure, up to 30 visits per Policy Year p.47 |
| Hospice care | HKD 30,000 per Policy Year p.47 |
| Chinese medicine | Inpatient: same limits as miscellaneous charges (HKD 16,000) and attending doctor's visit fee (HKD 950/day); Post-discharge: HKD 600 per visit, up to HKD 2,000 per Policy Year for 3 visits within 90 days p.47 |
| Physiotherapy | During Confinement (part of miscellaneous charges, HKD 16,000/year); Post-discharge (part of outpatient care, HKD 800/visit, up to HKD 5,000/year for 6 visits) p.20 |
| Congenital conditions | Covered if manifested or diagnosed after age 8 p.26 |
| Pregnancy complications | Covered for specific complications after 12-month waiting period, subject to basic and additional benefit limits p.40 |
| Emergency dental | Covered for injury to sound natural teeth within 30 days of accident, up to HKD 10,000 per Policy Year p.39 |
| Hospital cash | none p.47 |
| Companion bed | Fully Covered, up to 180 days per Policy Year p.47 |
| No-claim discount | 16% discount; reduced to 8% after a claim, then 0%; resumes 16% after 3 consecutive no-claim years p.38 |
| Exclusions beyond the VHIS standard list | Hair Mineral Analysis (HMA); purchase of durable medical equipment or appliances (e.g. wheelchairs, oxygen devices, spectacles) p.25 |
At a constant age of 45, Chow Tai Fook has filed 4 schedule changes on this plan since 2021, an average of +3.7% a year, taking the premium from HK$10,655 to HK$13,773.
| Year | Change |
|---|---|
| 2022 | +8.0% |
| 2023 | +8.0% |
| 2024 | +10.0% |
| 2025 | +0.7% |
| 2026 | no change |
A record of what has been filed, not a forecast of what you will pay.
| Option | Room | Deductible | Annual limit |
|---|---|---|---|
| Benefit Level 2 with SMM (HKD) | Ward | None | No annual limit |
| Benefit Level 2 with SMM (HKD) | Ward | None | No annual limit |
| Benefit Level 2 with SMM (HKD) | Ward | None | No annual limit |
| Benefit Level 2 with SMM (HKD) | Ward | None | No annual limit |
| Benefit Level 2 with SMM (HKD) | Ward | None | No annual limit |
| Benefit Level 2 with SMM (HKD) | Ward | None | No annual limit |
| Benefit Level 2 with SMM (HKD) | Ward | None | No annual limit |
| Benefit Level 2 with SMM (HKD) | Ward | None | No annual limit |
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.