Chow Tai Fook ''TopCare'' Medical Insurance Plan is a Flexi Plan certified under the Voluntary Health Insurance Scheme, certification number F00037-03-000-03. It entitles the insured to a semi-private room and covers treatment worldwide.
| Age | Annual premium |
|---|---|
| 30 | HK$11,276 |
| 45 | HK$17,398 |
| 60 | HK$28,467 |
| 75 | HK$51,545 |
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$2,300 |
| Hospital charges | HK$23,000 |
| Doctor's visits | HK$2,000 |
| Specialist fees | HK$9,000 |
| Intensive care | HK$9,000 |
| Surgeon's fee | HK$100,000 |
| Anaesthetist | As stated in the schedule |
| Operating theatre | As stated in the schedule |
| Diagnostic imaging | HK$30,000 |
| Non-surgical cancer treatment | HK$140,000 |
| Outpatient before and after | HK$8,000 |
| Psychiatric treatment | HK$60,000 |
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 first policy year, 100% from 31st day of first policy year onwards p.20 |
| Waiting period | 12 months for pregnancy complications p.38 |
| Cancellation and refund | Full refund within 21-day cooling-off period. After cooling-off, no refund if benefits paid. Pro-rata refund upon death of insured or company ceasing authorization. p.2 |
| Room class | Semi-Private Room p.46 |
| If a higher room is used | If Semi-Private Room entitled: 50% coinsurance for Standard Private Room, 75% coinsurance for Above Standard Private Room, under major medical benefit p.46 |
| Geographical cover | Worldwide p.20 |
| Psychiatric treatment area | Hong Kong only p.20 |
| Emergency treatment abroad | Covered worldwide, subject to annual limit p.20 |
| Full cover on core benefits | no p.46 |
| Annual limit | unlimited p.46 |
| Lifetime limit | none p.20 |
| Deductible options | none |
| How the deductible applies | none |
| Coinsurance | 15% for major medical benefit, 20% or 30% for prescribed diagnostic imaging tests p.46 |
| Pre-admission outpatient | 1 visit per confinement/day case procedure, HKD 1,200 per visit, up to HKD 8,000 per policy year p.46 |
| Post-discharge outpatient | 6 visits per confinement/day case procedure within 90 days, HKD 1,200 per visit, up to HKD 8,000 per policy year p.46 |
| General outpatient | none |
| Psychiatric treatment | HKD 60,000 per Policy Year p.46 |
| Diagnostic imaging coinsurance | 30% during confinement, 20% for day patient p.46 |
| Non-surgical cancer treatment | HKD 140,000 per policy year, plus HKD 140,000 per 6-year benefit period for major cancer top-up p.46 |
| Kidney dialysis | HKD 80,000 per Policy Year p.46 |
| Day case procedures | Covered as in-patient, plus HKD 1,200 cash allowance per day case procedure, once per policy year p.46 |
| Home nursing | HKD 1,200 per visit, 1 visit per day within 90 days after discharge, up to 30 visits per policy year p.46 |
| Hospice care | HKD 50,000 per Policy Year p.46 |
| Chinese medicine | Inpatient: same limits as miscellaneous charges (HKD 23,000 per policy year) and attending doctor's visit fee (HKD 2,000 per day, max 180 days). Post-discharge: HKD 900 per visit, up to HKD 3,000 per policy year, 3 visits within 90 days. p.46 |
| Physiotherapy | Covered as part of miscellaneous charges during confinement and post-discharge outpatient care p.20 |
| Congenital conditions | Covered from age 8 p.26 |
| Pregnancy complications | Covered for defined complications, subject to basic and additional benefit limits, after 12-month waiting period p.46 |
| Emergency dental | Covered for accident-related injury to sound natural teeth, up to HKD 20,000 per policy year p.46 |
| Hospital cash | HKD 1,000 per day, max 15 days per policy year, for using a lower ward class than entitled p.38 |
| Companion bed | Fully covered, max 180 days per policy year p.46 |
| No-claim discount | 16% discount, reduced to 8% or 0% if claims are made, resumes to 16% after 3 consecutive no-claim years p.38 |
| Exclusions beyond the VHIS standard list | sexual dysfunction; Hair Mineral Analysis (HMA); purchase of durable medical equipment (extensive list) p.26 |
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$13,458 to HK$17,398.
| Year | Change |
|---|---|
| 2022 | +8.0% |
| 2023 | +8.0% |
| 2024 | +10.0% |
| 2025 | +0.8% |
| 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 3 with SMM (HKD) | Semi-private | None | No annual limit |
| Benefit Level 3 with SMM (HKD) | Semi-private | None | No annual limit |
| Benefit Level 3 with SMM (HKD) | Semi-private | None | No annual limit |
| Benefit Level 3 with SMM (HKD) | Semi-private | None | No annual limit |
| Benefit Level 3 with SMM (HKD) | Semi-private | None | No annual limit |
| Benefit Level 3 with SMM (HKD) | Semi-private | None | No annual limit |
| Benefit Level 3 with SMM (HKD) | Semi-private | None | No annual limit |
| Benefit Level 3 with SMM (HKD) | Semi-private | 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.