Chow Tai Fook ''TopCare'' Medical Insurance Plan is a Flexi Plan certified under the Voluntary Health Insurance Scheme, certification number F00037-05-000-03. It entitles the insured to a ward room and covers treatment worldwide.
| Age | Annual premium |
|---|---|
| 30 | HK$921 |
| 45 | HK$1,488 |
| 60 | HK$2,126 |
| 75 | HK$4,102 |
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$155 |
| Hospital charges | HK$2,065 |
| Doctor's visits | HK$125 |
| Specialist fees | HK$775 |
| Intensive care | HK$775 |
| Surgeon's fee | HK$9,035 |
| Anaesthetist | As stated in the schedule |
| Operating theatre | As stated in the schedule |
| Diagnostic imaging | HK$3,230 |
| Non-surgical cancer treatment | HK$15,485 |
| Outpatient before and after | HK$650 |
| Psychiatric treatment | HK$6,455 |
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 p.26 |
| Waiting period | 12 months for pregnancy complications p.42 |
| Cancellation and refund | Full refund within 21-day cooling-off period; after cooling-off, cancellation with 30 days notice if no claims paid in policy year p.2 |
| Switching from another plan | Allowed to switch to plans with upgraded/added benefits (re-underwriting limited to new benefits) or downgraded/reduced benefits (no re-underwriting, discretion to accept/reject) p.19 |
| 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 p.43 |
| Geographical cover | worldwide p.20 |
| Psychiatric treatment area | Hong Kong only p.25 |
| Emergency treatment abroad | Covered worldwide p.20 |
| Full cover on core benefits | no p.46 |
| Annual limit | unlimited p.49 |
| Lifetime limit | none p.20 |
| Deductible options | none |
| Coinsurance | 20% or 30% for Prescribed Diagnostic Imaging Tests; 15% for Major Medical Benefit, increasing to 50% or 75% for higher room class p.43 |
| Pre-admission outpatient | 1 visit before admission, up to $650 per Policy Year p.46 |
| Post-discharge outpatient | 6 visits within 90 days after discharge, up to $650 per Policy Year p.46 |
| General outpatient | none |
| Psychiatric treatment | $6,455 per Policy Year p.46 |
| Diagnostic imaging coinsurance | 30% for inpatient, 20% for day patient p.46 |
| Non-surgical cancer treatment | $15,485 per Policy Year, plus $15,485 per 6-year Benefit Period for Major Cancer p.46 |
| Kidney dialysis | $6,455 per Policy Year p.47 |
| Day case procedures | Covered as inpatient for various items, plus $105 cash allowance per Day Case Procedure once per Policy Year p.24 |
| Home nursing | $105 per visit, 1 visit per day within 90 days after discharge, up to 30 visits per Policy Year p.47 |
| Hospice care | $3,875 per Policy Year p.47 |
| Chinese medicine | Inpatient Chinese medicine and treatment up to $2,065 per Policy Year (miscellaneous charges) and $125 per day (attending doctor's fee); Post-confinement Chinese medicine $80 per visit, up to $260 per Policy Year for 3 visits within 90 days p.47 |
| Physiotherapy | Covered during confinement under miscellaneous charges; covered for follow-up outpatient visits under pre/post-confinement outpatient care p.24 |
| Congenital conditions | Covered from age 8 p.26 |
| Pregnancy complications | Covered for specific complications, subject to basic and additional benefit limits p.42 |
| Emergency dental | Covered for injury to sound natural teeth due to accident, up to $1,295 per Policy Year p.42 |
| Hospital cash | none p.47 |
| Companion bed | Fully Covered, maximum 180 days per Policy Year p.46 |
| No-claim discount | 16% discount, reduced to 8% or 0% after a claim, restored to 16% after 3 consecutive no-claim years p.38 |
| Exclusions beyond the VHIS standard list | Purchase of durable medical equipment or appliances; traditional Chinese medicine and other alternative treatments (unless covered by specific benefit) 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$1,151 to HK$1,488.
| 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 1 with SMM (USD) | Ward | None | No annual limit |
| Benefit Level 1 with SMM (USD) | Ward | None | No annual limit |
| Benefit Level 1 with SMM (USD) | Ward | None | No annual limit |
| Benefit Level 1 with SMM (USD) | Ward | None | No annual limit |
| Benefit Level 1 with SMM (USD) | Ward | None | No annual limit |
| Benefit Level 1 with SMM (USD) | Ward | None | No annual limit |
| Benefit Level 1 with SMM (USD) | Ward | None | No annual limit |
| Benefit Level 1 with SMM (USD) | 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.