Chow Tai Fook ''TopCare'' Medical Insurance Plan is a Flexi Plan certified under the Voluntary Health Insurance Scheme, certification number F00037-06-000-03. It entitles the insured to a ward room and covers treatment worldwide.
| Age | Annual premium |
|---|---|
| 30 | HK$1,106 |
| 45 | HK$1,777 |
| 60 | HK$2,632 |
| 75 | HK$5,079 |
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 onwards p.25 |
| Waiting period | 12 months for pregnancy complications p.41 |
| Cancellation and refund | Full refund within 21-day cooling-off period; pro-rata refund for current policy year upon death of Insured Person or company ceasing authorization p.3 |
| 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.17 |
| Room class | Ward p.46 |
| If a higher room is used | If higher room class is used, coinsurance for major medical benefit increases: Ward to Semi-Private 50%, Ward to Standard Private or above 75% p.42 |
| Geographical cover | Worldwide, except for psychiatric treatment p.20 |
| Psychiatric treatment area | Hong Kong only p.24 |
| Emergency treatment abroad | Covered worldwide p.20 |
| Full cover on core benefits | No p.46 |
| Annual limit | Unlimited p.48 |
| Lifetime limit | None p.20 |
| Deductible options | None |
| How the deductible applies | None |
| Coinsurance | 30% for Prescribed Diagnostic Imaging Tests (inpatient), 20% for Prescribed Diagnostic Imaging Tests (day patient), 15% for Major Medical Benefit p.46 |
| Pre-admission outpatient | 1 visit prior to confinement/day case procedure, $105 per visit, up to $650 per Policy Year p.46 |
| Post-discharge outpatient | 6 follow-up visits within 90 days after discharge/day case, $105 per visit, up to $650 per Policy Year p.46 |
| General outpatient | None |
| Psychiatric treatment | $6,455 per Policy Year p.46 |
| Diagnostic imaging coinsurance | 30% (inpatient), 20% (day patient) p.46 |
| Non-surgical cancer treatment | $15,485 per Policy Year, plus $15,485 per 6-year Benefit Period for Major Cancer top-up p.46 |
| Kidney dialysis | $6,455 per Policy Year p.47 |
| Day case procedures | Covered as inpatient, plus $105 cash allowance per Day Case Procedure, once per Policy Year p.47 |
| Home nursing | $105 per visit, 1 visit per day within 90 days post-discharge/day case, 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 miscellaneous charges limit ($2,065/year) and attending doctor's visit fee limit ($125/day, max 180 days); Post-discharge 3 visits within 90 days, $80/visit, up to $260/year p.47 |
| Physiotherapy | During confinement under miscellaneous charges ($2,065/year); Post-discharge under outpatient care ($105/visit, up to $650/year) p.46 |
| Congenital conditions | Covered from age 8 p.27 |
| Pregnancy complications | Covered subject to basic and additional benefit limits, after 12-month waiting period from policy effective date p.41 |
| Emergency dental | $1,295 per Policy Year for emergency dental treatment due to accident p.47 |
| Hospital cash | None p.47 |
| Companion bed | Fully Covered, maximum 180 days per Policy Year p.47 |
| No-claim discount | 16% discount; reduces to 8% then 0% after a claim; 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; Specific Chinese medicines (e.g., ginseng, cordyceps) 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$1,375 to HK$1,777.
| 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 (USD) | Ward | None | No annual limit |
| Benefit Level 2 with SMM (USD) | Ward | None | No annual limit |
| Benefit Level 2 with SMM (USD) | Ward | None | No annual limit |
| Benefit Level 2 with SMM (USD) | Ward | None | No annual limit |
| Benefit Level 2 with SMM (USD) | Ward | None | No annual limit |
| Benefit Level 2 with SMM (USD) | Ward | None | No annual limit |
| Benefit Level 2 with SMM (USD) | Ward | None | No annual limit |
| Benefit Level 2 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.