Chow Tai Fook ''TopCare'' Medical Insurance Plan is a Flexi Plan certified under the Voluntary Health Insurance Scheme, certification number F00037-07-000-03. It entitles the insured to a semi-private room and covers treatment worldwide.
| Age | Annual premium |
|---|---|
| 30 | HK$1,455 |
| 45 | HK$2,245 |
| 60 | HK$3,673 |
| 75 | HK$6,651 |
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$300 |
| Hospital charges | HK$2,970 |
| Doctor's visits | HK$260 |
| Specialist fees | HK$1,165 |
| Intensive care | HK$1,165 |
| Surgeon's fee | HK$12,905 |
| Anaesthetist | As stated in the schedule |
| Operating theatre | As stated in the schedule |
| Diagnostic imaging | HK$3,875 |
| Non-surgical cancer treatment | HK$18,065 |
| Outpatient before and after | HK$1,035 |
| Psychiatric treatment | HK$7,745 |
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.40 |
| Cancellation and refund | Full refund within 21-day cooling-off period if no claim. After cooling-off, no refund of premium paid for current or previous policy years. p.2 |
| Switching from another plan | Switching to another plan with upgraded benefits may involve re-underwriting for the upgraded benefits 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 p.48 |
| Geographical cover | Worldwide p.20 |
| Psychiatric treatment area | Hong Kong only p.23 |
| 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 | 15% for major medical benefit p.48 |
| Pre-admission outpatient | 1 visit before admission, USD 155 per visit, up to USD 1,035 per Policy Year p.46 |
| Post-discharge outpatient | 6 visits within 90 days after discharge, USD 155 per visit, up to USD 1,035 per Policy Year p.46 |
| General outpatient | none, except for pre/post-hospitalisation, emergency, and Chinese medicine p.46 |
| Psychiatric treatment | USD 7,745 per Policy Year p.46 |
| Diagnostic imaging coinsurance | 30% during Confinement, 20% for Day Patient p.46 |
| Non-surgical cancer treatment | USD 18,065 per Policy Year, plus USD 18,065 per 6-year Benefit Period for Major Cancer top up p.46 |
| Kidney dialysis | Covered, USD 10,325 per Policy Year p.47 |
| Day case procedures | Covered as in-patient, plus USD 155 cash allowance per Day Case Procedure once per Policy Year p.22 |
| Home nursing | USD 155 per visit, 1 visit per day within 90 days after discharge, 30 visits per Policy Year p.46 |
| Hospice care | Covered, USD 6,455 per Policy Year p.47 |
| Chinese medicine | Inpatient: same limits as miscellaneous charges and attending doctor's visit fee. Post-discharge: USD 120 per visit, 3 visits within 90 days, up to USD 390 per Policy Year. Exclusions apply for certain Chinese medicines. p.47 |
| Physiotherapy | Covered during Confinement under miscellaneous charges, and as follow-up outpatient care post-discharge p.22 |
| Congenital conditions | Covered from age 8 p.26 |
| Pregnancy complications | Covered for specific complications, subject to basic and additional benefit limits, after 12 months from Policy Effective Date p.40 |
| Emergency dental | Covered within 30 days of accident for injury to sound natural teeth, up to USD 2,585 per Policy Year p.39 |
| Hospital cash | USD 130 per day, max 15 days per Policy Year, for staying in a lower ward class than entitled p.47 |
| Companion bed | Fully Covered, max 180 days per Policy Year p.46 |
| Direct billing and pre-authorisation | not stated |
| No-claim discount | 16% discount, reduced to 8% then 0% after a claim, resumes 16% after 3 consecutive no-claim years p.38 |
| Exclusions beyond the VHIS standard list | Traditional Chinese medicine (herbal, bone-setting, acupuncture, acupressure, tui na) and other alternative treatments (hypnotism, qigong, massage therapy, aromatherapy, naturopathy, hydropathy, homeotherapy) unless covered under Supplement 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$1,737 to HK$2,245.
| Year | Change |
|---|---|
| 2022 | +8.0% |
| 2023 | +8.0% |
| 2024 | +10.1% |
| 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 3 with SMM (USD) | Semi-private | None | No annual limit |
| Benefit Level 3 with SMM (USD) | Semi-private | None | No annual limit |
| Benefit Level 3 with SMM (USD) | Semi-private | None | No annual limit |
| Benefit Level 3 with SMM (USD) | Semi-private | None | No annual limit |
| Benefit Level 3 with SMM (USD) | Semi-private | None | No annual limit |
| Benefit Level 3 with SMM (USD) | Semi-private | None | No annual limit |
| Benefit Level 3 with SMM (USD) | Semi-private | None | No annual limit |
| Benefit Level 3 with SMM (USD) | 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.