Options of Various Geographical Coverage and Deductibles
Guaranteed Renewal Without a Lifetime Limit
Full Coverage for Most Benefit Items of Hospitalization and Surgical Expenses
Hospitalization Direct Billing Service
Issue Age : 15 days after birth to age 70
Policy Currency : HKD/ USD/ RMB
Coverage area : Worldwide, Worldwide (exclude USA)3 and Asia4
Deductible Options : Plan 1: HKD0/ USD0/ RMB0
Plan 2: HKD9,000/ USD1,125/ RMB7,200
Plan 3: HKD28,000/ USD3,500/ RMB22,400
Plan 4: HKD100,000/ USD12,500/ RMB80,000
Plan 5: HKD500,000/ USD62,500/ RMB400,000
Renewal : Guaranteed renewal5
Premium Payment Method : Annual, Semi-annual, Quarterly or Monthly
Benefit Term : To age 100 of the Insured
Premium Payment Term : To age 99 of the Insured
The Plan comes with three options for you to choose providing different geographic coverage, namely Worldwide, Worldwide(exclude USA) and Asia. The Plan also provides five levels of Deductibles, you can select the plan that is most convenient for you financially.
Upon successful enrolment, regardless of your subsequent health conditions and claims history, renewal is guaranteed. Also,the Plan has no lifetime limit2, so you do not have to worry about medical expenses.
The Plan provides you with full coverage for room and board charges during hospitalization, doctor’s fees, miscellaneous Hospital expenses, intensive care and surgeon’s fees, etc., (please refer to the Benefits Schedule for the maximum benefit amount) helping to relieve the financial burden that substantial medical expenses may bring to you and your family. The Plan also covers the medical expenses incurred for day-case surgery. What’s more, the Plan provides a cash allowance for surgery to enhance your protection.
Prior to your Hospital7 admission, all you have to do is to complete the pre-approval procedures8 and receive our notification of arrangement, and we will settle your medical expenses directly with the Hospital after your discharge, so you can focus on your recovery without the need of going through complex claims procedures.
In addition to hospitalization and surgical benefits, the Plan also covers medical expenses incurred for consultation before and after your Hospital Stay, private nurse’s fees and rehabilitation. Furthermore, the Plan offers you an array of extended benefits (please refer to the Benefits Schedule for details).
We understand you may need different levels of medical protection when going through different stages in your life. The Plan offers you the right to reduce your existing Deductible without having to undergo any medical underwriting6 once you reach the ages 50, 55, 60 or 65. This assists you in better planning for your life in retirement.
Starting from the 2nd Policy anniversary, you can enjoy a 15% discount on Deductibles in the following Policy year if you take out plan 2, 3 or 4 (excluding plan 1 and 5) and no benefits have been paid12 in the past 2 consecutive Policy Years. If no benefits have been paid12 in every subsequent policy year, you can enjoy an additional 5% discount on Deductibles annually, with the maximum discount up to 100%.
Benefit Schedule for details
| Worldwide | Worldwide (exclude USA)3 |
Asia4 | ||
|---|---|---|---|---|
| Outside Area of cover | All areas covered |
Emergency treatment only | ||
| Annual Limit | HKD22,000,000 |
HKD16,000,000 USD2,000,000 RMB12,800,000 |
HKD10,000,000 USD1,250,000 RMB8,000,000 |
|
| Annual Deductible | Plan 1 : HKD0/ USD0/ RMB0 Plan 2 : HKD9,000 / USD1,125/ RMB7,200 Plan 3 : HKD28,000/ USD3,500/ RMB22,400 Plan 4: HKD100,000/ USD12,500/ RMB80,000 Plan 5: HKD500,000/ USD62,500/ RMB400,000 |
|||
| Entitled Level of Accommodation | Standard Private Room1 | |||
| Benefit Items | Maximum Benefit Limit | |||
| 1. Confinement Benefits |
||||
| a. Hospital Room & Board Benefit | Full cover | |||
| b. Physician's Visit’s Fee | Full cover | |||
| c. Specialist's Fee | Full cover | |||
| d. Miscellaneous Hospital Expenses Benefit |
Full cover | |||
| e. Intensive Care Benefit | Full cover | |||
| f. Hospital Companion Bed Benefit | Full cover | |||
| g. Private Nurse's Fee Max. number of days per policy year |
Full cover 90 Days |
Full cover 60 Days |
Full cover 30 Days |
|
| h. Hospital Cash Benefit (per day) (applicable to stay in a ward room of a Hong Kong public hospital) |
HKD2,000/ USD250/ RMB1,600 | |||
| i. Lower Room Class Cash Benefit (per day)
(applicable to Standard Private Room in private Hospital in Hong Kong or Macau only)
Max. number of days per Policy Year |
HKD2,000/ USD250/ RMB1,600 30 days |
|||
j. Psychiatric Treatment Benefit (per Policy Year) Maximum number of days per policy year |
HKD60,000/ USD7,500/ RMB48,000 30 Days |
HKD50,000/ USD6,250/ RMB40,000 30 Days |
HKD40,000/ USD5,000/ RMB32,000 30 Days |
|
| 2. Surgical Benefits | ||||
| a. Surgeon's Fee | Full cover | |||
| b. Anaesthetist's Fee | Full cover | |||
| c. Operation Theatre Fee | Full cover | |||
| d. Day Case Surgery Fee | Full cover | |||
| e. Cash Allowance for Day Case Surgery (per procedure) | HKD2,000/ USD250/ RMB1,600 |
HKD1,500/ USD187.5/ RMB1,200 |
HKD1,000/ USD125/ RMB800 |
|
| f. Organ Transplant Benefit13 | Full cover | |||
| g. Medical Appliances Benefit | Full cover for designated medical appliances14 (HKD100,000/ USD12,500/ RMB80,000 per policy year for non-designated medical appliances） |
|||
| 3. Pre- &Post-hospitalization Benefits | ||||
| a. Pre-Hospitalization Outpatient (within 31 days before Confinement or day case surgery, 1 visit per day) |
Full cover | |||
| b. Post-Hospitalization Outpatient (within 60 days immediately after Discharge from Hospital or Day Case Surgery, 1 visit per day) |
Full cover | |||
| c. Post-Hospitalization Home Nursing Fee Max. number of days per policy year |
Full cover 365 Days |
Full cover 183 Days |
Full cover 90 Days |
|
| d. Post-Hospitalization Ancillary Service Benefit (within 90 days immediately after Discharge from Hospital or Day Care Surgery, 1 visit per day) - Registered Physiotherapist/ Chiropractor/ Speech Therapist/ Osteopathic Therapist/ Occupational Therapist/ Dietitian |
Full cover | |||
| e. Rehabilitation Benefit (per policy year) Max. number of days per policy year |
HKD80,000/ USD10,000/ RMB64,000 60Days |
|||
| 4. Extended Benefits | ||||
| a. Cancer Treatment Benefit (Including chemotherapy, radiotherapy, targeted therapy, hormonal therapy, immunotherapy, proton therapy and heavy-ion therapy, cyberknife and gamma knife performed on the Insured, and the consultation, medication and diagnostic tests for and in the course of these treatments) | Full cover | |||
| b. Kidney Dialysis Benefit9 |
Full cover | |||
| c. Reconstructive Surgery Benefit (per Covered Injury / per Covered Illness) |
HKD120,000 / USD15,000 / RMB96,000 | |||
| d. Stroke Rehabilitation Benefit (i) Home Facility Enhancement Benefit (per life) |
HKD60,000/ USD75,000/ RMB48,000 | HKD50,000/ USD6,250/ RMB40,000 | HKD40,000/ USD5,000/ RMB32,000 | |
| (ii) Stroke Ancillary Benefit (Chiropractor / Physiotherapist / Speech Therapist / Occupational Therapist / Neurosurgeon / Neurologist / Chinese medicine practitioner) | HKD1,000/ USD125/ RMB800
USD125,000/ RMB80,000 | HKD800/ USD100/ RMB640
USD10,000/ RMB64,000 | HKD600/ USD75/ RMB480
USD7,500/ RMB48,000 | |
| (iii) Disability Subsidy Benefit (per month)
(up to 30 months per life) |
HKD6,400 / USD800 / RMB5,120 | |||
| e. HIV/AIDS Treatment10 （Waiting period: 5 years) (per Insured per life） |
HKD1,000,000/ USD125,000/ RMB800,000 |
HKD1,000,000/ USD125,000/ RMB800,000 |
Not Applicable | |
| f. Traditional Chinese Medicines Benefit (within 90 days immediately after Discharge from Hospital or Day Case Surgery, 1 visit per day) Max. number of visits per Policy Year |
HKD1,000/ USD125/ RMB800 （per visit） 20 visits |
HKD800/ USD100/ RMB640 （per visit） 20 visits |
HKD600/ USD75/ RMB480 （per visit） 20 visits |
|
| g. Hospice Care Benefit （per Insured per life） |
HKD200,000/ USD25,000/ RMB160,000 |
HKD150,000/ USD18,750/ RMB120,000 |
HKD100,000/ USD12,500/ RMB80,000 |
|
| h. Pregnancy Complications （Waiting period : 1 year） |
Full cover | Full cover | Not Applicable | |
| 5. Emergency Treatment Benefits | ||||
| a. Emergency Outpatient | Full cover | |||
| b. Emergency Dental due to Accident | Full cover | |||
| 6. Death Benefits | ||||
| a. Compassionate Death Benefit | HKD80,000/ USD10,000/ RMB64,000 | |||
| b. Additional Accidental Death Benefit | HKD80,000/ USD10,000/ RMB64,000 | |||
| 7. Other Services15 | ||||
| a. Health checkup |
Once every 2 years | |||
| b. 24-hour Worldwide Emergency Assistance Service |
Included | |||
| c. Medical Second Opinion Service |
Included | |||
| d. Hospitalization Direct Billing Service (Cashless Hospitalization Service) |
Included | |||
| e. Medical Appointment Scheduling Service in Mainland China | Included | |||
| f. Medical Concierge Service in Mainland China | Included | |||
| g. Medical Appointment Scheduling Service in Hong Kong | Included | |||
| h. Medical Concierge Service in Hong Kong | Included | |||
Notes：
1.
Standard Private Room refers to a room for single occupancy and private use of the Insured during his/her Confinement, which contains a private bedroom, lavatory and bathroom without any or all of the en-suite facilities: companion room, lavatory for visitor, kitchen, dining room or sitting room. The Standard Private Room shall exclude any deluxe, suite, executive rooms and other upgraded rooms or the equivalence.
2.
Annual Limit is applicable to this Plan. Please refer to the “Benefits Schedule” for details.
3.
If the medical expenses are incurred in the USA, the Plan will only cover the medical expenses arising from Accidents.
4.
Asia refers to Afghanistan, Australia, Bangladesh, Bhutan, Brunei, Cambodia, China, Hong Kong, India, Indonesia, Japan, Kazakhstan, Kyrgyzstan, Laos, Macau, Malaysia, Maldives, Mongolia, Myanmar, Nepal, New Zealand, North Korea, Pakistan, the Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Tajikistan, Thailand, Timor-Leste, Turkmenistan, Uzbekistan and Vietnam. If the medical expenses are incurred outside the covered areas, the Plan will only cover the medical expenses arising from Accidents.
5.
China Life (Overseas) reserves the right to review the premium rates on each Policy anniversary and revises the terms and conditions and/or the benefit items of the Policy from time to time. If we decide to no longer offer the Plan, we will endeavor to enroll the Insured in another available medical plan.
6.
The Insured is entitled to reduce the Deductible without the need to undergo underwriting for one time only. After reduction of the Deductible, China Life (Overseas) will adjust the premium according to the premium rate applicable to a particular risk class, the actual age of the Insured and the special condition(s) applicable to his/her policy. After reduction of the Deductible, the new Deductible will apply to the claims over the covered diseases and covered injuries. The Annual Deductible under Plan 5 shall not be lower than HKD100,000 or the currency equivalent.
7. Hospital does not include any establishment or that portion of an establishment which is operated as a convalescent or nursing home, rest home, home for the aged, or an establishment for rehabilitation of alcoholics or drug addicts, or any similar purpose. For the list of designated hospitals located in China, please refer to China Life (Overseas)’s website http://www.chinalife.com.hk/customerservice/hospitals-in-china.
8.
Please refer to MasterCare Medical Plan Direct Billing Pre-approval Form for details.
9. The Insured must be diagnosed as having chronic and irreversible kidney failure.
10. The waiting period of HIV/AIDS Treatment Benefit is 5 years. The benefit is only payable if the signs or symptoms of such illness occur for the first time. This benefit is only payable once and the payment of this benefit shall be in lieu of all other benefits provided by the policy in respect of such Confinement and treatment. This benefit is not applicable to the Asia Plan.
11. The waiting period of Pregnancy Complications Benefit is 1 year. This benefit is not applicable to the Asia Plan.
12. benefits payable under Hospital Cash Benefit, Lower Room Class Cash Benefit, Day Case Surgery Fee and Cash Allowance for Day Case Surgery.
13. In the case of organ transplantation of heart, kidney, liver, lung or bone marrow performed on the Insured as recipient, China Life (Overseas) shall reimburse the Reasonable and Customary charges of the actual surgical costs to remove the organ or bone marrow from the donor which are charged to the Insured (including the Surgeon’s Fee, Anaesthetist’s Fee and Operating Theatre Fee, but excluding the costs of the organ or bone marrow).
14. Designated medical appliances include pacemaker, stents for percutaneous transluminal coronary angioplasty, intraocular lens, artificial cardiac valve, metallic or artificial joints for joint replacement, prosthetic ligament for replacement or implantation between bones and prosthetic intervertebral disc.
15. All services are provided by third party supplier(s) appointed by China Life (Overseas). China Life (Overseas) is not the service provider(s), and is not liable for the service quality provided. China Life (Overseas) reserves the right to amend the terms and conditions thereof from time to time without prior notice.
16. Reasonable and Customary means the charges for Treatment, procedure, supplies or other medical services which are Medically Necessary but do not exceed the general level of charges at the location for such Treatment, procedure, supplies or other medical services. China Life (Overseas) reserves the right to determine whether any of such charge is Reasonable and Customary with reference but not limited to, any relevant publication or information made available, such as schedule of fees, by the government, relevant authorities and recognized medical association at the location where such expenses are incurred.
Policyholder : Mr.
Lam (aged 33) married
Occupation : Senior
Account Service Manager
Mr. Lam has been married
for two years and his daughter will be born soon. He wants to ensure the quality
of life for his family remains unchanged even if his health deteriorates. While
medical costs keep soaring, he wants to top up his current basic group medical
protection by a comprehensive medical plan, in order to meet the varying needs
at his different life stages.
MasterCare Medical Plan has no lifetime limit2, and provides 3 different geographical coverage plans and 5 Deductible options, so Mr. Lam is able to choose the best protection according to his own budget and needs.
| Insured's Age | Incident |
|---|---|
| 33 | Mr. Lam takes out MasterCare Medical Plan and selects:
|
| 40 | Diagnosed with stomach cancer.
Mr. Lam decides to receive treatments in Hong Kong and he can place a claim of the related medical expenses below:
Claimed in full after HKD28,000 Deductible |
| 58 | Diagnosed with pneumonia.
Since Mr. Lam did not raise a claim during age 48 to age 58, the no claim deductible discount has accumulated to 55%. Therefore, he can place a claim of the related medical expenses below:
Claimed in full after Deductible and no claim Deductible discount: HKD28,000 x (1-55%)=HKD12,600
|
| 60 | Mr. Lam decides to retire.
He can choose to reduce the Deductible to HKD0 6. Since the Plan provides no lifetime limit2, Mr Lam can enjoy comprehensive medical protection without worrying about medical expenses and limit after retirement.
|
Please refer to the Policy documents for the complete definitions of the capitalised terms, as well as all the terms and conditions of this product. In the event of any dispute, China Life (Overseas) reserves the right to the final decision in deciding whether or not to accept the application and provide the insurance coverage.
This shall not be construed as any provision of or offer to sell or solicitation to buy any insurance product outside Hong Kong. China Life (Overseas) does not provide or offer to sell any insurance product outside Hong Kong.
