Healthy Life Medical Insurance Plan (VHIS)-China Life (Overseas)

Voluntary Health Insurance Scheme - Flexi Plan Certification Number	Healthy Life Medical Insurance Plan	Healthy Life Premier Medical Insurance Plan
Available for New Application	F00024-01-000-02	F00030-01-000-02 F00030-01-001-02 F00030-02-000-02 F00030-02-001-02
Not Available for New Application	F00024-01-000-01	F00030-01-000-01 F00030-01-001-01 F00030-02-000-01 F00030-02-001-01

Enrollment Terms

Issue Age : From 15 days after birth to 80 years old

Policy Currency : HKD

Premium Payment Term : To age 99 of the Insured Person

Benefit Term : To age 100 of the Insured Person

Premium Payment Method : Annual or Monthly

Plan Features

5 Plan Levels for Your Selection

The 5 plan levels include the ward level coverage Healthy Life Medical Insurance Plan, and the semi-private room or private room coverage Healthy Life Premier Medical Insurance Plan. Upon enrollment, you may select a plan level of Healthy Life Premier Medical Insurance Plan that has attached with Supplementary Major Medical Benefit for higher protection. If the actual medical expenses exceed the benefit limit, the Supplementary Major Medical Benefit will pay maximum 80% of the excess amount. This way you can focus on your treatment. For details of the benefit item and amount of each plan level, please refer to the Benefit Schedule.

No Claim Discount and Guaranteed Renewal to Age 100

There will be a discount on Premium if no benefits have been paid in the past 3 consecutive Policy Years or more. The discount will be 15% of the Premium of next Policy Year and to be deducted upon Premium payment.

So long as you have enrolled in the Plan successfully, the Plan is guaranteed to renew to age 100 regardless of your health condition and claim history after enrollment.

No Lifetime Benefit Limit whilst Covering Pre-existing Conditions

There is no Lifetime benefit limit set in the Plan but it is subject to an aggregate benefit limit for each year. In addition, pre-existing conditions are also covered where certain limitation are applied in the first 3 years after the Plan becomes effective. For more information, please refer to item 6 of the Important Note stated in this product brochure.

Room & Board and Surgeon's Fee

The expenses related to Room & board, Attending doctor's visit fee, Specialist's fee, surgical fees and Miscellaneous charges are covered, releasing you from any kind of financial burden. Please refer to the Benefit Schedule for the benefit amount of each item.

Extended Benefit - Pre- and post-Confinement/Day Case Procedure Outpatient Care

The Plan not only provides hospital confinement and surgical benefits, it also covers the expenses related to pre- and post-confinement / day case procedure outpatient care.

Prescribed Non-surgical Cancer Treatments, Prescribed Diagnostic Imaging Tests and Psychiatric Treatments

The cost for treating cancer is expensive.This is why the Plan offers coverage on Prescribed Non-surgical Cancer Treatment procedures, including radiotherapy, chemotherapy, targeted therapy, immunotherapy and hormonal therapy. Furthermore, the Plan also covers Prescribed Diagnostic Imaging Tests (e.g. MRI) for the investigation or treatment of a Disability, as well as Psychiatric treatments during the Confinement in Hong Kong.

Enhanced Benefits

The Healthy Life Premier Medical Insurance Plan of the Plan also provides the following enhanced benefits:

Emergency out－patient care (accidental injury)- the Insured Person is treated as a Day Patient in the Emergency department of a Hospital within 24 hours of an Accident occurred that causes the Disability
Home nursing (post surgery)- the service is provided at home by a registered nurse within 60 days from the date on which the Insured Person is discharged from the Hospital
Organ donor benefit
Outpatient kidney dialysis
Rehabilitative care
Companion bed

Tax Deduction

The Plan is a qualified Voluntary Health Insurance Scheme where the Policy Holder may enjoy a tax deduction. Please refer to the information provided by the government of the Hong Kong Special Administrative Region for details.

Benefit Schedule

(Policy Currency: HK Dollar)

Benefit Items¹	Ward	Semi-private	Semi-private with SMM	Private	Private with SMM
Certification Number	F00024-01-000-01	F00030-01-000-01	F00030-01-001-01	F00030-02-000-01	F00030-02-001-01
Entitled ward class⁶	Ward	Semi-private	Semi-private	Standard Private	Standard Private
(a)Room and board	750 per day Maximum 180 days per Policy Year	1800 per day Maximum 270 days per Policy Year	1800 per day Maximum 270 days per Policy Year	3800 per day Maximum 270 days per Policy Year	3800 per day Maximum 270 days per Policy Year
(b)Miscellaneous charges	14,000 per Policy Year	20,000 per Policy Year	20,000 per Policy Year	32,000 per Policy Year	32,000 per Policy Year
(c)Attending doctor’s visit fee	750 per day Maximum 180 days per Policy Year	2000 per day Maximum 270 days per Policy Year	2000 per day Maximum 270 days per Policy Year	4000 per day Maximum 270 days per Policy Year	4000 per day Maximum 270 days per Policy Year
(d)Specialist’s fee²	4,300 per Policy Year	5,600 per Policy Year	5,600 per Policy Year	10,400 per Policy Year	10,400 per Policy Year
(e)Intensive care	3,500 per day Maximum 25 days per Policy Year	4,200 per day Maximum 40 days per Policy Year	4,200 per day Maximum 40 days per Policy Year	5,000 per day Maximum 40 days per Policy Year	5,000 per day Maximum 40 days per Policy Year
(f)Surgeon’s fee Per surgery, subject to surgical category for the surgery/procedure in the Schedule of Surgical Procedures： Complex Major Intermediate Minor	50,000 25,000 12,500 5,000	65,000 32,500 16,250 6,500	65,000 32,500 16,250 6,500	90,000 45,000 22,500 9,000	90,000 45,000 22,500 9,000
(g)Anaesthetist's fee	35% of Surgeon’s fee payable⁵
(h)Operating theatre charges	35% of Surgeon’s fee payable⁵
(i)Prescribed Diagnostic Imaging Tests^2,3	20,000 per Policy Year Subject to 30% Coinsurance
(j)Prescribed Non-surgical Cancer Treatments⁴	80,000 per Policy Year	100,000 per Policy Year	100,000 per Policy Year	200,000 per Policy Year	200,000 per Policy Year
(k)Pre- and post-Confinement/Day Case Procedure outpatient care ²	580 per visit, up to 3,000 per Policy Year One prior outpatient visit or Emergency consultation per Confinement/Day Case Procedure Three follow-up outpatient visits per Confinement/Day Case Procedure (within 90 days after discharge from Hospital or completion of Day Case Procedure)
(l) Psychiatric treatments	30,000 per Policy Year
Other limits
Annual Benefit Limit for benefit items (a) – (l)	420,000	550,000	550,000	750,000	750,000
Lifetime Benefit Limit for benefit items (a) – (l)	Nil
Supplementary major medical benefit⁷ Eligible Expenses incurred in excess of the amounts payable under items (a) to (l) (including excess over per day limit, maximum number of days per Policy Year or per Policy Year limit)
Maximum benefit per Policy Year (Attained age 0 – 79)	80,000	Nil	150,000	Nil	300,000
Maximum benefit per Policy Year (Attained age 80 – 100)	30,000	Nil	50,000	Nil	80,000
Coinsurance	20%	Nil	20%	Nil	20%
Enhanced benefits
(a)Companion bed	Nil	450 per day Maximum 90 days per Policy Year	450 per day Maximum 90 days per Policy Year	650 per day Maximum 90 days per Policy Year	650 per day Maximum 90 days per Policy Year
(b)Emergency out-patient (accidental injury)	Nil	6,000 per Policy Year	6,000 per Policy Year	12,000 per Policy Year	12,000 per Policy Year
(c)Home nursing	Nil	800 per day Maximum 15 days per Policy Year Within 60 days after discharged from the Hospital maximum 1 time per day	800 per day Maximum 15 days per Policy Year Within 60 days after discharged from the Hospital maximum 1 time per day	1,600 per day Maximum 15 days per Policy Year Within 60 days after discharged from the Hospital maximum 1 time per day	1,600 per day Maximum 15 days per Policy Year Within 60 days after discharged from the Hospital maximum 1 time per day
(d)Organ donor benefit⁸	Nil	800,000 per Policy Year	800,000 per Policy Year	900,000 per Policy Year	900,000 per Policy Year
(e)Outpatient kidney dialysis⁹	Nil	50,000 per Policy Year Maximum 60 days per Policy Year	50,000 per Policy Year Maximum 60 days per Policy Year	75,000 per Policy Year Maximum 60 days per Policy Year	75,000 per Policy Year Maximum 60 days per Policy Year
(f)Rehabilitative care	Nil	30,000 per Policy Year	30,000 per Policy Year	50,000 per Policy Year	50,000 per Policy Year
Other benefit
Compassionate death benefit	10,000

Notes:

Eligible Expenses incurred in respect of the same item shall not be recoverable under more than one benefit item in the table above, unless otherwise specified.
China Life (Overseas) shall have the right to ask for proof of recommendation e.g. written referral or testifying statement on the claim form by the attending doctor or Registered Medical Practitioner.
Tests covered here only include computed tomography (“CT” scan), magnetic resonance imaging (“MRI” scan), positron emission tomography (“PET” scan), PET-CT combined and PET-MRI combined.
Treatments covered here only include radiotherapy, chemotherapy, targeted therapy, immunotherapy and hormonal therapy.
The percentage here applies to the Surgeon's fee actually payable or the benefit limit for the Surgeon's fee according to the surgical categorisation, whichever is the lower.
Ward class adjustment shall apply (if applicable) to the relevant benefit items. Please refer to Important Information item 8 for information.
The supplementary major medical benefit shall be payable for the Eligible Expenses incurred in excess of the amounts payable under items (a) – (l) taking into account the information stated on item 8 of Important Information (if applicable), subject to the Coinsurance as stated in the Benefit Schedule. The total amount of the supplementary major medical benefit is subject to the maximum benefit per Policy Year.
If the Insured Person is a donor in an organ transplantation surgery, and such procedure is undergone in Hong Kong, the Surgeon's fee, Anaesthetist's fee and operating theatre fee charged on the removal of organ or bone marrow will be paid.
The benefit shall be payable for the Eligible Expenses charged for haemodialysis or peritoneal dialysis performed on the Insured Person due to chronic and irreversible kidney failure.

Remarks:

Confinement means an admission of the Insured Person to a Hospital that is recommended by a Registered Medical Practitioner for Medical Service and as an Inpatient as a result of a Medically Necessary condition for a period of no less than 6 consecutive hours. No minimum period is required for Confinement in connection with any Emergency Treatment in a Hospital as a result of an Emergency for the performance of a surgical procedure or other Medical Service in a Hospital.
Day Case Procedure means a Medically Necessary surgical procedure for investigation or treatment to the Insured Person performed in a medical clinic, or day case procedure centre or Hospital with facilities for recovery as a Day Patient.
Coinsurance means a percentage of Eligible Expenses the Policy Holder must contribute after paying the Deductible (if any) in a Policy Year. For the avoidance of doubt, Coinsurance does not refer to any amount that the Policy Holder is required to pay if the actual expenses exceed the benefit limits under the Policy.
Medically Necessary mean the need to have medical service for the purpose of investigating or treating the relevant Disability in accordance with the generally accepted standards of medical practice.
Hospital means an establishment duly constituted and registered as a hospital under the laws of the relevant territory in which it is established, which is for providing Medical Service for sick and injured persons as Inpatients, and which (a) has facilities for diagnosis and major operations; (b) provides 24 hours nursing services by licensed or registered nurses; (c) has 1 or more Registered Medical Practitioners; and (d) is not primarily a clinic, a place for alcoholics or drug addicts, a nature care clinic, a health hydro, a nursing, rest or convalescent home, a hospice or palliative care centre, a rehabilitation centre, an elderly home or similar establishment.
Only one policy holder is allowed per policy

Terms and Conditions

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.

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Healthy Life Medical Insurance Plan

Date of Birth

Gender

Male

Female

Smoking in the past 12 months

Yes

Entitled ward class

Payment Method

Monthly

Annual

Discount code (if any)

$--

(Included the Levy of HK$)