| 1. | | Exclude premiums paid on Optional Outpatient Benefits. |
| 2. | | Optional Supplementary Medical Benefit is an optional benefit available for Plan A, B or C only; whereas Optional Outpatient Benefits is an optional benefit available for all plans. For details, please refer to respective benefit schedules and premium tables. |
| 3. | | Annual renewal is guaranteed with lifetime coverage for the insured person. Except those premium loading and/or case-based exclusion(s) agreed by the policyholder during application, Blue Cross will neither charge extra premium nor impose additional exclusions on an individual policy based on the insured person’s claim history or change in health status at the time of renewal. However, Blue Cross reserves the right to adjust the premium upon policy renewal due to other factors, for example, age-related adjustment or subscription to additional benefits, etc. Blue Cross has the right to revise the terms and benefits of the Certified Plan and/or adjust the Standard Premium on an overall portfolio basis upon policy renewal. |
| 4. | | Auto-renewal of policy is subject to the successful collection of premium by Blue Cross. |
| 5. | | Recommendation by the attending physician is required for tests or treatments performed during confinement, in day-case unit of a hospital, day-case procedure centre, or clinic. |
| 6. | | In the event any benefit in respect of any previous policy years is paid by Blue Cross after a no claim discount has been applied, the actual eligible no claim discount shall be recalculated for all policy year(s) subsequent to such benefit being paid. The policyholder shall repay to Blue Cross the difference between the no claim discount already applied by Blue Cross and the recalculated actual eligible no claim discount upon Blue Cross’ reasonable demand. Any claim made under Emergency Outpatient Treatment, Outpatient Surgery Cash Allowance or Cash Benefit for Top-up Subsidy (if applicable) will not affect the insured person’s eligibility for the No Claim Discount. |
| 7. | | In the event that the required number of eligible family members as at the policy effective date or renewal date cannot be fulfilled after a family discount has been applied, the family discount shall be recalculated for the relevant policy year(s) based on the same requirement specified. The policyholder shall repay to Blue Cross the difference between the family discount already applied by Blue Cross and the recalculated actual eligible family discount upon Blue Cross’ reasonable demand. |
| 8. | | For the purpose of family discount, “eligible family members” refer to you as the policyholder, your spouse/ child, your or your spouse’s parents/ grandparents/ brothers/ sisters. In counting the required number of eligible family members specified in the table, each eligible family member shall only be considered as one eligible family member regardless of the number of policies of the Certified Plan issued for that eligible family member. |
| 9. | | This service is not required to be certified by the Health Bureau and therefore does not form part of the Certified Plan. Please refer to the relevant terms and conditions for details. Opt-out is available for this service by giving a written notice to Blue Cross and it does not affect the premium. |
| 10. | | For details, please log in to BlueCross+ via Blue Cross website or “Blue Cross HK” mobile app. |
| 11. | | Assessment of the estimated eligible claim reimbursement amounts is for reference only. The actual eligible claim amount will be subject to the final claim decision of Blue Cross. All benefits will be payable subject to the terms and conditions of the policy and the full list of policy exclusions. |
| 12. | | “Cashless Service” is one of the Credit Facilities Services provided by Blue Cross. This service is not required to be certified by the Health Bureau and therefore does not form part of the Certified Plan. Please refer to the relevant terms and conditions for details. For admission to designated Hong Kong and Macau network hospitals, the insured person is required to complete and submit to Blue Cross the Pre-assessment Form for application and approval at least 7 working days prior to admission. For admission to designated mainland network hospitals, the designated mainland network hospitals can provide administrative support to the insured person in applying for the “Cashless Service”. Blue Cross reserves the right to not issue the Letter of Guarantee (LOG) or issue the LOG with a particular limit. Blue Cross may withdraw or suspend the Credit Facilities Services anytime without prior written notice. All matters and disputes in relation to the Credit Facilities Services will be subject to the final decision of Blue Cross. The liability of Blue Cross under the policy is limited to indemnify the insured person for the eligible medical expenses payable in accordance with the Certified Plan. Any medical expenses that fall outside policy coverage shall be borne by the policyholder/the insured person. Blue Cross shall also recover from the policyholder/the insured person the medical expenses settled on behalf of the insured person which fall outside policy coverage (if any). For the list of our designated Hong Kong, Macau and mainland network hospitals, please log in to BlueCross+ via Blue Cross website or “Blue Cross HK” mobile app. |
| 13. | | Except for “Psychiatric Treatments”. |