Medical Insurance - Super Medical Insurance

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Your All-round Whole Life Medical Protection

To deal with aging population, mutating infectious diseases and ever – escalating medical costs, an all-round medical insurance product helps alleviate your future financial burden on medical care in the long run.

Super Medical Insurance Series provides 4 plans tailored for specific age and gender groups, namely Super Junior, Super Lady, Super Man and Super Senior, to fulfill medical protection needs in different stages of life.

Plan Highlights

Plan Features

	Super Junior
	Super Lady
	Super Man
	Super Senior

Plan Coverage

Health Checkup Programmes

Important Notes

Exclusions

	Plan Highlights

	No waiting period – Medical protection starts once the policy is takes effect
	Easy enrolment with no medical examination is required
	"No Hospital Bills to Pay" Service – No pre-payment for admission, no claims upon discharge¹
	Worldwide coverage with benefit amounts remain unchanged regardless of the duration of overseas stay
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Plan Features

4 Plans Giving You Lifetime Protection

Plan Name	Enrolment Age**	Coverage
Super Junior	0* - 18	Comprehensive inpatient care covering the medical expenses for common diseases in children such as: • Asthma • Hand-foot-and-mouth disease • Rubella (German measles) • Bacterial meningitis • Kawasaki disease
Super Lady	19 - 55	Comprehensive inpatient care covering the medical expenses for common diseases in women such as: • Breast cancer • Cervix cancer • Heart disease • Lung cancer • Colon cancer • Cerebrovascular diseases
Super Man	19 - 55	Comprehensive inpatient care covering the medical expenses for common diseases in men such as: • Prostate cancer • Heart disease • Nasopharyngeal cancer • Cirrhosis of the liver • Hypertension
Super Senior	56 - 70	Comprehensive inpatient care covering the medical expenses for common diseases in elderly such as: • Stroke • Osteoporosis • Coronary heart disease • Diabetes mellitus • Prostate cancer

*	"0" year old means the age of 12 days.
**	Guaranteed lifetime renewal (not applicable to Optional Supplementary Medical Benefits).

Comprehensive Inpatient Coverage

Super Medical Insurance Series provides a wide range of benefits to cover your expenses during hospitalisation due to sickness or injuries.

- Room and board	- Charges for intensive care
- Miscellaneous hospital charges	- Daily hospital cash allowance
- Surgeon's fees	- Emergency outpatient treatment
- Anaesthetist's fees	- Outpatient surgery cash allowance
- Operating theatre charges	- Companion bed⁺
- Physician's visit fees	- Registered private nurse's fees⁺
- Specialist's fees

⁺	Applicable to designated plans only

No Additional Premium on Claims History upon Renewal

Regardless of your claims history and the change of health status, no additional premium will be imposed individually upon policy renewal.

Guaranteed Lifetime Renewal²

After enrolment, we guarantee your policy will be renewable for lifetime, regardless of your health status or claims history. We guarantee the insured under the Super Junior can enrol in the Super Lady or Super Man at age 19. An insured adult can also join the Super Senior at age 56.

24-hour Worldwide Emergency Aid

If you need assistance in an emergency condition while travelling overseas, simply make a call to our 24-hour Worldwide Emergency Aid Hotline at any time, our dedicated officers will provide you with appropriate assistance such as hospital admission deposit guarantee service, medical repatriation, travel information, and medical or legal referral service. In case of emergercy, you can be sure help is just a call away.

Emergency Medical Assistance in China

In case of emergency requiring hospitalisation in China, simply present the "Medpass Card" and you can receive medical treatments in over 200 network hospitals or medical units without paying any deposits.

Coverage for Prolonged and Advanced Treatments

Chronic treatments always impose heavy financial burdens to patients. We offer coverage for chronic treatments to relieve your financial burden due to prolonged recovery such as kidney dialysis, cancer therapy, organ transplantation, tumour related treatment, and pacemaker implantation, etc.

In response to the needs of cancer or kidney dialysis patient, we provide a new "Cancer Therapy and Kidney Dialysis" Benefit^▲ with up to extra HK$120,000 per policy year to cover the medical expenses incurred by radiotherapy, chemotherapy, cyber knife, gamma knife as cancer therapy and kidney dialysis.

^▲	Recommendation by the attending physician is required for hospital confinement or in day-case unit of hospital or clinic.

Coverage for Pre- and Post-Surgical Treatments

Covering both pre- and post-surgical treatments related to the same injury or illness. The coverage includes one pre-surgical consultation, all follow-up clinic consultations within 6 weeks after surgical operation and Chinese medicine practitioner treatments of up to 5 visits.

Free Coverage for Newborn Infant

If both parents are covered under Super Medical Insurance Series, their newborn infant will be covered under the Basic Plan from the age of 12 days until the next policy renewal date.

Free Annual Checkup Programme

Your health is our utmost concern, our free annual checkup programme includes health screening profiles and professional advice on laboratory reports from our medical consultants, enabling you to stay on top of your health conditions with preventive treatment in place.

Extended Health Checkup Programmes

Our Extended Health Checkup Programmes offer more comprehensive checkup services at your choice at preferential rates, enabling you to monitor your health conditions and detect early symptoms.

Optional Benefits to Cater Your Specific Needs

Based on your own needs, you may choose to enhance the basic coverage by selecting the Optional Supplementary Medical Benefits and/or the Optional Outpatient Benefits on top of the basic coverage. Moreover, the Optional Outpatient Benefits also provide a number of plan levels to cater your specific needs.

No Claim Discount³

Upon renewal, the insured will receive No Claim Discount on the premium payable for the Basic Hospital and Surgical Benefits, if no claim under Basic Hospital and Surgical Benefits has been made during the respective no claim period as specified in the table below.

No Claim Period Immediately Preceding Renewal	Discount Rate
1 year	5%
2 consecutive years	5%
3 consecutive years	10%
4 consecutive years	10%
5 consecutive years or more	15%

Plan Coverage

1.	Basic Hospital and Surgical Benefits
	The benefits cover 100% eligible expenses up to the following maximum benefit limit:

Plan Level		Maximum Benefit Limit (HK$)
Plan Level		Supreme	Superb	Super
Benefit Items		Level of Accommodation
Benefit Items		Private	Semi-private	Ward
1.	Room and Board (Per day) - Max. 90 days per policy year	3,300	1,950	830
2.	Miscellaneous Hospital Charges (Per policy year)	30,500	22,500	18,500
3.	Surgeon’s Fees⁺ (Per operation) • Complex • Major • Intermediate • Minor - Including Chinese Medicine Practitioner Treatment, 5 visits per operation, 1 visit per day, limit per visit	147,000 49,000 25,000 10,000 180	114,000 38,000 20,000 8,000 150	90,000 30,000 15,000 6,000 120
4.	Anaesthetist’s Fees^ (Per operation) • Complex • Major • Intermediate • Minor	44,100 14,700 7,500 3,000	34,200 11,400 6,000 2,400	27,000 9,000 4,500 1,800
5.	Operating Theatre Charges^ (Per operation) • Complex • Major • Intermediate • Minor	44,100 14,700 7,500 3,000	34,200 11,400 6,000 2,400	27,000 9,000 4,500 1,800
6.	Physician’s Visit Fees (Per day) - Max. 90 days per policy year	3,300	1,950	830
7.	Specialist’s Fees (Per policy year) - Referral letter is required	9,700	7,100	6,100
8.	Charges for Intensive Care (Per day) - Max. 30 days per policy year	8,600	6,600	5,600
9.	Cancer Therapy and Kidney Dialysis (Per policy year) - Referral letter is required	120,000	80,000	50,000
10.	Daily Hospital Cash Allowance^▲ (Per day) - Max. 45 days per policy year	1,650	980	410
11.	Emergency Outpatient Treatment (Per policy year)	3,000	3,000	2,500
12.	Outpatient Surgery Cash Allowance^# (Per surgical Day Case Procedure*)	1000	1000	1000
Applicable to Super Junior Plan only
13.	Companion Bed for Insured Child (Per day) - Max. 90 days per policy year	3,300	1,950	830
Applicable to Super Senior Plan only
14.	Companion Bed for Insured Senior (Per day) - Max. 90 days per policy year	3,300	1,950	830
15.	Registered Private Nurse’s Fees (Per day) - Max. 90 days per policy year	1,220	800	410
	Overall Maximum Limit Per Policy Year (for aged 76 or above)	650,000	300,000	180,000

Remarks:

⁺	Surgeon’s Fees will be calculated in accordance with the Surgical Schedule, including operation performed by a surgeon during a confinement or Day Case Procedure* upon the written recommendation of the attending physician.
^	On condition that Surgeon’s Fees are payable by Blue Cross.
^▲	Daily Hospital Cash Allowance applies to general ward of public hospital in Hong Kong only.
^#	Only applicable to the following day case procedures: gastroscopy (including esophagogastroduodenoscopy), colonoscopy, cystoscopy, arthroscopy, colposcopy and bronchoscopy.
*	“Day Case Procedure” means a medically necessary medical or surgical procedure which is performed by a physician in an outpatient facility. An outpatient facility may refer to a physician’s clinic, a day case centre, a day care centre, or an outpatient department or equivalent facility established and operated by a hospital.

Optional Benefits

Optional benefits give you extended coverage for inpatient and outpatient treatments.

Optional Supplementary Medical Benefits

You can opt for Optional Supplementary Medical Benefits corresponding to the plan level of your Basic Hospital and Surgical Benefits. The benefits cover either 80% or 100% of the eligible expenses in excess of items 1-8 and 13-14 under Basic Hospital and Surgical Benefits up to the following overall maximum benefit limit per policy year:

Plan Level	Supreme	Superb	Super
Level of Accommodation	Private	Semi-private	Ward
Reimbursement Percentage	80% or 100%
Overall Maximum Benefit Limit Per Policy Year (HK$)	600,000	450,000	300,000

If the insured is confined to a level of hospital facilities and services higher than the entitled level, the eligible claims will be calculated based on below scale of reimbursement:

Entitled Level of Accommodation	Actual Level of Accommodation	Reimbursement Percentage of All Eligible Claims^‡
Ward	Semi-private	50%
Ward	Private	25%
Ward	Deluxe	12.5%
Semi-private	Private	50%
Semi-private	Deluxe	25%
Private	Deluxe	50%

^‡	Applicable to Optional Supplementary Medical Benefits only.

Remark:

All expenses incurred must be Reasonable and Customary⁴ and Medically Necessary⁵.

3.	Optional Outpatient Benefits (Plan 3A or 3B)
	Optional Outpatient Benefits offer two reimbursement options either 80% or 100% of eligible outpatient expenses. You may visit any clinic of your own choice and subject to the maximum benefit limit listed in the table below.

	If premium is paid annually, you are entitled to use Blue Cross Healthcare Card in any network clinic for general practitioner’s consultations, Chinese medicine practitioner treatments or specialist’s consultations. Consultations in network clinics are subject to a co-payment of HK$30 for the 80% reimbursement option and no co-payment is required for the 100% reimbursement option.

Plan Level (3A)	Maximum Benefit Limit (HK$)
Plan Level (3A)	Supreme A	Superb A	Super A
	80% or 100%
General Practitioner’s Consultation* - 1 visit per day, limit per visit	350	260	200
Chinese Medicine Practitioner Treatment* - Including Chinese bone-setting and acupuncture - 15 visits per policy year, 1 visit per day, limit per visit	180	150	120
	*Max. 35 visits per policy year for these two benefit items
Specialist’s Consultation - Referral letter is required^# - 10 visits per policy year, 1 visit per day, limit per visit	520	400	300
Prescribed Medicines and Drugs - Prescription letter is required for procurement from pharmacy outside hospital or clinic - Limit per policy year	7,800	5,800	4,300
Diagnostic X-rays and Laboratory Tests - Referral letter is required - Limit per policy year	2,500	1,900	1,500
Physiotherapy and Chiropractic Services - 10 visits per policy year, 1 visit per day, limit per visit	350	260	200

^#	Except for gynecology, orthopaedics & traumatology, dermatology, ophthalmology, oncology, urology, nephrology and paediatrics.

Remark:

All expenses incurred must be Reasonable and Customary⁴ and Medically Necessary⁵.

Plan Level (3B)	Maximum Benefit Limit (HK$)
Plan Level (3B)	Supreme B	Superb B	Super B
	80% or 100%
General Practitioner’s Consultation* - 1 visit per day, limit per visit	350	260	200
Chinese Medicine Practitioner Treatment* - Including Chinese bone-setting and acupuncture - 10 visits per policy year, 1 visit per day, limit per visit	180	150	120
	*Max. 30 visits per policy year for these two benefit items
Specialist’s Consultation - Referral letter is required^# - 10 visits per policy year, 1 visit per day, limit per visit	520	400	300
Physiotherapy and Chiropractic Services - 10 visits per policy year, 1 visit per day, limit per visit	350	260	200

^#	Except for gynecology, orthopaedics & traumatology, dermatology, ophthalmology, oncology, urology, nephrology and paediatrics.

Remark:

All expenses incurred must be Reasonable and Customary⁴ and Medically Necessary⁵.

	Health Checkup Programmes

	1. Free Annual Checkup Programme
	2. Extended Health Checkup Programmes

	For full details, please refer to "Super Medical Insurance Series" Brochure.

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Important Notes

1.	No Hospital Bills to Pay only applicable to admission to private hospitals in Hong Kong. A Hospitalisation Pre-registration Form is required to be completed and return to Blue Cross for registration and authorisation process at least 4 working days prior to admission. The liability of Blue Cross under the policy is limited to indemnify the insured for the eligible medical expenses payable in accordance with the Super Medical Insurance Series. Blue Cross shall recover from the insured the medical expenses settled on behalf of the insured which fall outside coverage of the policy (if any).
2.	Guaranteed Lifetime Renewal is not applicable to Optional Supplementary Medical Benefits. Renewal is guaranteed (subject to the availability of the Plan at the time of renewal) and Blue Cross will neither charge extra premium nor impose additional exclusions on an individual policy based on the insured’s health status or claims history at the time of renewal. However, Blue Cross reserves the right to revise the terms and conditions of the policy and adjust the premium upon policy renewal due to, for example, age-related adjustment, a particular risk class or change of risk class.
3.	In the event that after the insurance coverage for that insured is renewed at a No Claim Discount, a claim by that insured for any benefit under the Basic Hospital and Surgical Benefits section, which has accrued in the previous period of insurance, is paid or becomes payable by Blue Cross, the policyholder shall reimburse the discounted amount to Blue Cross within 21 days from the date of the invoice. No benefits shall be payable to the insured under this policy unless the discounted amount is received by Blue Cross.
4.	Reasonable and Customary refers to a charge for medical treatments, services or supplies which does not exceed the general level of charges being charged by the relevant service providers or suppliers of similar standing in the locality where the charge is incurred for similar treatments, services or supplies to individuals of the same sex and age, for a similar disease or injury. The Reasonable and Customary charges shall not in any event exceed the actual charges incurred. In determining whether an expense is Reasonable and Customary, Blue Cross may make reference to the following (if applicable): a) the gazette issued by the Hong Kong Government which sets out the fees for the private patient services in public hospitals in Hong Kong; b) industrial treatment or service fee survey; c) internal claim statistics; d) extent or level of benefit insured; and/or e) other pertinent source of reference in the locality where the treatments, services or supplies are provided.
5.	Medically Necessary refers to the need to have treatment or service for the purpose of treating a disability in accordance with the generally accepted standards of medical practice and such treatment or service must: a) require the expertise of a qualified medical practitioner; b) be consistent with the diagnosis and necessary for the treatment of the condition; c) be rendered in accordance with professional and prudent standards of medical practice, and not be rendered primarily for the convenience or the comfort of the Insured, his/her family members, caretaker or attending qualified medical practitioner; and d) be rendered in the most cost-efficient manner and setting appropriate in the circumstances.

Exclusions

1.	Treatment or test which is not Medically Necessary; or purchase of drugs which are not prescribed by a physician.
2.	Confinement solely for the purpose of general checkup, diagnostic X-ray, advanced imaging, laboratory test or physiotherapy.
3.	Treatment related to Congenital Conditions (except Hernias, Strabismus and Phimosis) or Developmental Conditions or disease of similar kind.
4.	Pre-existing Conditions.
5.	Expenses directly or indirectly arising from Human Immunodeficiency Virus ("HIV") and its related Disability, including Acquired Immune Deficiency Syndrome (AIDS) and/or any mutations, derivation or variations thereof, consequential upon an HIV infection occurring before the Insured Effective Date.
6.	Treatment or Disability directly or indirectly arising from or consequent upon: the abuse of drugs or alcohol, self-inflicted injuries or attempted suicide, illegal activity, or driving or maneuvering machines whilst exceeding the prescribed alcohol and drug limit, or venereal and sexually transmitted disease or its sequelae.
7.	Any charges in respect of services for beautification, cosmetic purposes or non-medically related conditions; expenses for hearing tests, routine blood tests, general check-ups, vaccinations or inoculations, etc.
8.	Treatment of a dental condition and oral surgery (except treatment of an emergency and surgery arising from an accident received by an insured during confinement) as well as follow up treatment of the dental condition or oral surgery whether as an inpatient or outpatient.
9.	All investigation, treatment, surgical procedure and counselling service relating to maternity conditions and its complications, including diagnostic tests for pregnancy or resulting childbirth, abortion or miscarriage; birth control or reversal of birth control; sterilisation or sex reassignment of either sex; infertility, etc.
10.	Treatment directly or indirectly arising from any psychotic, psychological, or psychiatric conditions and any physiological or psychosomatic manifestations thereof.
11.	Treatment or Disability directly or indirectly arising from war (declared or undeclared), civil war, invasion, acts of foreign enemies, hostilities, rebellion, revolution, insurrection or military or usurped power; resulting from taking part in military, air force, naval and other disciplinary services.


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For more information and related documents, please download here.				Talk to us directly:
Product Leaflet	Terms and Conditions	Application Forms	Welcome Offer	3608 2988 or email us

Notes:

1.	The above information is for reference only. Please refer to policy for the exact terms and conditions and the full list of policy exclusions. For more information or a copy of the policy terms and conditions, please contact our Customer Service Department on 3608 2988/ by email cs@bluecross.com.hk for enquiry.
2.	Should there be any discrepancy between the English and the Chinese versions of the above information, the English version shall apply and prevail.

The above product(s) is/are offered for sale in Hong Kong only and is/are underwritten by Blue Cross (Asia-Pacific) Insurance Limited, an authorised insurer in Hong Kong.