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  Caring Medical Protection Plus is designed exclusively for our existing group medical insurance members as a "top-up" cover to their company’s medical plan. With a modest premium, you can enhance your medical cover by "leveraging" your group medical cover.

No underwriting is required upon enrolment. The Plan offers guaranteed acceptance of all pre-existing conditions currently covered by your company medical policy as well as guaranteed renewal up to the age of 99.

No matter you leave the company or move to a new job, this Plan can always provide you and your family the same medical cover.
 
       
  Plan Highlights    
  Plan Coverage    
  Enrolment Guideline    
  Important Notes  
  Exclusions    
       
       
Plan Highlights
 
       
  Strengthen Your Medical Protection with Leverage  
  Generally, group medical cover aims to provide employees the basic medical benefits as part of the remuneration. These plans usually may not be sufficient to cover all your medical expenses and you will have to pay the shortfall at your own expenses. To decide whether you need to top up your health protection, first, you need to study your group medical insurance plan in terms of its coverage and maximum benefit limits.  
       
  Take coronary angioplasty as an example, a major surgery usually costs patient around HK$60,000. If your group medical cover can reimburse HK$15,000-$30,000 for such operation, you will have to pay a shortfall of HK$30,000-$45,000 out of pocket. With this Plan, you can receive an additional benefit of HK$30,000-$49,000 (depending on the selected plan level) on top of your group medical cover. With a modest premium, you can simply enhance your health protection by "leveraging" your group medical cover and reduce your chance of paying medical costs.  
       
  Maintain Same Protection in Long Run  
  Whether you are moving from one employer to another or planning to retire, you will be able to convert the coverage of your existing Blue Cross Group Medical Plan to Caring Medical Protection Plus, enjoying the same level of individual medical coverage as before.  
     
  Your Choice of Benefit Reimbursement Options  
  Basic Hospital and Surgical Benefits offer 2 reimbursement options: Benefit Sub-limit per disability or Lump Sum per policy year, covering expenses including Room and Board, Surgeon’s Fees, Specialist's Fees, Charges for Intensive Care, etc.

If you choose Lump Sum per policy year, you can also select annual deductible, which enables you to enjoy cost-effective yet flexible medical protection plan.
 
     
  Guaranteed Acceptance of Pre-existing Conditions without Underwriting1  
  When you apply for a new individual medical insurance plan, underwriting and excluding "pre-existing conditions" are usually a must. Some insurers may require health examination upon enrolment, so the chance of having an application declined would increase with age. For our group medical members enrolling in this Plan, they can have peace of mind that no underwriting, medical examination or health declaration2 is required. Apart from offering guaranteed acceptance, we also guarantee you that all pre-existing conditions currently covered by your group medical plan will be automatically covered under this Plan*.
Except for the exclusions of this Plan.
 
     
  Guaranteed Renewal up to Age 993  
  Many individual medical plans in market are only renewable till the age of 70 to 80 or policy renewal is subject to claims history. After enrolment in this Plan, we guarantee your policy will be renewable till the age of 99, giving you coverage up to age 100, regardless of your health status or claims history.  
     
  One-stop Claims Solution  
  You can enjoy greater ease and convenience with this Plan by submitting two claims in one go. If your group and individual medical policies are underwritten by two insurers, you need to submit two claims applications, one after another, when your claim cannot be fully reimbursed by your group medical cover. The claims procedures are complicated as the process involves the retrieval of all medical receipts from one insurer to another.  
     
  Smart MedClaim Hotline  
  Prior to your hospital stay, you can get to know whether the medical expenses can be fully covered by us. Simply make a call to our Hotline on 3608 2988 (press 2153) for a Pre-hospitalisation Claim Assessment, our dedicated officer will help you estimate the eligible claim amounts4 based on your group and individual medical policies, enabling you to plan your budget ahead and undergo treatment with peace of mind.  
     
  24-hour Worldwide Emergency Aid  
  If you need assistance with an emergency condition while travelling overseas, you can call our 24-hour Worldwide Emergency Aid Hotline at any time, through which the dedicated officer can provide you with appropriate assistance for hospital admission deposit guarantee service, medical repatriation, travel information and medical or legal referral service. In case of emergency, you can be sure help is just a call away.  
     
  Worldwide Medical Coverage  
  Whether you are travelling overseas for leisure or on business, you can receive immediate inpatient treatment when needed no matter where you are. Besides, all benefit limits remain the same no matter how long you stay overseas.  
     
  Optional Outpatient Benefits for Enhanced Coverage  
  You can opt for Optional Outpatient Benefits to cater for your personal needs. With this enhanced health protection, you can be certain that you and your whole family are well taken care of.  
     
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Plan Coverage
 
     
 
Basic Hospital and Surgical Benefits (Benefit Sub-limit)
The benefits cover 100% of eligible expenses up to the following maximum benefit limit per disability:
 
 
Benefit Items Maximum Benefit Limit Per Disability* (HK$)
Plan Level Premier
(1)
Superior
(2)
Standard
(3)
Level of Accommodation Private Semi-private Ward
1.

Room and Board
- Max. 90 days per disability, limit per day

2,850 1,650 720
2.

Miscellaneous Hospital Charges

26,800 19,500 15,900
3. Surgeon's Fees5
• Complex
• Major
• Intermediate
• Minor
- Including Chinese Medicine Practitioner Treatment,
  5 visits per disability, 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#
• 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#
• 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
- Max. 90 days per disability, limit per day

2,850 1,650 720
7.

Specialist's Fees
- Referral letter is required

8,800 6,800 5,800
8.

Charges for Intensive Care
- Max. 30 days per disability, limit per day

8,600 6,600 5,600
9.

Registered Private Nurse's Fees
- Max. 90 days per disability, limit per day

1,080 720 360
10.

Daily Hospital Cash Allowance6
- Max. 45 days per disability, limit per day

1,400 820 360

Overall Maximum Benefit Limit Per Policy Year*
(Applicable to insured aged 76 or above)

650,000 300,000 180,000
 
   
   
 
#  On condition that Surgeon’s Fees are payable by Blue Cross.
 
 
Remark:  All expenses incurred must be Reasonable and Customary8 and Medically Necessary9.
 
   
   
 
Basic Hospital and Surgical Benefits (Lump Sum)
The benefits cover 100% of eligible expenses with a lump sum payment in excess of the annual deductible (if applicable) up to the following maximum benefit limit per policy year:
 
 
Plan Level Maximum Benefit Limit Per Policy Year (HK$)
Premier
(4)
Superior
(5)
Standard
(6)
Level of Accommodation Private Semi-private Ward
Annual Deductible7
0 120,000 300,000
0 60,000 150,000
0 30,000 80,000
Maximum Benefit Limit Per Policy Year^ 650,000 300,000 180,000
 
   
   
 
Blue Cross will reimburse the eligible expenses for items 1-9 in the table of Basic Hospital and Surgical Benefits (Benefit Sub-limit) up to the above maximum benefit limit per policy year. However, all benefits payable in respect of Chinese Medicine Practitioner Treatments are subject to the maximum benefit limit as stated under item 3 in the table of Basic Hospital and Surgical Benefits (Benefit Sub-limit).
 
 
Remark:  All expenses incurred must be Reasonable and Customary8 and Medically Necessary9.
 
     
 
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 Basic Hospital and Surgical Benefits (Lump Sum) only.
 
     
 
Optional Outpatient Benefits
The benefits cover 80% of eligible outpatient expenses. You may visit any clinic at 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 per visit.
 
 
Benefit Items Maximum Benefit Limit (HK$)
Plan Level Premier Superior Standard
General Practitioner’s Consultation
- 1 visit per day, limit per visit

Chinese Medicine Practitioner Treatment
- Including Chinese bone-setting and acupuncture
   10 visits per policy year, 1 visit per day, limit per visit
340



180
250



150
200



120
Max. 25 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
510 380 300
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

340 250 190
 
   
   
 
Remark:  All expenses incurred must be Reasonable and Customary8 and Medically Necessary9.
 
     
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Enrolment Guideline
 
     
  Top Up Option  
 
Exclusive to existing Blue Cross Group Medical Insurance Members with Basic Hospital and Surgical Benefits.
Members can choose one plan between Plan 1 to 6 under Basic Hospital and Surgical Benefits according to their needs.
Within 30 days from the Member's commencement date or upon each renewal date of the group medical policy.
Policy effective date must be the same as the Member's commencement date or renewal date of the group medical policy.
Claims Tips
- When the insured files a claim with us, we will do the claims assessment based on the group medical
   policy and this Plan in one go. Fast and simple!
Step 1: Eligible medical expenses are first reimbursed by the group medical policy
Step 2: Any shortfall will then be reimbursed by this Plan
- For claims related to pre-existing conditions, the shortfall will be reimbursed by this Plan according to
  the following table:
Plan Year Basic Hospital and Surgical Benefits
Reimbursement Percentage of Eligible Medical Expenses*
1 50%
2 and after 100%
All benefits payable above are subject to the maximum limits as per schedule of benefits (if applicable).
 
   
   
     
  Conversion Option  
 
Exclusive to Blue Cross Group Medical Insurance Members with Basic Hospital and Surgical Benefits who are going to resign or retire.
Members can choose one plan between Plan 1 to 6 under Basic Hospital and Surgical Benefits according to their needs.
Within 30 days from the date of termination of the group medical membership.
Policy effective date must be the following day of the last day of employment.
 
     
  Plan Level  
  Without underwriting, all applicants can choose a corresponding plan level based on their existing group medical insurance plan. The higher level of accommodation they are entitled in the group medical cover, the more options of plan level they will have. Please refer to the below table for details:  
 
Existing Group Medical Insurance Plan Caring Medical Protection Plus
Level of Accommodation Corresponding Plan Level of Basic Hospital and Surgical Benefits
Private Premier (1)/Superior (2)/Standard (3)/Premier (4)/Superior (5)/Standard (6)
Semi-private Superior (2)/Standard (3)/Superior (5)/Standard (6)
Ward Standard (3)/ Standard (6)
 
  If applicants opt for a plan level higher than the corresponding plan levels listed above or opt for Optional Outpatient Benefits while such benefits are not provided under the existing group medical policy, their applications are subject to underwriting.

If applicants enrol in Optional Outpatient Benefits, they can only opt for a plan level corresponding to or lower than the plan level of Basic Hospital and Surgical Benefits. Please refer to the below table for details:
 
 
Plan Level of Basic Hospital and Surgical Benefits Corresponding Plan Level of Optional Outpatient Benefits
Premier (1)/Premier (4) Premier/Superior/Standard
Superior (2)/Superior (5) Superior/Standard
Standard (3)/ Standard (6) Standard
 
     
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Important Notes
 
     
 
1.
In respect to Pre-existing Conditions, the insured shall retain coverage provided by the preceding group policy under this Policy i.e. the benefits payable to the insured under the Hospital and Surgical Benefits Section of this Policy will be equivalent to 100% of the eligible expenses for any claim, subject to the applicable benefit limits. In case where the insured remains covered by the in-force group policy, if he is afflicted with a medical disability which is a Pre-existing Condition covered under the in-force group policy, the benefits payable to the insured under this section will be equivalent to 100% of the eligible expenses, subject to the applicable limits. Notwithstanding the aforesaid, during the first period of insurance, the Company shall only pay 50% of the eligible expenses under Hospital and Surgical Benefits Section, subject to the applicable benefit limits. The Company is not liable for any claim for disability which is a Pre-existing Condition that is not covered under the preceding group policy or in-force group policy.
2.
The application is subject to underwriting if the insured member opts for a higher level of inpatient or outpatient benefits than his previous group medical insurance policy, enrols in the outpatient benefits where his previous group medical insurance policy does not provide any outpatient coverage, or was insured under this Plan but then terminated the policy and re-enrols. In which case, Blue Cross reserves the right to charge extra premium or impose exclusions or decline his application according to its underwriting decision.
3.
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.
4.
The customer must complete and submit the Pre-hospitalisation Claim Assessment Form. Assessment of the estimated eligible claim amounts is for customers' reference only, the actual eligible claim amounts will be subject to the final claim decision. All benefits will be payable subject to the terms and conditions and the full list of policy exclusions.
5.
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. "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.
6.
Daily Hospital Cash Allowance applies to general ward of public hospital in Hong Kong only.
7.
The Annual Deductible is only applicable to the Basic Hospital and Surgical Benefits (Lump Sum). With respect to an insured of age 50, 55, 60 or 65 at renewal, the policyholder may apply for lowering the Annual Deductible within 31 days before or after the relevant renewal without providing Blue Cross with further evidence of the insured's health status. This right can only be exercised once during the lifetime of an insured and is irrevocable. The change shall only take effect on renewal and subject to the approval of Blue Cross.
8.
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.
9.
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.
 
   
   
     
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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, unless specified otherwise in the Benefits Provisions.
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 checkups, 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.
12.
Any exclusions or conditions previously imposed to the individual on the group medical insurance policy.
 
   
   
     
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  For more information and related documents, please download here.   Talk to us directly:
  Product Leaflet Terms & 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 click here or 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.