the hong kong polytechnic university voluntary medical ... · available to existing members of the...

29 June 2017

THE HONG KONG POLYTECHNIC UNIVERSITY

Voluntary Medical Insurance Plan offered by AIA -

“StepUp Medical Protection Plan” (StepUp Plan)

The requirements of StepUp Plan are set out below:

1. The StepUp Plan is for Members of the Staff Medical Benefit Scheme (PolyU Scheme). The maximum age of the Scheme Members for enrolment to the StepUp Plan shall be 65 (i.e. before the Scheme Member reaches the 66th birthday).

2. On joining the voluntary plan, pre-existing conditions of Scheme Members already covered under the PolyU Scheme will continue to be covered if the Scheme Members have been covered under the PolyU Scheme (Scheme Membership) and if applicable, the StepUp Plan (excluding the period which overlaps with the Scheme Membership, if any), for an aggregate duration of twelve (12) consecutive months. The StepUp should be lifetime renewable.

3. Scheme Members shall be entitled to enrol to the StepUp Plan by paying the premium required, and subject to the following enrolment period:

(a) New Scheme Member: within 30 days after joining the PolyU Scheme1; otherwise, within 30 days after subsequent Policy Anniversary of the PolyU Scheme on 1 July 20182 or 1 July 20192; or

(b) Existing Scheme Member2: within 30 days after 1 July 2017; otherwise, within 30 days after

the subsequent Policy Anniversary on 1 July 2018 or 1 July 2019; or (c) Existing and New Scheme Member3: within 30 days after termination of his/her membership

under the PolyU Scheme (i.e., upon retirement or termination of employment) and before reaching the 66th birthday, whichever is earlier.

4. The choice of the Scheme Member of the plan level of StepUp Plan shall not exceed the Designated Room Level of the Scheme Member under the PolyU Scheme.

If you would like to obtain more information of the StepUp Plan, please refer to the product brochure available from AIA website at aia.com.hk or call the AIA hotline 3108 1686.

1 The commencement date of StepUp Plan membership will be the same as the start date of the PolyU Scheme membership. 2 The StepUp Plan membership to commence on 1 July of 2017/2018/2019 as appropriate depending on the year of enrolment. 3 The StepUp Plan membership to commence on the day immediately after the last day of the PolyU Scheme membership.

With a successful career to pursue and a family to raise, it’s more important than ever for you to take good care of yourself. That’s why we designed an enhanced medical protection plan for you.

Available to existing members of The Hong Kong Polytechnic University / CPCE medical plan, the comprehensive

is a lifetime plan that tops up your group medical insurance. Your acceptance into the plan is guaranteed with no underwriting required, enabling you to enhance your cover and prepare for future protection needs for just an affordable premium.

Even if you leave the company or enter retirement, you will remain covered under , giving you and your loved ones the reassurance you need.

MEDICAL PROTECTIONSTEPUP MEDICAL PROTECTION PLAN

1

Cover at a glanceProduct Nature Medical protection insurance plan

Members under The Hong Kong Polytechnic University /CPCE medical plan

For more information, please read the “Benefits schedule for the StepUp Medical Protection Plan” in this brochure.

Medical Network Privileges

By seeking treatment through AIA medical network, you can enjoy the following privileges:• 90% reimbursement with no deductible for core benefits• Cashless arrangement service for designated clinical

operations

Core Benefits

15 days to age 65

Lifelong

Issue Age (of the insured)

Protection up to Age

“AIA”, “the Company”, “We”, “our” or “us” herein refers to (Incorporated in Bermuda with limited liability).

Eligibility

• Comprehensive hospitalisation and surgical care• Extended care protection for renal dialysis and cancer

treatment – including related tests, targeted therapy, chemotherapy and radiotherapy for the latter

• Other benefits include advanced diagnostic imaging (including tests performed in outpatient setting) and medical appliances

• Worldwide emergency assistance services, including emergency medical evacuation

WorldwideGeographic Cover

• Outpatient – Plan 1 to 4 Optional Benefit

Plan Option • Plan 1 – Ward plan• Plan 2 – Semi-Private plan • Plan 3 – Standard Private plan

Guaranteed acceptanceUnderwriting Requirement

StepUp Medical Protection Plan

StepUp

AIA International Limited

(StepUp)

Portable protection for extra peace of mind

In life, it’s good to have an extra safety net. When you join , you can renew your cover every year. The renewal

premium will be based on the prevailing premium rates at the time of renewal. Even if you leave the company, your group medical cover ends or you retire, your cover under this plan will continue, giving you protection at all times.

Guaranteed acceptance with no underwriting required

There is no medical underwriting requirement when you apply for this plan. Your application is guaranteed to be accepted, so you can obtain the protection you need with ease.

Cover for pre-existing conditions

If you have been covered under The Hong Kong Polytechnic University / CPCE medical plan and (if applicable) for a total duration of at least 12 continuous months (excluding the period which overlaps with the scheme membership, if any), any pre-existing conditions you have will be covered under , giving you immediate comprehensive protection.

Comprehensive cover for your medical expenses

offers you reimbursement for a range of medical expenses. This includes expenses such as hospital room and board, intensive care, surgery, hospital expenses, advanced diagnostic imaging (including tests performed in outpatient setting) and medical appliances.

For more information, please read the “Benefits schedule for the ” in this brochure.

Extended care support for renal dialysis and cancer treatment

We understand the extra support you need when a serious illness occurs. In the unfortunate event that you are diagnosed with cancer or kidney failure, we will provide extended care protection for renal dialysis and cancer treatment – including related tests, targeted therapy, chemotherapy and radiotherapy for the latter.

Quality medical network privileges

To serve you better, our medical network comprises carefully selected medical practitioners from across a range of medical disciplines. Within this network, you can enjoy quality medical services and receive the following additional benefits:

• 90% reimbursement with no deductible for core benefits

If you seek treatment within our medical network, we will reimburse 90% of your medical expenses, and no deductible will apply.

• Cashless arrangement for 4 designated surgical procedures at outpatient clinic

You can use your electronic network card to book a designated surgery at a network clinic on a cashless basis, freeing you from the hassle of settling bills and making a subsequent claim.

The 4 designated procedures are:1. lens operation including cataract removal and

prosthetic lens insertion2. colonoscopy, with or without a biopsy or papilloma

removal3. upper endoscopy up to the level of the duodenum4. excisions of skin lumps or a tumour of subcutaneous

tissue, including lipomas, neurofibromas or its variants, sebaceous cysts, malignant melanomas and nevi, etc.

The cashless arrangement is subject to a per disability limit and an additional per disability limit for network benefits, and you are required to settle the shortfall (if any).

For more information, please refer to our network services leaflet for .

2 MEDICAL PROTECTIONSTEPUP MEDICAL PROTECTION PLAN

StepUp

StepUp

StepUp

StepUp


Portable protection for extra peace of mind

In life, it’s good to have an extra safety net. When you join , you can renew your cover every year. The renewal

premium will be based on the prevailing premium rates at the time of renewal. Even if you leave the company, your group medical cover ends or you retire, your cover under this plan will continue, giving you protection at all times.

Guaranteed acceptance with no underwriting required

There is no medical underwriting requirement when you apply for this plan. Your application is guaranteed to be accepted, so you can obtain the protection you need with ease.

Cover for pre-existing conditions

If you have been covered under The Hong Kong Polytechnic University / CPCE medical plan and (if applicable) for a total duration of at least 12 continuous months (excluding the period which overlaps with the scheme membership, if any), any pre-existing conditions you have will be covered under , giving you immediate comprehensive protection.

Comprehensive cover for your medical expenses

offers you reimbursement for a range of medical expenses. This includes expenses such as hospital room and board, intensive care, surgery, hospital expenses, advanced diagnostic imaging (including tests performed in outpatient setting) and medical appliances.

For more information, please read the “Benefits schedule for the ” in this brochure.

Extended care support for renal dialysis and cancer treatment

We understand the extra support you need when a serious illness occurs. In the unfortunate event that you are diagnosed with cancer or kidney failure, we will provide extended care protection for renal dialysis and cancer treatment – including related tests, targeted therapy, chemotherapy and radiotherapy for the latter.

Quality medical network privileges

To serve you better, our medical network comprises carefully selected medical practitioners from across a range of medical disciplines. Within this network, you can enjoy quality medical services and receive the following additional benefits:

• 90% reimbursement with no deductible for core benefits

If you seek treatment within our medical network, we will reimburse 90% of your medical expenses, and no deductible will apply.

• Cashless arrangement for 4 designated surgical procedures at outpatient clinic

You can use your electronic network card to book a designated surgery at a network clinic on a cashless basis, freeing you from the hassle of settling bills and making a subsequent claim.

The 4 designated procedures are:1. lens operation including cataract removal and

prosthetic lens insertion2. colonoscopy, with or without a biopsy or papilloma

removal3. upper endoscopy up to the level of the duodenum4. excisions of skin lumps or a tumour of subcutaneous

tissue, including lipomas, neurofibromas or its variants, sebaceous cysts, malignant melanomas and nevi, etc.

The cashless arrangement is subject to a per disability limit and an additional per disability limit for network benefits, and you are required to settle the shortfall (if any).

For more information, please refer to our network services leaflet for .


3

Flexibility to suit your needs

We understand that everyone’s situation is different. That’s why we offer optional outpatient benefit to suit your personal medical needs.

When you apply for this plan together with the optional outpatient benefit, there is no medical underwriting requirement*, allowing you to obtain a more comprehensive protection with ease.

Choice of plans will be subject to your existing cover of The Hong Kong Polytechnic University / CPCE medical plan, if any. For more information, please refer to “Plan selection rule” in this brochure.

*After the policy is effective, you can apply for the optional outpatient benefit on the policy anniversary date. Medical underwriting is required.

Plan Option • Plan 1 – Ward plan• Plan 2 – Semi-Private plan • Plan 3 – Standard Private plan

Optional Benefit Plan 1 to 4 – Outpatient benefit

StepUp

Insured’s Age

Aged 28

Covered under the group medical insurance scheme provided by the employer

Purchased –

Plan 2

Per disability limitHK$200,000 + HK$100,000 (additional network limit)

Additional benefits for cancer and renal dialysis treatmentReceive an additional limit of HK$200,000 for treatment per covered disability


5

StepUpMedical Protection Plan

Example

Case 1: Policy owner and insured: Alan (aged 28)

Occupation: Assistant Administrative Manager

Marital status: Single

Alan has great ambitions for his life and career. He understands that youth is currently his greatest asset, so he decides to purchase the – Plan 2, with no medical underwriting required, boosting the medical cover on top of his company’s group medical scheme.

provides Alan with a ‘top-up’ protection at an affordable premium, with a per disability limit of HK$200,000 and an additional network limit of HK$100,000 to supplement his employer’s group medical scheme.

What’s more, if Alan is diagnosed with cancer or kidney failure, gives him an additional layer of cover of HK$200,000 for treatment per covered disability.

Current cover: AIA group medical scheme

(The following example is hypothetical and for illustrative purposes only. If there are any changes in the values, no separate announcement will be made.)

StepUp

StepUp

The works in tandem with other existing group medical insurance plans, which can provide full cover for basic medical needs and minor medical claims. In situations where expenses cannot be covered in full by a group medical plan, the outstanding amount can be settled through .


StepUp


6MEDICAL PROTECTIONSTEPUP MEDICAL PROTECTION PLAN

Example

Case 2: Policy owner and insured: Bonnie (aged 45)

Occupation: Senior Customer Services Manager

Marital status: Married with a son and a daughter

Family comes first for Bonnie, who understands what an impact unexpected medical expenses can have on her family’s finances. She purchases the

– Plan 1 to supplement her company’s group medical plan, giving her additional financial support and peace of mind even in the face of the unexpected.

After purchasing , Alice visits a family physician for her digestive problems, and is advised to undergo a gastroscopy.

She uses her electronic network card to book an outpatient gastroscopy at a network clinic on a cashless basis, freeing her from the hassle of making a claim afterwards.

Current cover: AIA group medical scheme

(The following example is hypothetical and for illustrative purposes only. If there are any changes in the values, no separate announcement will be made.)

StepUp

StepUp

Protection PlanStepUp Medical


7

Maximum Benefit (HK$)

Ward Semi-Private Standard Private

Plan 1 Plan 2 Plan 3

100,000 200,000 500,000

50,000 100,000 100,000

Network Non-Network

Benefits schedule for the

Benefit items are reimbursed on a “reasonable and customary” basis. For more information, please refer to point 1 of the “Product Limitation” section under “Important Information”.

Room Type Entitlement

Plan

Deductible (per disability) applies to items 1 to 11and 13 to 14

Per disability limit applies to items 1 to 12

Additional per disability limit for network benefitsapplies to items 1 to 12

Reimbursement percentage applies to item 12

Deductible applies to item 12

Reimbursement percentage applies to items 1 to 11 and 13 to 14

Network Non-Network Network Non-Network

90% 80% 90% 80% 90% 80%

100% N/A 100% N/A 100% N/A

0 N/A 0 N/A 0 N/A

0 5,000 0 15,000 0 28,000

I. Confinement Benefits

1. Hospital daily room and board benefit 2. Physician’s visit 3. Specialist’s fee 4. Miscellaneous hospital expenses benefit5. Intensive care benefit

II. Surgical Benefits

6. Surgery benefit Including surgeon’s fee, anaesthetist's fee and operating theatre charge

7. Outpatient surgery benefit Including surgeon’s fee, anaesthetist's fee and operating theatre charge

8. Medical appliances benefit Specified items: Include:

i. pace maker

ii. stents for Percutaneous Transluminal Coronary Angioplasty

iii. intraocular lens (standard)

iv. artificial cardiac valve

v. metallic or artificial joints for joint replacement

vi. prosthetic ligaments for replacement or implantation between bones

vii. prosthetic intervertebral disc

III. Post-hospitalisation / Outpatient Surgery Outpatient Consultation

9. Follow-up consultation and diagnostic tests within 31 days after confinement or outpatient surgery

Core Benefits


12. For these designated operations conducted under the plan’s medical network, cashless arrangement service can be arranged, and no deductible or coinsurance will apply:

i. lens operation including cataract removal and prosthetic lens insertion ii. colonoscopy, with or without biopsy or papilloma removal iii. upper endoscopy up to the level of the duodenum iv. excision of skin lumps or tumours of subcutaneous tissue, including lipomas, neurofibromas or its variants, sebaceous cysts, malignant melanomas, and nevi, etc.


VII. Emergency Treatment Benefits

Worldwide emergency assistance servicesa. Emergency medical evacuationb. Repatriation of remainsc. Compassionate visit by one immediate family member For staying in hospital more than 5 consecutive days

d. Return of children under aged 18 to Hong Kong For staying in hospital more than 5 consecutive days

Maximum aggregate limit of

HK$1,000,000 per trip

e. 24-hour worldwide telephone enquiry services Included


100,000 (Plan 1) 200,000 (Plan 2) 300,000 (Plan 3)

Room Type Entitlement

Per disability limitapplies to items 13 to 14

VI. Additional Benefits for Cancer and Renal Dialysis Treatment

13. Cancer treatment including radiotherapy, chemotherapy, targeted therapy, diagnostic imaging tests, etc.

14. Renal dialysis treatment

Core Benefits (continued)

V. Network Clinical Surgery Benefit

IV. Other Benefits

Adjustment factor

Received Treatment in Adjustment FactorRoom Type Entitlement

Ward Semi-Private 50%

If the insured is confined in a hospital room of a type that is at a higher level than the room type corresponding to the plan level chosen, the benefit payable shall be paid according to the benefits schedule, and subject to adjustment by a percentage indicated in the column of “Adjustment Factor” below:

10. Advanced diagnostic imaging (including tests performed in outpatient setting) Including Magnetic Resonance Imaging, Computerised Tomography Scan and Positron Emission Tomography Scan

11. Emergency outpatient treatment benefit If the insured sustains a covered injury and is treated as an outpatient in the outpatient department of a hospital within 24 hours of the accident resulting

in such covered injury

Standard Private

Semi-Private

Semi-Private

Ward

Ward

VIP / Deluxe / Suite


Standard Private


Standard Private

50%

0%

50%

0%

25%


9

Reimbursement percentage


Maximum Benefit (HK$)

Plan 4

80% 80% 80% 80%

150 250 350 500

Outpatient Benefit

1. Outpatient consultation (Including Western medication per visit)

15010 visits per policy year







1,00010 visits per policy year

2. Outpatient specialist fee (Including Western medication per visit)

2,500 3,000 4,000 5,000

2,500 3,000 4,000 5,000

2,500 3,000 4,000 5,0006. Diagnostic procedures and laboratory test (per policy year)





3. Physiotherapy and Chiropractic treatment (per visit)

Optional Benefit – Outpatient

The number of visit under items 1 to 4 is limited to 50 visits per policy year.

5. Psychiatric treatment (Including Western medication per policy year)

4. Registered Chinese Medicine Practitioner consultation (Including Chinese medicine)

7. Prescribed medicines, other than doctor’s and hospital’s clinic

(per policy year)

Recommendation by a registered doctor in writing is required

Consultation must be rendered by a western registered doctor


Member enrolment guidelines and plan selection rule

Application submission period(must be submitted within one of the below periods) Plan selection rule

New join and existing employees and their dependants*(iii) Within 30 days after the policy anniversary on 1 July 2018 / 2019

Existing employees and their dependants*(ii) Within 30 days after 1 July 2017

(iv) Within 30 days after membership termination in The Hong Kong Polytechnic University / CPCE medical plan

New join employees and their dependants*(i) Within 30 days after joining The Hong Kong

Polytechnic University / CPCE medical plan

(v) Within 30 days prior to the insured reaching the age of 66

• No restriction on plan choice

Members under The Hong Kong Polytechnic University / CPCE medical plan(members must be holders of Hong Kong identity cards at the time of application)

* If The Hong Kong Polytechnic University / CPCE medical plan is offered to employees’ dependants.

• Insured employee and insured dependant must enrol in the same plan, including core benefits and optional outpatient benefit, if applicable.

• Must enrol in the same room type or lower as The Hong Kong Polytechnic University / CPCE medical plan:

Class 1

Class 2

Corresponding room type entitlement

Semi-Private

Ward

Class

Important information1. This brochure is for reference only. It is not, and does not form part of, a

contract of insurance and is designed to provide an overview of the key features of this product. The precise terms and conditions of this plan are specified in the policy contract. Please refer to the policy contract for the definitions of capitalised terms, and the exact and complete terms and conditions of cover. This brochure should be read along with the illustrative document (if any) and other relevant marketing materials, which include additional information and important considerations about this product. We would like to remind you to review the relevant product materials provided to you and seek independent professional advice if necessary.

2. This plan is an insurance plan without any savings element. All premiums are paid for the insurance and related costs.

3. This brochure is for distribution in Hong Kong only.

Key Product Risks1. You need to pay the premium for this plan for life. If you do not pay the

premium within 31 days of the due date, the policy will be terminated and you / the insured will lose the cover.

2. We will terminate your plan and you / the insured will lose the cover when one of the following happens:

• the insured passes away;

• you do not pay the premium within 31 days of the due date; or

We reserve the right to cancel this policy at any time by giving a 30-day prior written notice without cause to the Owner. The unearned portion of the premium at the time of cancellation without interest shall be returned to you after deducting any debt owed by you to us under the policy.

3. We underwrite the plan and you are subject to our credit risk. If we are unable to satisfy the financial obligations of the policy, you may lose your cover and the remaining premium for that policy year.

4. Future medical costs will be higher than they are today due to inflation. Hence, the benefit amounts and the future premium rate of this plan may be adjusted to reflect inflation.

5. Your current planned benefit may not be sufficient to meet your future needs since the future cost of living may become higher than they are today due to inflation. Where the actual rate of inflation is higher than expected, you may receive less in real terms even if we meet all of our contractual obligations.

Key ExclusionsUnder this plan, we will not cover conditions that result from any of the following events:

• Any treatment, investigations, services or supplies which are not medically necessary.

• Any Pre-existing Conditions for which the insured received medical treatment, diagnosis, consultation or prescribed medicines / drugs during the ninety (90) days preceding the effective date of this coverage unless the insured affected by these conditions has been insured under The Hong Kong Polytechnic University / CPCE medical plan (if applicable) and this plan for a total duration of at least twelve (12) continuous months (excluding the period which overlaps with the scheme membership, if any).

• Self-destruction, intentional self-inflicted injury or drug abuse.

• War or warlike operations, civil commotion, any violation or attempted violation of law or resisting arrest, acts of terrorism where the insured is a terrorist, the use of atomic, biological or chemical contamination due to any act of terrorism, when the insured travels to a country at war, or where there is warlike operation, mutiny, riot, civil commotion, martial law or a state of siege, or a war zone as recognised by the United Nations.

• Pregnancy, miscarriage, child birth, voluntary termination of pregnancy, or complications of them, mental or nervous disorder, except for mental illness and emotional disorder benefit (see benefits schedule of optional outpatient benefit, item 5 for details), AIDS or any complications associated with HIV infection.

• Cosmetic or plastic surgery, dental care or surgery, corrective aids and the treatment of refractive errors unless necessitated by injury caused by an accident, body check-up, gradual recovery of health or rest care.

The above-mentioned are for reference only. Please refer to your policy contract for the complete list and details of exclusions.

Premium AdjustmentIn order to provide you with continuous protection, we will review this plan annually including its premium rate and product features. When reviewing the premium rate, we will consider the following factors:

1. Overall claim costs incurred from all policies under this plan.

2. The expected claim outgo in the coming year which reflects the impact of medical trends, medical cost inflation and product feature revisions.

We reserve the right to revise the benefit structure, terms and conditions and / or product features, so as to keep pace with medical advancements. We will give you a written notice of such revision 30 days before any policy anniversary or upon renewal.

Product Limitation1. We only cover the charges or expenses on a reasonable and customary

basis.

“Reasonable and customary” means:

• the medical services, diagnosis and / or treatments are necessary and delivered according to standards of good medical practice;

• the costs of your medical services and the duration of your hospital stay are not more expensive or longer than the usual level of charges or duration for similar treatment in the locality of such service delivered; and

• the charges that are for experimental, screening and preventive services or supplies, as well as those that are only incurred if insurance exists, are excluded.

“Medically necessary” means that the medical services, diagnosis and / or treatments are:

• delivered according to standards of good medical practice;

• necessary; and

• cannot be safely delivered in a lower level of medical care.

2. An “adjustment factor” is applied to the calculation of the benefit payable when the insured is confined in a hospital room of a type that is at a higher level than the room type corresponding to the plan level chosen, the benefit payable shall be paid according to the benefits schedule, and the adjustment factor will also apply. For details, please refer to the “Adjustment factor” in this brochure.

3. An insured employee and insured dependant under The Hong Kong Polytechnic University / CPCE medical plan must enrol in the same plan, including core benefits and optional outpatient benefit, if applicable.

4. Dependant child(ren) aged 15 days to 17 years must enrol in this plan together with his / her parent and they must enrol in the same plan.

Claim ProcedureIf you wish to make a claim, you must send us the appropriate forms and proof within 90 days of the date on which the covered event happened. You can get the appropriate claims forms from your financial planner, or by calling the AIA Customer Hotline on (852) 2232 8888, or by visiting any AIA Customer Service Centre.

Cancellation RightYou have the right to cancel and obtain a refund of any premiums paid by giving written notice to us. Such notice must be signed by you and submitted to the Customer Service Centre of AIA International Limited at 12/F, AIA Tower, 183 Electric Road, North Point, Hong Kong within 21 days after the delivery of the policy or issue of the written notice to you or your representative informing you that the policy is available, whichever is earlier.

Please contact AIA Voluntary Solutions Hotline for details

(852) 3108 1686 aia.com.hk [email protected]


11

12MEDICAL PROTECTIONSTEPUP MEDICAL PROTECTION PLANAnnual Premium Table (HK$) – Core Benefits

0 2,115 4,067 8,203

1 2,115 4,067 8,203

2 2,115 4,067 8,203

3 2,115 4,067 8,203

4 2,115 4,067 8,203

5 1,395 2,684 5,412

6 1,395 2,684 5,412

7 1,395 2,684 5,412

8 1,395 2,684 5,412

9 1,395 2,684 5,412

10 1,395 2,684 5,412

11 1,395 2,684 5,412

12 1,395 2,684 5,412

13 1,395 2,684 5,412

14 1,395 2,684 5,412

15 1,395 2,684 5,412

16 1,401 2,696 5,438

17 1,409 2,711 5,467

18 1,424 2,740 5,527

19 1,442 2,772 5,593

20 1,458 2,805 5,658

21 1,476 2,841 5,729

22 1,496 2,883 5,815

23 1,520 2,930 5,910

24 1,537 2,967 5,986

25 1,557 3,007 6,065

26 1,604 3,103 6,261

27 1,650 3,192 6,441

28 1,695 3,284 6,625

29 1,740 3,374 6,807

30 1,779 3,454 6,969

31 1,821 3,539 7,138

32 1,856 3,612 7,286

33 1,895 3,691 7,446

34 1,931 3,764 7,593

35 1,972 3,880 7,892

36 2,024 3,986 8,106

37 2,071 4,082 8,302

38 2,126 4,195 8,532

39 2,184 4,314 8,774

40 2,197 4,431 9,014

41 2,250 4,539 9,232

42 2,315 4,668 9,495

43 2,385 4,737 9,780

44 2,444 4,814 10,026

45 2,444 4,891 10,128

46 2,520 4,978 10,439

47 2,610 5,156 10,812

48 2,698 5,331 11,178

49 2,741 5,416 11,356

AgeWard Semi-Private Standard Private

50 2,793 5,519 11,571

51 2,862 5,655 11,857

52 2,975 5,880 12,328

53 3,096 6,118 12,827

54 3,211 6,344 13,302

55 3,320 6,757 15,059

56 3,429 6,979 15,557

57 3,557 7,238 16,134

58 3,697 7,524 16,772

59 3,866 7,869 17,539

60 4,106 8,358 18,630

61 4,461 9,080 20,242

62 4,911 9,996 22,281

63 5,343 10,875 24,241

64 5,770 11,742 26,172

65 6,179 12,839 28,319

66* 6,430 13,500 29,472

67* 6,798 14,271 30,837

68* 7,189 15,093 32,281

69* 7,606 15,969 33,813

70* 7,961 16,713 35,391

71* 8,345 17,519 37,100

72* 8,736 18,340 38,836

73* 9,150 19,208 40,674

74* 9,568 20,088 42,537

75* 9,855 20,691 43,813

76* 10,155 21,317 45,140

77* 10,459 21,958 46,496

78* 10,774 22,619 47,894

79* 11,098 23,299 49,335

80* 11,432 24,002 50,824

81* 11,777 24,725 52,356

82* 12,128 25,462 53,916

83* 12,490 26,221 55,521

84* 12,867 27,014 57,204

85* 13,248 27,812 58,893

86* 13,321 27,966 59,218

87* 13,381 28,091 59,482

88* 13,450 28,238 59,794

89* 13,516 28,377 60,089

90* 13,579 28,508 60,367

91* 13,649 28,654 60,676

92* 13,711 28,787 60,956

93* 13,784 28,940 61,281

94* 13,845 29,066 61,547

95* 13,911 29,204 61,839

96* 13,980 29,350 62,150

97* 14,043 29,481 62,427

98* 14,116 29,635 62,752

99* 14,182 29,775 63,051

AgePlan 1 Plan 2 Plan 3



Effective Date: 1 July 2017

Note:• Premium payable is calculated according to the insured's attained age and the applicable premium at the time of application or renewal.• Premiums stated above are non-guaranteed and may increase with the increase of age. We will regularly (not less than once per year) review the impact of

medical inflation and claim performance on premium. As a result, premium may be adjusted in order to continuously provide customers with long term medical protection.

• All premiums (including renewal premiums) shown above are based on the standard premium rate and do not include any extra premiums due to loading. Moreover, the actual renewal premiums will be calculated according to the insured's attained age and the applicable premium rate at the time of renewal. Such premium rate is non-guaranteed and subject to revision by the Company from time to time.

• The premium discount is only applicable to standard premiums and shall not apply to any extra premiums due to loading.

* For renewal only. Policy owner will be advised of the renewal premium for aged 100 and above before renewal.


13

0 187 359 724

1 187 359 724

2 187 359 724

3 187 359 724

4 187 359 724

5 123 237 478

6 123 237 478

7 123 237 478

8 123 237 478

9 123 237 478

10 123 237 478

11 123 237 478

12 123 237 478

13 123 237 478

14 123 237 478

15 123 237 478

16 124 238 480

17 124 239 483

18 126 242 488

19 127 245 494

20 129 248 500

21 130 251 506

22 132 255 513

23 134 259 522

24 136 262 529

25 137 266 536

26 142 274 553

27 146 282 569

28 150 290 585

29 154 298 601

30 157 305 615

31 161 312 630

32 164 319 643

33 167 326 657

34 171 332 670

35 174 343 697

36 179 352 716

37 183 360 733

38 188 370 753

39 193 381 775

40 194 391 796

41 199 401 815

42 204 412 838

43 211 418 864

44 216 425 885

45 216 432 894

46 223 440 922

47 230 455 955

48 238 471 987

49 242 478 1,003

AgeWard Semi-Private Standard Private

50 247 487 1,022

51 253 499 1,047

52 263 519 1,089

53 273 540 1,133

54 284 560 1,175

55 293 597 1,330

56 303 616 1,374

57 314 639 1,425

58 326 664 1,481

59 341 695 1,549

60 363 738 1,645

61 394 802 1,787

62 434 883 1,967

63 472 960 2,140

64 509 1,037 2,311

65 546 1,134 2,501

66* 568 1,192 2,602

67* 600 1,260 2,723

68* 635 1,333 2,850

69* 672 1,410 2,986

70* 703 1,476 3,125

71* 737 1,547 3,276

72* 771 1,619 3,429

73* 808 1,696 3,592

74* 845 1,774 3,756

75* 870 1,827 3,869

76* 897 1,882 3,986

77* 924 1,939 4,106

78* 951 1,997 4,229

79* 980 2,057 4,356

80* 1,009 2,119 4,488

81* 1,040 2,183 4,623

82* 1,071 2,248 4,761

83* 1,103 2,315 4,903

84* 1,136 2,385 5,051

85* 1,170 2,456 5,200

86* 1,176 2,469 5,229

87* 1,182 2,480 5,252

88* 1,188 2,493 5,280

89* 1,193 2,506 5,306

90* 1,199 2,517 5,330

91* 1,205 2,530 5,358

92* 1,211 2,542 5,382

93* 1,217 2,555 5,411

94* 1,223 2,567 5,435

95* 1,228 2,579 5,460

96* 1,234 2,592 5,488

97* 1,240 2,603 5,512

98* 1,246 2,617 5,541

99* 1,252 2,629 5,567

AgePlan 1 Plan 2 Plan 3




Monthly Premium Table (HK$) – Core Benefits





* For renewal only. Policy owner will be advised of the renewal premium for aged 100 and above before renewal.


Optional Outpatient Benefit

Age group Plan 1 Plan 2 Plan 3 Plan 4

0 – 19 3,599 5,204 6,843 9,776

20 – 29 3,433 4,960 6,522 9,317

30 – 39 3,433 4,960 6,522 9,317

40 – 49 3,527 5,095 6,700 9,571

50 – 59 3,527 5,095 6,700 9,571

60 – 64 4,073 5,888 7,726 11,037

65 – 69* 4,396 6,341 8,334 11,906

≥70* 5,741 8,308 10,913 15,590






Annual Premium Table (HK$) – Optional Outpatient Benefit

Age group Plan 1 Plan 2 Plan 3 Plan 4

0 – 19 318 460 604 863

20 – 29 303 438 576 823

30 – 39 303 438 576 823

40 – 49 311 450 592 845

50 – 59 311 450 592 845

60 – 64 360 520 682 975

65 – 69* 388 560 736 1,051

≥70* 507 734 964 1,377

Monthly Premium Table (HK$) – Optional Outpatient Benefit

* For renewal only (applicable to aged 66 or above).

Effective Date: 1 July 2017* For renewal only (applicable to aged 66 or above).

PTA999344(PU).0617

1友心意計劃與僱員計劃的成員資格生效日期相同。 2 視乎參加年份，友心意計劃的成員資格於 2017/2018/2019年的 7月 1日生效。 3 友心意計劃的成員資格生效日期為緊接僱員計劃成員資格終止日之後一天。

2017年 6月 29日

（中譯本 - 此中譯本內容以英文本為準）

香港理工大學

由友邦保險提供的自願參與醫療保險計劃 -

「友心意醫療保障計劃」（友心意計劃）

友心意計劃的投保細則如下︰

1. 大學僱員醫療福利計劃(僱員計劃)的成員參加友心意計劃之最高年齡

為 65歲(即到達 66歲生日之前)。

2. 如僱員計劃成員一直無間斷地受保於僱員計劃及友心意計劃（如適用）

合共12個月（兩者互相重疊的時間除外），則受保於僱員計劃之「已

存在傷病」將會在友心意計劃繼續受保障。友心意計劃可終身續保。

3. 僱員計劃成員只需支付保費，便可參加友心意計劃。申請參加限期如

下:

(a) 新入職僱員計劃成員︰於加入僱員計劃後 30 日內 1；否則，只可

於保單週年日後 30 日內參加。即 2018 年 7 月 1 日 2或 2019 年 7

月 1 日 2後 30日內；或

(b) 現有僱員計劃成員 2︰2017 年 7 月 1 日後 30 日內；否則，只可於

保單週年日後 30 日內參加。即 2018 年 7 月 1 日或 2019 年 7 月 1

日後 30日內；或

(c) 現有和新入職的僱員計劃成員 3︰在僱員計劃成員資格終止（即退

休或離職）後 30日內及未達 66歲生日前，以較早者為準。

4. 僱員計劃成員選擇友心意計劃的計劃級別將不可以超過其於僱員計

劃的指定住房級別。

如欲瞭解友心意計劃詳情，請從友邦保險網站 aia.com.hk參閱產品簡

介或致電專線 3108 1686 查詢！

要全力攀登事業高峰，成為家人的重要依靠，您必須照顧個人健康，才能繼續放手拼搏。我們因此特別為您悉心設計本醫療計劃，為您提供更完善保障。

「友心意」醫療保障計劃（「友心意」）為現有香港理工大學／專業及持續教育學院之醫療計劃成員而設，與您僱主提供的計劃相輔相成，以相宜保費提供全面的終身保障，申請可獲保證接納，無須接受醫療核保，助您提升保障，妥善策劃未來保障需要。

即使您離職或準備退休，仍可享有「友心意」的保障，摯愛從此安枕無憂。

醫療保障「友心意」醫療保障計劃

1

保障一覽

產品性質醫療保障保險計劃

計劃選項 ‧ 計劃一——普通房計劃‧ 計劃二——半私家房計劃 ‧ 計劃三——標準私家房計劃

欲知更多詳情，請細閱本小冊子的「友心意」醫療保障計劃利益一覽表。

醫療網絡優惠若您選用 AIA醫療網絡的服務，可享以下優惠：‧ 90%的主要保障賠償及無須繳付墊底費‧ 指定門診手術免找數服務

主要保障

全球地域保障範圍

終身保障至年齡

保證接納申請核保要求

‧ 門診——計劃一至四附加保障

「AIA」、「友邦」、「本公司」或「我們」是指友邦保險（國際）有限公司（於百慕達註冊成立之有限公司）。

投保資格

‧ 全面住院及手術護理‧ 延伸護理保障涵蓋腎臟透析及癌症治療，後者包括相關測試、標靶治療、化療及電療

‧ 其他保障包括先進診斷掃描（包括在門診進行）及醫療裝備 ‧ 環球緊急支援服務，包括緊急醫療運送

香港理工大學／專業及持續教育學院之醫療計劃成員

投保年齡（受保人） 15日至65歲

可攜式保障　倍添可靠稱心

準備多一重安全網，活得安穩自在。當您成功投保「友心意」，

您便可每年續保，而續保保費會根據續保時適用的保費表

釐定。即使您離職、團體醫療保障完結，甚至退休，此

計劃仍然繼續提供保障，時刻為您帶來支援。

保證接納申請　無須接受核保

投保本計劃無須接受醫療核保，申請保證接納，輕鬆獲取

多項保障。

受保已存在病症　加強保障

若您於香港理工大學／專業及持續教育學院之醫療計劃

及「友心意」（如有）下合共受保至少連續12個月（兩者

互相重疊的時間除外），任何在受保前已存在的疾病同樣

得到「友心意」的保障，為您即時送上全面適切的保障。

保障全面　賠償多項醫療費用

「友心意」為您提供全面的實報實銷醫療保障。賠償項目

包括病房及膳食費用、深切治療費用、手術費用、住院雜

費、先進診斷掃描（包括在門診進行）的檢查費用，以及

醫療裝置費用等。

欲知更多詳情，請細閱本小冊子的「友心意」醫療保障

計劃利益一覽表。

特設延伸保障　涵蓋腎臟透析與癌症治療

當您患上嚴重疾病，您和您的摯愛更需要有額外支援。

假若您不幸確診患上癌症或腎衰竭，我們會提供延伸護理

保障，涵蓋腎臟透析及癌症治療，後者包括相關測試、標靶

治療、化療及電療，助您踏上康復之路。

優質醫療網絡　獲享額外優勢

友邦精心挑選不同範疇的註冊醫生，組成強大醫療網絡，

為您提供更卓越的醫療服務。選用醫療網絡服務，不單可

享優質醫療服務，更可額外獲得以下保障：

• 90%的主要保障賠償及無須繳付墊底費

假如您選用醫療網絡提供的服務，可享90%賠償費用及

無須繳付墊底費。

• 為四種指定門診手術提供免找數服務

您只需憑電子「網絡卡」，即可於網絡診所預約指定

門診手術，並可享免找數服務，無須為繳費及索償程序

而操心。

免找數服務涵蓋的四項指定手術為︰

1. 晶狀體手術包括摘除白內障及置入人造晶狀體

2. 結腸鏡檢查術，包括乳頭狀瘤切除、息肉切除或

活組織檢查術

3. 上消化道內視檢查術，至十二指腸部分

4. 切除皮膚腫塊或腫瘤，包括脂肪瘤、神經纖維瘤、

皮脂囊腫、痣或色素瘤

免找數服務按每病症限額及網絡專用之額外每病症限額

而定，您需處理有關醫療費用差額（如有）。

有關醫療網絡卡的更多資訊，請參閱「友心意」網絡

服務小冊子。

2 醫療保障「友心意」醫療保障計劃

可攜式保障　倍添可靠稱心

準備多一重安全網，活得安穩自在。當您成功投保「友心意」，

您便可每年續保，而續保保費會根據續保時適用的保費表

釐定。即使您離職、團體醫療保障完結，甚至退休，此

計劃仍然繼續提供保障，時刻為您帶來支援。

保證接納申請　無須接受核保

投保本計劃無須接受醫療核保，申請保證接納，輕鬆獲取

多項保障。

受保已存在病症　加強保障

若您於香港理工大學／專業及持續教育學院之醫療計劃

及「友心意」（如有）下合共受保至少連續12個月（兩者

互相重疊的時間除外），任何在受保前已存在的疾病同樣

得到「友心意」的保障，為您即時送上全面適切的保障。

保障全面　賠償多項醫療費用

「友心意」為您提供全面的實報實銷醫療保障。賠償項目

包括病房及膳食費用、深切治療費用、手術費用、住院雜

費、先進診斷掃描（包括在門診進行）的檢查費用，以及

醫療裝置費用等。

欲知更多詳情，請細閱本小冊子的「友心意」醫療保障

計劃利益一覽表。

特設延伸保障　涵蓋腎臟透析與癌症治療

當您患上嚴重疾病，您和您的摯愛更需要有額外支援。

假若您不幸確診患上癌症或腎衰竭，我們會提供延伸護理

保障，涵蓋腎臟透析及癌症治療，後者包括相關測試、標靶

治療、化療及電療，助您踏上康復之路。

優質醫療網絡　獲享額外優勢

友邦精心挑選不同範疇的註冊醫生，組成強大醫療網絡，

為您提供更卓越的醫療服務。選用醫療網絡服務，不單可

享優質醫療服務，更可額外獲得以下保障：

• 90%的主要保障賠償及無須繳付墊底費

假如您選用醫療網絡提供的服務，可享90%賠償費用及

無須繳付墊底費。

• 為四種指定門診手術提供免找數服務

您只需憑電子「網絡卡」，即可於網絡診所預約指定

門診手術，並可享免找數服務，無須為繳費及索償程序

而操心。

免找數服務涵蓋的四項指定手術為︰

1. 晶狀體手術包括摘除白內障及置入人造晶狀體

2. 結腸鏡檢查術，包括乳頭狀瘤切除、息肉切除或

活組織檢查術

3. 上消化道內視檢查術，至十二指腸部分

4. 切除皮膚腫塊或腫瘤，包括脂肪瘤、神經纖維瘤、

皮脂囊腫、痣或色素瘤

免找數服務按每病症限額及網絡專用之額外每病症限額

而定，您需處理有關醫療費用差額（如有）。

有關醫療網絡卡的更多資訊，請參閱「友心意」網絡

服務小冊子。


3

靈活彈性配合所需

我們深明醫療需要因人而異，因此本計劃設有附加門診

保障以供選擇，配合您的個人醫療需要。

在投保本計劃時，若同時申請附加門診保障，無須接受

醫療核保*，即可獲得更全面的保障。

計劃選項須根據您現有的香港理工大學／專業及持續教育

學院之醫療計劃保障而定（如有）。欲知更多詳情，請細閱

本小冊子的「計劃選擇規則」。

* 在保單生效後，您可於保單週年日申請附加門診保障，惟須

接受醫療核保。

計劃選項 ‧ 計劃一——普通房計劃‧ 計劃二——半私家房計劃‧ 計劃三——標準私家房計劃

附加保障計劃一至四——門診保障

4 醫療保障「友心意」醫療保障計劃


5

受保人年齡

28歲

僱主已提供團體醫療保險計劃

購買「友心意」醫療保障計劃 —— 計劃二

每病症限額20萬港元+ 10萬港元（額外醫療網絡專用限額）

癌症及腎透析特別保障為每項確診病症提供額外20萬港元的治療賠償

Alan滿腹大計，期望在事業上儘快上位！精明的他懂得把握年青的優勢，因此，他

決定投保「友心意」醫療保障計劃 —— 計劃二，不需要接受醫療核保，加上所屬公司

已提供團體醫療保險計劃，他可進一步提高醫療保障水平，讓自己安心在事業上拼搏。

「友心意」為每病症提供高達20萬港元限額，並備有額外10萬港元醫療網絡專用限額，

Alan只需繳付相宜保費即可享額外支援，彌補團體醫療計劃的不足。

此外，假如Alan不幸確診患上癌症或腎衰竭，「友心意」會為每項確診病症提供額外

20萬港元的治療賠償。

案例

案例一：

保單持有人及受保人： Alan（28歲）

職業：助理行政經理

婚姻狀況：未婚

現有保障：友邦團體醫療保險計劃

「友心意」醫療保障計劃與其他團體醫療保險計劃相輔相成。團體醫療保險計劃

一般為基本醫療需要及小額醫療費用提供全數賠償。若團體醫療保險計劃未能

為相關醫療開支提供全數賠償，「友心意」可支付剩餘金額。

（以下個案及數字乃假設並只作舉例說明之用，若以下數值有任何更改，恕不作

任何通知。）

6醫療保障「友心意」醫療保障計劃

Bonnie一向以家為先。她深明突如其來的醫療開支會打擊家庭財政狀況，因此，她

決定投保「友心意」醫療保障計劃 —— 計劃一，以彌補公司提供的團體醫療保險

計劃的不足。萬一遇上任何突發情況，她亦可得到額外財務支援，保障家人的生活。

Bonnie投保「友心意」後，因消化不良而向家庭醫生求診，醫生建議她接受胃鏡

檢查。

她憑「友心意」的電子「網絡卡」於網絡診所預約門診胃鏡檢查，更可享免找數

服務，免卻事後索償手續。

案例（以下個案及數字乃假設並只作舉例說明之用，若以下數值有任何更改，恕不作

任何通知。）

案例二：

保單持有人及受保人： Bonnie（45歲）

職業：高級客戶服務經理

婚姻狀況：已婚，育有一子一女

現有保障：友邦團體醫療保險計劃


7

最高限額（港元）

普通房半私家房標準私家房

計劃一計劃二計劃三

100,000 200,000 500,000

50,000 100,000 100,000

醫療網絡非醫療網絡

「友心意」醫療保障計劃利益一覽表

賠償項目須符合「合理及慣常」的原則。詳情請參閱「重要資料」下的「產品限制」第1項。

主要保障

計劃

病房級別

墊底費（每病症）第1至11及13至14項適用

每病症限額第1至12項適用

額外每病症限額（網絡專用）第1至12項適用

賠償百分比第12項適用

賠償百分比第1至11及13至14項適用

醫療網絡非醫療網絡醫療網絡非醫療網絡

90% 80% 90% 80% 90% 80%

0 5,000 0 15,000 0 28,000

100% 不適用 100% 不適用 100% 不適用

墊底費第12項適用

0 不適用 0 不適用 0 不適用

I. 住院賠償

1. 每日病房及膳食費用賠償2. 醫生巡房費賠償3. 專科醫生費用 4. 住院雜費賠償5. 深切治療費用賠償

II. 手術費用賠償

6. 手術惠益包括外科手術費、麻醉師費及手術室費

7. 門診手術惠益包括外科手術費、麻醉師費及手術室費

8. 醫療裝置費用惠益指定項目：

包括：

III. 出院／門診手術後門診諮詢

9. 出院後或門診手術後的31日內所接受之門診諮詢及診斷測試

i. 起搏器

ii. 經皮冠狀動脈腔內成形術的支架

iii. 眼內人造晶體

iv. 人工心瓣

v. 金屬或人工關節置換

vi. 人工韌帶置換或植入

vii. 人工椎間盤


12. 於本公司醫療網絡內的診所接受以下門診手術，可享免找數服務，無須支付墊底費或共同保險費用。受保門診手術包括：

i. 晶狀體手術包括摘除白內障及置入人造晶狀體

ii. 結腸鏡檢查術，包括乳頭狀瘤切除、息肉切除或活組織檢查術

iii. 上消化道內視檢查術，至十二指腸部分

iv. 切除皮膚腫塊或腫瘤，包括脂肪瘤、神經纖維瘤、皮脂囊腫、痣或色素瘤


100,000（計劃一） 200,000（計劃二） 300,000（計劃三）

病房級別

VI. 癌症及腎透析特別保障

13. 癌症相關治療包括電療、化療、標靶治療及確診測試等費用

14. 腎透析治療

主要保障（續）

V. 網絡門診手術惠益

VII. 緊急治療費用賠償

環球緊急支援服務

a. 緊急醫療運送b. 運返遺體c. 安排一名直屬家屬探望如需連續住院超過5日

d. 送返未滿18歲之兒童返回香港如需連續住院超過5日

最高總限額

1,000,000 港元

每一旅程

e. 24小時全球電話諮詢服務已包括

10. 先進診斷掃描 (包括在門診進行) 包括磁力共振造影、電腦斷層掃描及正電子釋放斷層掃描

11. 意外急症門診治療費用賠償若受保人因意外引致受保受傷，並於該意外發生後24小時內在醫院急症門診部以門診病人身份接受治療

IV. 其他醫療保障

調整基數

如受保人於住院期間入住病房之級別較所選計劃相對的病房級別高，可支付的賠償將按利益一覽表計算，並根據下表

之「調整基數」一欄作出調整 :

治療期間病房級別調整基數計劃內病房級別

普通房半私家房 50%

每病症限額第13至14項適用

標準私家房

半私家房

半私家房

普通房

普通房

VIP房／豪華房／套房


標準私家房


標準私家房

50%

0%

50%

0%

25%


9

賠償比率 %

計劃一門診保障

計劃二

最高限額（港元）

計劃三計劃四

80% 80% 80% 80%

150 250 350 500

150每個保單年度10次







1,000每個保單年度10次

2,500 3,000 4,000 5,000

2,500 3,000 4,000 5,000

2,500 3,000 4,000 5,000





附加保障 – 門診

1至4項每個保單年度的求診次數上限為50次。

需要醫生簽發的轉介信

必須由執業西醫提供診斷

1. 一般門診諮詢

（每次求診連藥物）

2. 專科門診治療

（每次求診連藥物）

6. 診斷程序及化驗費

（每個保單年度）

3. 物理治療及脊醫治療

（每次求診）

5. 精神疾病或情緒失調諮詢

（每個保單年度連藥物）

4. 註冊中醫師諮詢

（連中醫藥物）

7. 於醫生及醫院診所以外的註冊藥房配藥費

（每個保單年度）


成員投保指引及計劃選擇規則

遞交申請時段（必須在以下其中一個時段內遞交）

計劃選擇規則

新入職僱員及其家屬*(i) 參加香港理工大學／專業及持續教育學院之醫療計劃起30日內

新入職或現有公司僱員及其家屬*(iii) 於「保單週年日」（即2018／2019年7月1日）起的30日內

現有公司僱員及其家屬*(ii) 2017年7月1日起30日內

(iv) 香港理工大學／專業及持續教育學院之醫療計劃會籍終止後的30日內

(v) 受保人即將到達66歲的30日內

• 不設計劃選擇限制

香港理工大學／專業及持續教育學院之醫療計劃成員(成員於遞交申請時必須為香港身份證持有人)

* 如香港理工大學／專業及持續教育學院之醫療計劃提供家屬保障。

• 必須選擇與香港理工大學／專業及持續教育學院之醫療計劃同一病房保障級別或以下的計劃：

• 受保僱員與其受保家屬須申請相同保障的計劃，包括主要保障及附加門診保障（如適用）

級別一

級別二

相應之病房級別級別

半私家房

普通房


11

重要資料

1. 此產品簡介只供參考，並非及不構成保險契約的一部份，是為提供本產品主要特點概覽而設。本計劃的精確條款及條件列載於保單契約。有關此計劃條款的定義、契約條款及條件之完整敘述，請參閱保單契約。此產品簡介應與包括本產品附加資料及重要考慮因素的說明文件（如有）及有關的市場推廣資料一併閱覽。此外，請詳閱相關的產品資料，並在需要時諮詢獨立的專業意見。

2. 本計劃為保險計劃，並不包括任何儲蓄成分。所有繳付的保費都用作提供保險及相關開支的用途。

3. 此產品簡介只於香港派發。

主要產品風險

1. 您須終身為此計劃繳付保費。若您於保費到期日後31日內仍未繳交保費，保單將會被終止，同時您／受保人也會失去保障。

2. 如以下任何一種情況發生，我們將會終止您的保單，而您／受保人將失去保障：

‧ 受保人身故；

‧ 於保費到期日後31日內仍未繳交保費；或

我們保留權利隨時以不少於三十（30）日以書面通知持有人取消此保單。餘下之保費在不計利息及扣除有關此保單之債務後將退還給保單持有人。

3. 此計劃由我們承保，因此您受我們的信貸風險所影響。若我們無法按保單的承諾履行其財務責任，受保人可能損失其保障而您亦可能損失保單年度餘下已繳的保費。

4. 通脹會導致未來醫療費用增加。因此，本計劃的賠償金額以及未來保費率都有可能受調整，以反映通脹。

5. 由於通脹可能會導致未來生活費用增加，您現有的預期保障可能無法滿足您未來的需求。如實際的通脹率高於預期，即使我們履行所有的合約責任，閣下收到的金額（以實際基礎計算）可能會較預期少。

主要不保事項

本計劃並不承保以下各種事故所引起的情況：

‧ 任何非醫療所需的治療、檢驗、服務或物品。

‧ 任何受保人於保障生效九十（90）日前接受醫療、診斷、諮詢或處方藥物的任何疾病，如受保人已連續獲香港理工大學／專業及持續教育學院之醫療計劃及此計劃（如有）保障達合共十二（12）個月（兩者互相重疊的時間除外），則不在此限。

‧ 自毀、故意傷害自己的行為或濫用藥物。

‧ 戰爭、軍事行動及騷亂，違法或意圖違法行為或拒捕，受保人作為恐怖分子參與任何恐怖主義活動，或因任何恐怖主義行為而使用原子、生物或化學武器以及放射性、生物或化學污染，又或受保人旅行之國家正發生戰爭或軍事行動、叛變、暴動、騷亂、戒嚴或被困、或被聯合國確認為戰區。

‧ 懷孕、流產、分娩、墮胎或其他生育相關的併發症，精神病或精神分裂（精神疾病或情緒失調惠益除外，詳見附加門診保障——利益一覽表第5項）、愛滋病（AIDS）或受人體免疫力缺乏病毒（HIV）感染的任何相關的併發症。

‧ 美容或整形手術，牙科護理或手術，屈光障礙及矯正輔助儀器（因意外傷害而必須接受治療除外），健康檢查，復康或療養。

上述只供參考，有關全部及詳細不保事項，請參閱此計劃之保單契約。

保費調整

為能持續為您提供保障，我們會每年檢視本計劃，包括保費率及產品內容。在檢視保費時，我們會考慮以下因素：

1. 所有此計劃之保單的整體索償情況。

2. 來年預期索償額（反映醫療趨勢、醫療成本通脹和產品內容改動所帶來的影響）。

我們有權更改利益、條款及細則及／或產品內容，以配合醫療科技的進步。如有更改，我們會在續保或保單週年日30日前以書面通知保單持有人。

產品限制

1. 我們只會根據「合理及慣常」的原則，為受保人所需支付的費用及開支作出賠償。

「合理及慣常」是指：

‧ 醫療服務、診斷及／或治療乃為「醫療所需」並符合良好醫療慣例標準；

‧ 所需要的醫療服務費用及住院時間不超過當地提供類似治療的一般服務標準；及

‧ 不包括實驗性、普查及屬預防性質的服務或物品以及因保險的存在而產生的費用。

「醫療所需」是指此等醫療服務、診斷及／或治療：

‧ 與專業醫療慣例一致；

‧ 均為必須；及

‧ 不可以在較低醫療護理水平的情況下進行。

2. 「調整基數」是指當受保人於住院期間入住病房之級別較所選計劃相對的病房級別高，我們在計算可支付的賠償時，將按利益一覽表計算，並因應「調整基數」作出調整。詳情請參閱本小冊子的「調整基數」。

3. 於香港理工大學／專業及持續教育學院之醫療計劃下的受保僱員與其受保家屬須申請相同保障的計劃，包括主要保障及附加門診保障（如適用）。

4. 年齡由15天至17歲的兒童必須與父或母同時申請，並申請相同計劃級別。

索償過程

如要索償，您須於受保事故發生後90日內遞交所需表格及文件證明。您可向您的財務策劃顧問索取賠償申請表，或致電AIA客戶熱線（852）2232 8888，又或親身蒞臨友邦客戶服務中心。

取消投保權益

您有權以書面通知我們取消保單並取回已繳保費。有關書面通知必須由您簽署，並確保由交付新保單或發出可領取保單通知書給您或您的代表後起計21日內（以較先者為準），呈交至香港北角電氣道183號友邦廣場12樓之友邦保險（國際）有限公司客戶服務中心。

請即致電「友邦僱員自選計劃」專線瞭解詳情

(852) 3108 1686 aia.com.hk [email protected]

12醫療保障「友心意」醫療保障計劃年繳保費表（港元）– 主要保障

注意事項 :

‧ 應繳保費是根據受保人投保或續保時的實際年齡及適用之保費率而定。

‧ 上表所列之保費為非保證。保費除了可以因年齡增長而提高外，我們還會定期（不少於每年一次）檢視醫療通脹及整體賠償情況對保費的影響，為求持續提供長遠醫療保障給客戶，我們在檢視後可能會調整保費。

‧ 上述保費（包括續保保費）是以標準保費率作計算，並未包括任何額外附加保費。此外，實際續保保費將根據受保人續保時的實際年齡及適用之保費率而定。保費表所列之保費為非保證，本公司可隨時作出更改。

‧ 保費折扣只適用於一般標準保費，並不適用於任何額外附加保費。

生效日期 : 2017年 7月 1日

*此為續保保費率，100歲及以後之保費率將於續保前通知保單持有人。

0 2,115 4,067 8,203

1 2,115 4,067 8,203

2 2,115 4,067 8,203

3 2,115 4,067 8,203

4 2,115 4,067 8,203

5 1,395 2,684 5,412

6 1,395 2,684 5,412

7 1,395 2,684 5,412

8 1,395 2,684 5,412

9 1,395 2,684 5,412

10 1,395 2,684 5,412

11 1,395 2,684 5,412

12 1,395 2,684 5,412

13 1,395 2,684 5,412

14 1,395 2,684 5,412

15 1,395 2,684 5,412

16 1,401 2,696 5,438

17 1,409 2,711 5,467

18 1,424 2,740 5,527

19 1,442 2,772 5,593

20 1,458 2,805 5,658

21 1,476 2,841 5,729

22 1,496 2,883 5,815

23 1,520 2,930 5,910

24 1,537 2,967 5,986

25 1,557 3,007 6,065

26 1,604 3,103 6,261

27 1,650 3,192 6,441

28 1,695 3,284 6,625

29 1,740 3,374 6,807

30 1,779 3,454 6,969

31 1,821 3,539 7,138

32 1,856 3,612 7,286

33 1,895 3,691 7,446

34 1,931 3,764 7,593

35 1,972 3,880 7,892

36 2,024 3,986 8,106

37 2,071 4,082 8,302

38 2,126 4,195 8,532

39 2,184 4,314 8,774

40 2,197 4,431 9,014

41 2,250 4,539 9,232

42 2,315 4,668 9,495

43 2,385 4,737 9,780

44 2,444 4,814 10,026

45 2,444 4,891 10,128

46 2,520 4,978 10,439

47 2,610 5,156 10,812

48 2,698 5,331 11,178

49 2,741 5,416 11,356

年齡

50 2,793 5,519 11,571

51 2,862 5,655 11,857

52 2,975 5,880 12,328

53 3,096 6,118 12,827

54 3,211 6,344 13,302

55 3,320 6,757 15,059

56 3,429 6,979 15,557

57 3,557 7,238 16,134

58 3,697 7,524 16,772

59 3,866 7,869 17,539

60 4,106 8,358 18,630

61 4,461 9,080 20,242

62 4,911 9,996 22,281

63 5,343 10,875 24,241

64 5,770 11,742 26,172

65 6,179 12,839 28,319

66* 6,430 13,500 29,472

67* 6,798 14,271 30,837

68* 7,189 15,093 32,281

69* 7,606 15,969 33,813

70* 7,961 16,713 35,391

71* 8,345 17,519 37,100

72* 8,736 18,340 38,836

73* 9,150 19,208 40,674

74* 9,568 20,088 42,537

75* 9,855 20,691 43,813

76* 10,155 21,317 45,140

77* 10,459 21,958 46,496

78* 10,774 22,619 47,894

79* 11,098 23,299 49,335

80* 11,432 24,002 50,824

81* 11,777 24,725 52,356

82* 12,128 25,462 53,916

83* 12,490 26,221 55,521

84* 12,867 27,014 57,204

85* 13,248 27,812 58,893

86* 13,321 27,966 59,218

87* 13,381 28,091 59,482

88* 13,450 28,238 59,794

89* 13,516 28,377 60,089

90* 13,579 28,508 60,367

91* 13,649 28,654 60,676

92* 13,711 28,787 60,956

93* 13,784 28,940 61,281

94* 13,845 29,066 61,547

95* 13,911 29,204 61,839

96* 13,980 29,350 62,150

97* 14,043 29,481 62,427

98* 14,116 29,635 62,752

99* 14,182 29,775 63,051


普通房半私家房標準私家房年齡




13

注意事項 :





*此為續保保費率，100歲及以後之保費率將於續保前通知保單持有人。

生效日期 : 2017年 7月 1日

月繳保費表（港元） – 主要保障

0 187 359 724

1 187 359 724

2 187 359 724

3 187 359 724

4 187 359 724

5 123 237 478

6 123 237 478

7 123 237 478

8 123 237 478

9 123 237 478

10 123 237 478

11 123 237 478

12 123 237 478

13 123 237 478

14 123 237 478

15 123 237 478

16 124 238 480

17 124 239 483

18 126 242 488

19 127 245 494

20 129 248 500

21 130 251 506

22 132 255 513

23 134 259 522

24 136 262 529

25 137 266 536

26 142 274 553

27 146 282 569

28 150 290 585

29 154 298 601

30 157 305 615

31 161 312 630

32 164 319 643

33 167 326 657

34 171 332 670

35 174 343 697

36 179 352 716

37 183 360 733

38 188 370 753

39 193 381 775

40 194 391 796

41 199 401 815

42 204 412 838

43 211 418 864

44 216 425 885

45 216 432 894

46 223 440 922

47 230 455 955

48 238 471 987

49 242 478 1,003

50 247 487 1,022

51 253 499 1,047

52 263 519 1,089

53 273 540 1,133

54 284 560 1,175

55 293 597 1,330

56 303 616 1,374

57 314 639 1,425

58 326 664 1,481

59 341 695 1,549

60 363 738 1,645

61 394 802 1,787

62 434 883 1,967

63 472 960 2,140

64 509 1,037 2,311

65 546 1,134 2,501

66* 568 1,192 2,602

67* 600 1,260 2,723

68* 635 1,333 2,850

69* 672 1,410 2,986

70* 703 1,476 3,125

71* 737 1,547 3,276

72* 771 1,619 3,429

73* 808 1,696 3,592

74* 845 1,774 3,756

75* 870 1,827 3,869

76* 897 1,882 3,986

77* 924 1,939 4,106

78* 951 1,997 4,229

79* 980 2,057 4,356

80* 1,009 2,119 4,488

81* 1,040 2,183 4,623

82* 1,071 2,248 4,761

83* 1,103 2,315 4,903

84* 1,136 2,385 5,051

85* 1,170 2,456 5,200

86* 1,176 2,469 5,229

87* 1,182 2,480 5,252

88* 1,188 2,493 5,280

89* 1,193 2,506 5,306

90* 1,199 2,517 5,330

91* 1,205 2,530 5,358

92* 1,211 2,542 5,382

93* 1,217 2,555 5,411

94* 1,223 2,567 5,435

95* 1,228 2,579 5,460

96* 1,234 2,592 5,488

97* 1,240 2,603 5,512

98* 1,246 2,617 5,541

99* 1,252 2,629 5,567

年齡計劃一計劃二計劃三

普通房半私家房標準私家房年齡




年齡組別計劃一計劃二計劃三計劃四

0 – 19 3,599 5,204 6,843 9,776

20 – 29 3,433 4,960 6,522 9,317

30 – 39 3,433 4,960 6,522 9,317

40 – 49 3,527 5,095 6,700 9,571

50 – 59 3,527 5,095 6,700 9,571

60 – 64 4,073 5,888 7,726 11,037

65 – 69* 4,396 6,341 8,334 11,906

≥70* 5,741 8,308 10,913 15,590

年繳保費表（港元） – 附加門診保障

年齡組別計劃一計劃二計劃三計劃四

0 – 19 318 460 604 863

20 – 29 303 438 576 823

30 – 39 303 438 576 823

40 – 49 311 450 592 845

50 – 59 311 450 592 845

60 – 64 360 520 682 975

65 – 69* 388 560 736 1,051

≥70* 507 734 964 1,377

月繳保費表（港元）– 附加門診保障

生效日期 : 2017年 7月 1日

注意事項 :





*此為續保保費率（適用於 66歲或以上）。

生效日期 : 2017年 7月 1日*此為續保保費率（適用於 66歲或以上）。

附加門診保障

PTA999345(PU).0617

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