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Bupa HealthPlus Health Insurance Scheme

Schedule of Benefits Maximum Limit per Member (HK$)

1 January 2018 Edition 201811 ()

A Hospital and Surgical Benefit

Semi-private Roomee

Deductible Options (Each Member each Contract Year)r

()r 0 / 12,000 / 40,000

Area of cover Worldwide

USA Cover - Maximum Limit for treatment received in the USA (Each Contract Year) - ()

500,000 (reimburse 50% of eligible medical expenses

50%)

Overall Annual Limit - Below attained age of 65 on the Contract Effective Date -65

3,000,000

Overall Annual Limit - Attained age of 65 or above on the Contract Effective Date -65

1,000,000

1 Room and Board

Full cover

2 Miscellaneous Hospital Services

3 Intensive Care (Maximum 30 days each Contract Year) (30)

4 Anaesthetist's Fees

5 Operating Theatre Fees

6 In-patient Physician's Fees (For non-surgical case only) ()

7 Companion Bed

8 Private Nursing (Maximum 90 days each Contract Year) (90)

Subject to written referralt from the attending Registered Medical Practitioner

t

640 each day

9 Cancer Treatment and Kidney Dialysis (Each Contract Year) ()

Chemotherapy, radiotherapy, cyberknife or gamma knife for cancer treatment or kidney dialysis as a result of chronic and irreversible kidney failure, performed during Hospital Confinement or in day-case unit of a Hospital or clinic upon recommendation by the attending Registered Medical Practitioner

625,000

10 Emergency Out-patient Benefit for Accidents (Each Contract Year) ()

8,800

11 Organ Transplant (Each Disability) ()

Subject to pre-approval by Bupa for organ transplant surgery performed overseas

525,000

Maximum Limit for items A12 - A13 A12 - A13

Bupa HealthPlus Appointed Specialist

Other Specialists

12 Surgeon and Attendance Fees (For surgical case only) (Each operation)y

() ()y

Complex Full cover 84,000 Major 48,500 Intermediate 20,400 Minor 8,700

13 In-patient Specialist's Fees (Each Contract Year)y

()y

Subject to written referralt from the attending Registered Medical Practitioner (except for services performed by pathologist, radiologist and Physiotherapist during Hospital Confinement)

Full cover

6,600

t ()

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Bupa (Asia) Limited () Address: 18/F, Berkshire House, 25 Westlands Road, Quarry Bay, Hong Kong 25 18 Telephone : (852) 2517 5175 Facsimile : (852) 2548 1848 Website : www.bupa.com.hk

Bupa Hong Kong

1

www.bupa.com.hk

3

Bupa HealthPlus Health Insurance Scheme

Schedule of Benefits Maximum Limit per Member (HK$)

1 January 2018 Edition 201811 ()

A Hospital and Surgical Benefit

Semi-private Roomee

14 Pre-admission and Non-surgical Post-hospitalisation Out-patient Care (Each Contract Year)() ()

Covers out-patient fees related to the hospitalisation including: - pre-admission visits within 30 days prior to hospitalisation - post-hospitalisation follow-up visits for non-surgical treatment within 90 days after discharge

from Hospital follow-up visits after surgery and chemotherapy or radiotherapy treatment for cancer will be paid under items A15 - A22

- 30 - 90

A15 - A22

4,400

Post-hospitalisation Out-patient Care (After surgery or cancer treatment) ()

Items A15 - A21 cover the expenses of follow-up out-patient visits after receiving surgery, chemotherapy or radiotherapy, and shall be payable after the eligible claims under A1-A14 have exceeded the Deductible, if selected. The out-patient visits must be made within 90 days after discharge from Hospital, or receiving a Day Case Surgery or Clinical Operation, chemotherapy and radiotherapy.A15 - A21A1-A14()90

Maximum Limit for items A12 - A13 A12 - A13

Bupa HealthPlus Appointed Service Providers

Other Service Providers

15 Post-hospitalisation Diagnostic Imaging and Laboratory Tests (Each Contract Year)u ()u

Subject to written referralt from the attending Registered Medical Practitioner t

Full cover 3,200

16 Post-hospitalisation Physiotherapy (Treatment fee only)u ()u

Must be performed by a Physiotherapist and subject to written referralt from the attending Registered Medical Practitioner t

Full cover 250 each visit

(Up to 20 visits each Contract Year 20)

17 Post-hospitalisation Out-patient Consultation

Including consultation fees and prescribed Western Medication Written referralt from the attending Registered Medical Practitioner is required if the out-patient consultation is not provided by your attending Registered Medical Practitioner t

850 each visit (Up to 20 visits each Contract Year 20)

18 Post-hospitalisation Psychological Counselling (Consultation fee only) ()

Must be performed by a Psychologist and subject to written referralt from the attending Registered Medical Practitioner t

1,600 each visit (Up to 5 visits each Contract Year 5)

19 Post-hospitalisation Dietetic Consultation (Consultation fee only) ()

Must be performed by a Dietitian and subject to written referralt from the attending Registered Medical Practitioner t

740 each visit (Up to 5 visits each Contract Year 5)

20 Post-hospitalisation Occupational Therapy (Treatment fee only) ()

Must be performed by an Occupational Therapist and subject to written referralt from the attending Registered Medical Practitioner t

640 each visit (Up to 5 visits each Contract Year 5)

21 Post-hospitalisation Speech Therapy (Treatment fee only) ()

Must be performed by a Speech Therapist and subject to written referralt from the attending Registered Medical Practitioner t

640 each visit (Up to 5 visits each Contract Year 5)

Post-hospitalisation Chinese medicine treatment

Item A22 covers follow-up Chinese medicine treatment after receiving surgery for Stroke, Coronary Artery Disease (CAD), or Cancer, and chemotherapy or radiotherapy for the treatment of Cancer, and shall be payable after the eligible claims under A1-A14 have exceeded the Deductible, if selected. The Chinese medicine treatment must be received within 180 days after discharge from Hospital or receiving chemotherapy or radiotherapy.

A22A1-A14()180

22 Post-hospitalisation Chinese Herbalist Consultation and Acupuncture

420 each visit prescribed at the Registered Chinese Medicine Practitioner's clinic on the same day of consultation

Covers consultation fees and acupuncture (including basic Medically Necessary Chinese Medicines

(Up to 10 visits each Contract Year 10) and obtained from a legitimate source) ()

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Bupa HealthPlus Health Insurance Scheme

Schedule of Benefits 1 January 2018 Edition 201811 Maximum Limit per Member (HK$) ()

B Clinical Benefit (Optional) ()

Network Benefitii

Non-network Benefit

No. of Bupa HealthPlus Appointed Service Providers Around 1,400 N/A

1 General Practitioner (Per visit) () Full cover for eligible medical expenses (Including consultation fee and up to 5 days of basic Medically Necessary

Western Medication) (5

)

300 (Consultation fee only)

600 (Consultation fee only)

2 Specialist (Per visit) () Subject to written referralt from a Registered Medical Practitionert

3 Home Consultation (Per visit) ()

N/A 585 (Consultation fee only)

4 Physiotherapist (Per visit) (Treatment fee only) () ()

Subject to written referralt from a Registered Medical Practitioner t

Full cover for eligible medical expenses

490

5 Chiropractor (Per visit) (Treatment fee only) () ()

Subject to written referralt from a Registered Medical Practitioner t

N/A 490

6 Chinese Herbalist (Per visit) ()

Consultation fee (including basic Medically Necessary Chinese Medicines prescribed at the Registered Chinese Medicine Practitioner's clinic on the same day of consultation and obtained from a legitimate source) Payable for acupuncture performed by a Registered Chinese Medicine Practitioner under Non-network Benefit ()

Full cover for eligible medical expenses (Including consultation fee

and up to 2 packets of basic Medically

250

7 Chinese Bonesetter (Per visit) ()

Consultation fee (including basic Medically Necessary Chinese Medicines prescribed at the Registered Chinese Medicine Practitioner's clinic on the same day of consultation and obtained from a legitimate source) Payable for acupuncture performed by a Registered Chinese Medicine Practitioner under Non-network Benefit ()

Necessary Chinese Medicines)

()

250

8 Diagnostic Imaging and Laboratory Tests (Each Contract Year) ()

Subject to written referralt from a Registered Medical Practitionert

Full cover for eligible medical expenses

2,650

9 Prescribed Western Medication (Each Contract Year) ()

Medically Necessary Western Medication prescribed by a Registered Medical Practitioner and obtained from a legitimate source

3,250

Maximum number of visits for both Network Benefit and Non-network Benefit in aggregate per Contract Year for items 1 - 7 is 50 in total, with a sub-limit of 20 visits per Contract Year for items 6 -7. Subject to a maximum of one visit per item per day.1-7506-720

C Dental Benefit (Optional) ()

Maximum Limit per Member (HK$) ()

Scaling and polishing (Maximum 2 visits each Contract Year) (2 500 each visit

Routine oral examination

Unlimited

Intraoral X-ray and medications X

Fillings and extractions

Drainage of abscesses

Pins for cusp restoration

Dentures, crowns and bridges (Only if necessitated by an Accident) ()

Maximum Limit each Contract Year 2,000

D Free Bupa Worldwide Assistance Programme (Each Contract Year) () Provides guarantee or advancement of admission deposit in the event of hospitalisation overseas and in Mainland China, unlimited cover for emergency medical evacuation and repatriation, and an extra hospital benefit of up to HK$120,000 after repatriation to Hong Kong. A 24-hour hotline for travel, medical or legal information and assistance is also available. 1224

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Bupa HealthPlus Health Insurance Scheme

1

Schedule of Benefits 1 January 2018 Edition 201811

Notes

About Hospital and Surgical Benefit Clinical Operation or Day Case Surgery, if eligible, will be paid under Hospital and Surgical Benefit. Clinical Operation and Day Case Surgery refer to Medically Necessary surgical procedures that may be carried out at a clinic or day-case unit of a Hospital by a Registered Medical Practitioner where a stay in Hospital is not required, provided that the surgical procedure is classified as such by Bupa. You must be confined at the Semi-private room level or lower. If you are confined to a Private Room of a Hospital, Bupa will only reimburse 50% of all eligible claims for hospital expenses under Hospital and Surgical Benefit, up to the benefit item limit. This Benefit shall not apply to any Hospital Confinement in class of suite, VIP or deluxe room of a Hospital.

About Bupa HealthPlus (BHP) Card and cashless hospitalisation If you are admitted to a designated private Hospital in Hong Kong, Bupa will directly settle your eligible medical expenses with the Hospital, subject to a Credit Limit (Up to HK$800,000) approved by Bupa. Please call us and submit a registration form before you are admitted to Hospital. We will provide you with a Pre-authorisation Confirmation / Guarantee of Payment Letter (hereafter called the GOP Letter). If you receive emergency treatment outside the office hours of Bupa, please obtain authorisation from Bupa on the next working day or prior to your discharge from Hospital. For the list of designated private Hospitals in Hong Kong, please visit Bupa's website at www.bupa.com.hk > Medical Insurance > Bupa HealthPlus. This list is subject to change from time to time. The Subscriber will have to pay any medical expenses that exceeds the Credit Limit and submit a claim to Bupa for reimbursement of any eligible medical expenses. Your BHP card is not applicable to the day-case centre of the local private Hospital. Please settle your payment first and submit a claim to Bupa. You may need to reimburse Bupa for the amount of Deductible and Shortfall, if any. Please refer to the Contract for more details.

e For in-patient treatments at Gleneagles Hong Kong Hospital, please visit www.bupa.com.hk/pdf/ghk.pdf or call Bupa to get details of the room types and how they are classified under Bupas cover prior to your hospital stay.

r About Deductible Benefit under Hospital and Surgical Benefit shall be payable after the eligible claims under items A1-A14 have exceeded the selected Deductible. Eligible claims under items A15 - A22 will not be counted towards the Deductible.

t About referral letter A referral letter is valid for the same or related medical condition for six months from the issue date. Another referral letter is required for treatment of a new or unrelated medical condition.

y About full cover for Surgeon and Attendance Fees & In-patient Specialist's Fees Please follow the requirements below to enjoy full cover (i) You will need to choose a Bupa HealthPlus Appointed Specialist and designated clinic for consultation. Always present your doctor's referral letter (except for

gynaecology, paediatrics and family medicine) and your BHP Card upon registration. You can receive your treatment at designated private Hospitals in Hong Kong or Bupa HealthPlus Appointed Day Case Centre. Treatment must be attended by the Bupa HealthPlus Appointed Specialist.

(ii) Pre-authorisation confirmation must be obtained from Bupa for the following situations: - Treatment received at a Hospital (including the day-case centre of a Hospital); - Specialist treatment for which the relevant specialty is not practised by any Bupa HealthPlus Appointed Specialist.

(iii) If you receive emergency treatment outside the office hours of Bupa, please obtain subsequent authorisation from Bupa on the next working day before discharge from Hospital.

If any of the above requirements is not followed, your claims, if eligible, will be reimbursed up to the item limit applicable to Other Specialists. u About full cover for Physiotherapy, Diagnostic Imaging and Laboratory Tests under Hospital and Surgical Benefit

Physiotherapy, Diagnostic Imaging and Laboratory Tests must be referred by your attending doctor who is a Bupa HealthPlus Appointed Specialist and performed at a Bupa HealthPlus Appointed Physiotherapy Centre or Diagnostic Centre. Always present your attending doctor's referral letter, Certificate for Diagnostic & Imaging / Physiotherapy Service (hereafter called the Certificate) and your BHP Card upon registration. Otherwise, your claims, if eligible, will be reimbursed up to the item limit applicable to Other Service Providers. The Certificate will be issued together with the GOP Letter for Hospital Confinement or Day Case Surgery. If you undergo a Clinical Operation where GOP Letter is not provided, please call Bupa to obtain the Certificate. You can settle the eligible medical expenses with your BHP Card at a Bupa HealthPlus Appointed Physiotherapy Centre or Diagnostic Centre.

i About Network Benefit under Clinical Benefit Please follow the requirements below to enjoy full cover (i) Your clinical treatment must be performed by a Bupa HealthPlus Appointed Service Provider and carried out at their clinics. (ii) Specialist consultation (except for gynaecology, paediatrics and family medicine) and physiotherapy must be referred by a Bupa HealthPlus Registered Medical

Practitioner. (iii) If the specialist treatment for which the relevant specialty is not practised by any Bupa HealthPlus Appointed Specialist, pre-authorisation confirmation from Bupa

is required. (iv) Please present your BHP Card upon registration for treatment and use it to pay the medical expenses. If any of the above requirements is not followed, your claims, if eligible, will be reimbursed under Non-network Benefit.

50%//

(80)/()www.bupa.com.hk > >

e www.bupa.com.hk/pdf/ghk.pdf r

A1-A14A15-A22 t

6 y

(i) ()

(ii) - () -

(iii)

u ()()

i (i) () (ii) () (iii) (iv)

In the event of any discrepancy in respect of the meaning between the Chinese version and the English version, the English version shall prevail. All terms and conditions are subject to the Contract. 4

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www.bupa.com.hk/pdf/ghk.pdfwww.bupa.com.hkwww.bupa.com.hk/pdf/ghk.pdfwww.bupa.com.hk

Bupa HealthPlus

Excellent protection at your fingertips www.bupa.com.hk

Introduction to Bupa HealthPlus

Bupa HealthPlus is designed to reduce your worries arising from illnesses by looking after your medical expenses throughout the healthcare stages of diagnosis, hospitalisation and recovery. This scheme provides up to HK$3 million annual benefitq to cover hospital stay in a semi-private room, giving full reimbursement of hospital expensesw and offsetting the medical costs incurred during diagnosis before hospital admission and follow-up outpatient consultations after hospitalisation. With additional subscription, we also cover certain medical conditions that have occurred before enrolment, which are not usually eligible for claims. Along with family discounts and deductible options, you will find this scheme affordable for you and your loved ones.

300qw

Overview of your cover

Cover at a glance

Basic benefit Hospital and Surgical Benefit

Optional benefits Clinical Benefit Dental Benefit

Cover for pre-existing conditions An option to cover your medical conditions which had commenced prior to scheme application, subject to additional subscription and Bupas approval

Free benefits Free Bupa Worldwide Assistance Programme

Medical card Yes. Medical card is provided to support cashless treatment in designated private hospitals in Hong Konge and outpatient consultations of our network doctors

e

Benefit level Semi-private Room

Deductible options $0/ $12,000/ $40,000 per Contract Year 0/ 12,000/ 40,000

Family discountr 10% discount for 2 members2 9 r 15% discount for 3 members or more3 85

Eligibility

Eligibility of family members Subscriber: 18 years or above18 and issue age Subscribers children: 15 days or above :15 Subscribers legal spouse, parents and parents-in-law

Children aged under 10 must enrol together with a parent under the same contract 10

Renewal Renewal of your cover is guaranteed for life regardless of your claims history or changes to your health conditionu

u

Please refer to the Schedule of Benefits for more information.

q The annual maximum cover for members aged 65 or above and for treatment received in the USA is different. Please refer to the Schedule of Benefits for details.

w You need to follow the required procedures to enjoy full cover or cashless treatment. Please refer to the notes in the Schedule of Benefits and Contract for more details.

e For the list of designated private hospitals in Hong Kong, please visit Bupa's website at www.bupa.com.hk > Medical Insurance > Bupa HealthPlus. This list is subject to change from time to time.

r Family discount is only applicable to Bupa HealthPlus subscriptions of Hospital and Surgical Benefit. q 65 w e www.bupa.com.hk > > r

1

www.bupa.com.hkwww.bupa.com.hk

Looking after your medical costs all the way through

Full cover on your hospital expenses This scheme provides worldwide cover of up to HK$3 million per yearq to fully reimburse a wide range of hospital expenses at the semi-private room levelw. By removing the benefit limits for most items, the simplicity of this scheme helps minimise your worries on unexpected out-of-pocket expenses.

Extended cover for post-surgery follow-up treatments Apart from expenses incurred through hospital confinement, medical costs resulting from follow-up consultations, which are necessary for a complete recovery, can add up rapidly. To minimise your out-of-pocket expenses, Bupa HealthPlus fully covers the cost of post-surgery follow-up advanced imaging, laboratory tests and physiotherapyw, and reimburses other post-surgery outpatient care such as up to 20 outpatient visits, dietitian consultations, to name a few.

Chinese herbalist consultations to aid recovery after illnesses Chinese medicine treatments are becoming popular means to improve health condition, especially for the recuperation from serious illnesses. Bupa HealthPlus covers Chinese herbalist consultations and acupuncture within 180 days after receiving cancer treatment or surgery for stroke or Coronary Artery Diseaset .

Enhanced cover by including your pre-existing conditions With additional subscriptions, you can have the option to cover certain common pre-existing medical conditions that have arisen prior to your enrolment to Bupa HealthPlus. The actual amount will be determined at the time of your enrolment as a fixed percentage of the subscription of the Hospital and Surgical Benefit and Clinical Benefit. The percentage will not change even if there is a subsequent change in your health conditiony.

Guaranteed lifetime renewal Bupa guarantees that your cover can be renewed for lifeu. Your subscription will be based on your age only no matter how much you claim on conditions arising after your membership starts.

q The annual maximum cover for members aged 65 or above and for treatment received in the USA is different. Please refer to the Schedule of Benefits for details.

w You need to follow the required procedures to enjoy full cover or cashless treatment. Please refer to the notes in the Schedule of Benefits and Contract for more details.

t Please consult your attending doctor before receiving any Chinese herbalist consultations.

y The total subscription for Hospital and Surgical Benefit and Clinical Benefit will be adjusted on a yearly basis.

u Bupa guarantees that your cover can be renewed for life as long as you meet the requirements as stated in the Residency Clause of your contract. Bupa reserves the right to amend the subscription, benefits, terms and conditions upon your contract renewal. Please refer to your contract for further details.

2

Minimise your out-of-pocket medical expenses incurred from follow-up treatments after hospitalisation.

300qw

Xw20

180t

y

u

q 65 w

t

y

u

3

Health cover that is affordable

Deductible options to help lower the subscription Bupa HealthPlus features three deductible options for the Hospital and Surgical Benefit to give you the flexibility to make this plan more affordable. By choosing a deductible, we can reimburse your hospital expenses as soon as your eligible claims exceed the amount of your selected deductible. This works for individuals who use their existing medical cover, e.g. group cover from employers, to offset the deductible. You and each family member can select a different deductible to suit each persons needs.

Lifetime family discount Enrol your family members to Bupa HealthPlus and enjoy discounts on your subscription every year. All of the covered members in your scheme are entitled to 10% discount when 2 family members are enrolled and 15% discount when 3 family members or more are enrolled at the same timer .

29385r

r Family discount is only applicable to Bupa

HealthPlus subscriptions of Hospital and

Surgical Benefit.

4

Claims service pledge No claims procedure is required if you use the Bupa HealthPlus Card. All other claims will be settled within 5-7 working days after full documentation is received.

5 - 7

Effortless in every way from

scheme enrolment to claims

Easy enrolment Enrolment is simple - no medical examinations are required when you apply for this scheme.

Cashless arrangement and no claim hassle ei Enjoy the convenience of cashless treatment at designated private hospitals in Hong Konge with the Bupa HealthPlus medical cardi . 80o With prior arrangements made, you will not be required to make w upfront payments or submit claims as we will directly settle your expenses with the hospital up to HK$800,000o. If Clinical Benefit is opted, you can also enjoy cashless treatment at Bupas appointed clinics with the Bupa HealthPlus Cardw .

Dedicated person to follow-up on your claims A dedicated Care Manager can be assigned to follow-up on your claims if you are admitted to a local private hospital.

w You need to follow the required procedures to enjoy full cover or cashless treatment. Please refer to the notes in the Schedule of Benefits and Contract for more details.

e For the list of designated private hospitals in Hong Kong, please visit Bupa's website at www.bupa.com.hk > Medical Insurance > Bupa HealthPlus. This list is subject to change from time to time.

i Your Bupa HealthPlus Card cannot be used at the day-case centre of the local private hospitals. o You need to reimburse Bupa for the deductible, if any, as well as the shortfall which includes medical expenses that are not eligible for claims. w e www.bupa.com.hk > > i o

5

www.bupa.com.hkwww.bupa.com.hk

6

-

The World of Bupa

Bupa A global healthcare specialist Bupa began in the UK in 1947. We fund and provide healthcare services to fulfil our purpose of helping people live longer, healthier, happier lives. Our diversified services include health insurance, clinics, hospitals, dental centres, care homes, and more.

We employ over 86,000 people, principally in the UK, Australia, Spain, Poland, Hong Kong, Chile, Brazil, Saudi Arabia, India, New Zealand, and the US. With no shareholders, we reinvest our profits to provide more and better healthcare for customers.

Bupas presence in Hong Kong Bupa is a leading provider in healthcare funding and provision with two independent units, Bupa Hong Kong and Quality

1947

86,000

HealthCare.

Bupas purpose is helping people live longer, healthier, happier lives.

Bupa Hong Kong

In Hong Kong, we are known as the health insurance specialist providing domestic and international health insurance. We have gained the trust of more than 400,000 individuals, and 3,200 companies including major corporations in public utility and telecom industry. We have provided quality health insurance for Hong Kongs civil servants for more than 20 years.

We have applied our expertise to provide our members with comprehensive and flexible insurance plans to suit every life stage and lifestyle. Through our extensive provider network in Hong Kong, we offer our members a wide choice of doctors.

Quality HealthCare Quality HealthCare Medical Services Limited (QHMS), Hong Kong, became part of Bupa, an international healthcare group, in October 2013. QHMS operations span diagnostics, primary healthcare and day care specialties. With roots tracing back to 1868, QHMS serves the community through a network of around 100 multi specialty centres and over 800 affiliated clinics offering Western Medicine, Traditional Chinese Medicine, Diagnostics & Imaging, Dental, Physiotherapy, and other healthcare services. It also operates a private nursing agency. QHMS is one of the largest providers of healthcare services to corporates in Hong Kong. In 2016, the Group recorded more than 2.8 million healthcare visits. QHMS endeavors to enhance the quality of our professional services continuously to satisfy the needs of customers and patients.

40 3,200 20

2013 10 1868 100 800 2016 280

Professionals are standing by round-the-clock

We are here for you at all times, offering utmost peace of mind. Apart from paying your medical bills, we minimise your worries through personal support when you are unwell.

24/7 Customer Care helpdesk Our 24/7 Customer Care helpdesk operates 24 hours every day, with a live person to directly answer your queries about your cover.

Health Coaching Services The Health Coaching Services gives you guidance on your healthcare issues through the following services:

Our 24/7 Healthline is staffed with a team of qualified nurses and healthcare professionals, supported by doctorsa, providing assistance and guidance from how to care for a sick child or the elderly to discussing your symptoms, diagnosis and treatment options.

A second medical opinion can be arranged and paid for in the event of serious illnesses, so you can obtain an expert opinion of your diagnosis and treatment options from a global panel of medical specialists, making sure you are well informed to make decisions about your treatment.

Doctor referrals can be made based on your condition and needs.

When you inform Bupa of your hospital treatment, a dedicated Care Manager can be in touch with you to advise you on your benefits and follow-up on your claims. The Care Manager can also make a courtesy visit, with your consent, if you are admitted into a local private hospital.

A qualified nurse can support you throughout your treatment and recovery, from explaining your treatment in everyday language and overseeing costs to arranging consultations after hospital discharge in the event of major and complex surgeries.

2424

24a

a Doctors will be available during scheduled office hours to support the nurses for answering the enquiries. Office hours: Mon Fri, from 9am to 7pm (Hong Kong time), except public holidays.

97

24/7 Customer Care helpdesk to help you at all times 24

The use of Health Coaching Services is free of charge. If the services suggested by us are not covered under your Bupa HealthPlus Health Insurance Scheme, you will be responsible for the fees incurred.

7

Question Time

1 How can I enjoy cashless treatment in a hospital?

Please follow this procedure to enjoy cashless treatment at designated private hospitals in Hong Kong

First you will need to obtain pre-authorisation approval from Bupa before hospital admission. If your attending doctor is a Bupas appointed specialist, this will be arranged by your doctor. Otherwise, please apply for the approval yourself.

Upon approval, Bupa will provide you with a Guarantee of Payment (GOP) letter which guarantees the payment of your hospital expenses up to the approved credit limit, which is HK$800,000 for each confinement. If you have made some previous hospital claims and the balance of your benefit is under HK$800,000, such balance will become the credit limit. Please show the GOP letter together with your Bupa HealthPlus Card and the referral letter of your attending doctor to the hospital.

For emergency hospital admissions outside of our office hours, please obtain our approval on the next working day.

2 How can I ensure that I receive full cover when I need to go for diagnostic imaging, lab tests, or physiotherapy after my surgery or cancer treatment?

You will have to visit the medical diagnostic centres and physiotherapists in our network to enjoy full cover. All tests or treatments must be related to your surgery or cancer treatment. If your surgery is performed at a designated private hospital, please show your Bupa HealthPlus Card, an approval document issued to you before your hospital admittance and your attending doctors referral letter to the network diagnostic centre or physiotherapist. If your surgery is performed at a clinic, you will also need to contact Bupa to obtain an approval document before your visit. In all cases, this benefit will be payable after your eligible claims for hospital expenses have exceeded the deductible amount.

3 How do I enjoy the Chinese medicine treatments after I am hospitalised?

After cancer treatment or surgery to cure Stroke and Coronary Artery Disease, you can seek Chinese herbalist consultations within 180 days after your hospital discharge, or after you receive cancer treatment. This benefit is payable after your eligible claims for hospital expenses have exceeded the deductible amount.

4 How is my deductible calculated when I incur medical expenses?

If you have chosen a deductible, we will begin reimbursement once your eligible claims have exceeded the chosen deductible amount. For example, if the deductible is HK$12,000, and you have incurred HK$50,000 in hospital expenses that are eligible for 100% reimbursement, your benefit payable after deducting the deductible will be HK$50,000 HK$12,000 = HK$38,000. Please note that if the hospital expenses of HK$50,000 are incurred in the USA, your eligible claim will be HK$25,000 because the reimbursement rate is 50%. Subtract the HK$12,000 deductible, you will receive a payout of HK$13,000.

1

8080

2

3

180

4

12,00050,000100%50,00012,00038,00050%25,00012,000 13,000

8

9

General Exclusions

We want to help you understand your coverage before enrolment. Below are the general exclusions:

Pre-existing conditions (unless such conditions have been disclosed in the application and accepted by Bupa to be covered under the contract, and if applicable, with an upward adjustment to the amount of subscription which shall be notified in writing). For the avoidance of doubt, the General Exclusions under the Free Bupa Worldwide Assistance Programme Clause of the contract applies notwithstanding any pre-existing conditions covered under the contract. Treatment, medical service, medication or investigation which is not medically necessary. Any illness or injury for which compensation is payable under any laws or regulations or any other insurance policy or any other sources except to the extent that such charges are not reimbursed by any such compensation, insurance policy or sources. Any charges for accommodation, nursing and services received in health hydros, nature cure clinics, convalescent home, rest home, home for the aged or similar establishments. Any charges in respect of surgical or non-surgical cosmetic treatment, or hearing tests, routine blood tests, general check-ups, vaccinations or inoculations, Hair Mineral Analysis (HMA), health supplements or body weight control, eye refraction including but not limited to routine eye tests or any costs of fitting of spectacles or lens (unless benefit is available). Congenital conditions, developmental conditions or hereditary

conditions.Treatment that commenced during the first five years of the member's coverage commencement date of the Contract and which in any way arises from, is attributable to, or is consequential upon Human Immunodeficiency Virus Infection. Sexually transmitted (venereal) diseases or their sequel. Treatment relating to pregnancy, including diagnostic tests for pregnancy or resulting childbirth, abortion or miscarriage; birth control or sterilisation of either sex; infertility including in-vitro fertilisation or any other artificial method of inducing pregnancy; sexual dysfunction including but not limited to impotence, erectile dysfunction, premature ejaculation, regardless of cause. Misuse or overdose of drugs or being under the influence of alcohol, self-inflicted injuries or attempted suicide. Treatment relating to any illness or injury resulting from participation in criminal activities. Alternative treatment including but not limited to Chinese medicines treatment, acupuncture, acupressure, Tui Na, hypnotism, rolfing, massage therapy, aromatherapy (unless benefit is available). Senile Dementia (including Alzheimer's disease), Parkinson's disease, psychological or psychiatric condition(s) of any and all kinds, including but not limited to psychoses, neuroses, depression, anxiety, anorexia nervosa, schizophrenia, behavioural disorders, delirium, insomnia, neurasthenia (unless benefit is available). Any charges for the procurement or use of special braces and appliances, including but not limited to spectacles, hearing aids and other equipments such as wheel chairs and crutches. Any treatment or investigation related to dental or gum conditions (unless benefit is available) except for emergency treatment arising from accidents or the extraction of impacted wisdom teeth during hospital confinement. Follow-up treatment from such hospital confinement shall not be covered. Treatment arising from war, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection or military or usurped power or terrorist acts. Non-medical services, including but not limited to guest meals, radio, telephone, photocopy, taxes (except the Value-Added Tax or Goods and Services Tax for medical services), medical report charges and the like. Experimental and / or new medical technology or procedure not yet approved by Bupa.

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In the event of any discrepancy in respect of the meaning between the Chinese version and the English version, the English version shall prevail. All terms and conditions are subject to the Contract.

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Bupa (Asia) Limited

18/F, Berkshire House 25 Westlands Road, Quarry Bay, Hong Kong2518

Telephone (852) 2517 5175 Facsimile (852) 2548 1848

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www.bupa.com.hk

Bupa Hong Kong

www.bupa.com.hkhttp:MP209/5/1117/4.5K

Schedule of Benefits/Bupa HealthPlus Scheme Overview & Features/Company Background/FAQ/General Exclusions/Table of Subscriptions/Bupa Membership Important Notes/Application Form/