Bupa Together Health Insurance Scheme 保柏互通保額醫療保障計劃 Schedule of Benefits 保障金額表 Effective from 1 January 2017 自 2017 年 1 月 1 日起生效 B Free Double Benefit

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1 Bupa Together Health Insurance Scheme 保柏互通保額醫療保障計劃 Schedule of Benefits 保障金額表 Effective from 1 January 2017 自 2017 年 1 月 1 日起生效 Maximum Limit per Member (HK$) 每位會員最高賠償額 ( 港幣 ) A Hospital and Surgical Benefit 住院及手術保障 Full Cover Benefit w 全數賠償保障 w Room level 住房等級 Ward 大房 Standard Benefit 標準保障 Bupa HealthCare Appointed Hospitals 保柏康健特選醫院 Canossa Hospital / HK Adventist Hospital Stubbs Road / HK Adventist Hospital Tsuen Wan / HK Baptist Hospital / HK Sanatorium & Hospital / St Paul s Hospital / St Teresa s Hospital / Union Hospital 嘉諾撒醫院 / 香港港安醫院 - 司徒拔道 / 香港港安醫院 - 荃灣 / 香港浸信會醫院 / 養和醫院 / 聖保祿醫院 / 聖德肋撒醫院 / 仁安醫院 N/A 不適用 No. of Bupa HealthCare Appointed Specialists 保柏康健特選專科醫生數目 Around 約 600 N/A 不適用 1 Room and Board (Maximum 270 days each Contract Year) 住房及膳食費 ( 每合約年度最多 270 日 ) 2 Miscellaneous Hospital Services (Each Contract Year) 住院雜費 ( 每合約年度計 ) 3 Intensive Care (Supplement to Room and Board)(Each Contract Year) 深切治療 ( 住房及膳食費之補足 )( 每合約年度計 ) 4 Private Nursing (Maximum 120 days each Contract Year) 私家看護費 ( 每合約年度最多 120 日 ) Subject to written referral e from the attending Registered Medical Practitioner 須獲主診註冊西醫書面轉介 e 5 Surgeon and Attendance Fees (For surgical case only)(each operation) 外科醫生費及巡房費 ( 只適用於外科手術 )( 每次手術計 ) Complex 複雜 Major 大型 Intermediate 中型 Minor 小型 6 Anaesthetist s Fees (Each operation) 麻醉科醫生費 ( 每次手術計 ) Complex 複雜 Major 大型 Intermediate 中型 Minor 小型 7 Operating Theatre Fees (Each operation) 手術室費用 ( 每次手術計 ) Complex 複雜 Major 大型 Intermediate 中型 Minor 小型 8 In-patient Physician s Fees (For non-surgical case only) (Maximum 270 days each Contract Year) 住院醫生巡房費 ( 只適用於非手術治療 )( 每合約年度最多 270 日 ) 9 In-patient Specialist s Fees (Each Contract Year) 住院專科醫生費 ( 每合約年度計 ) Subject to written referral e from the attending Registered Medical Practitioner r 須獲主診註冊西醫書面轉介 er 10 Companion Bed (Maximum 270 days each Contract Year) 住院加床費 ( 每合約年度最多 270 日 ) Full cover 全數賠償 每日 940 each day 19,100 22,300 每日 420 each day 52,000 29,800 12,000 5,780 16,500 9,300 3,800 2,280 18,000 10,200 4,200 2,350 每日 700 each day 2,680 每日 470 each day 11 Cancer Treatment and Kidney Dialysis (Each Contract Year) 癌症治療及洗腎 ( 每合約年度計 ) Chemotherapy, radiotherapy, cyberknife or gamma knife for cancer treatment or kidney dialysis during Hospital Confinement or in day-case unit of a Hospital or clinic upon recommendation by the attending Registered Medical Practitioner 經主診註冊西醫建議下於住院期間或醫院日症房或診所進行之化療 電療 使用數碼導航刀或伽碼刀以治療癌症或洗腎 12 Pre-admission and Post-hospitalisation Out-patient Care (Each Contract Year) 入院前及出院後之門診護理 ( 每合約年度計 ) Including two pre-admission visits and all related post-hospitalisation follow-up visits on an out-patient basis within six weeks after discharge from Hospital 包括 2 次入院前及出院後 6 星期內所有與住院治療有關之跟進療程門診費用 13 Emergency Out-patient Benefit for Accidents (Each Contract Year) 緊急意外門診保障 ( 每合約年度計 ) Maximum Annual Benefit Pool (Per Contract) t 每年最高通用賠償額 ( 每合約計 ) t One Member 1 名會員 Two Members 2 名會員 Three Members 3 名會員 Four Members or above 4 名會員或以上 Individual Overall Annual Limit 個人每年最高賠償額 Below attained age of 65 on the Contract Effective Date 於合約生效日未滿 65 歲之會員 Attained age of 65 or above on the Contract Effective Date 於合約生效日年滿 65 歲或以上之會員 2,300 6, , , ,000 1,000,000 Subject to the available Maximum Annual Benefit Pool 以可享用的每年最高通用賠償額為限 100,000 Subject to the available Maximum Annual Benefit Pool or HK$500,000 whichever is lower 以可享用的每年最高通用賠償額或港幣 500,000 元為限, 以較低者為準 MP168/6/1116/22K Printed on recycled paper 以再造紙印刷 1

2 Bupa Together Health Insurance Scheme 保柏互通保額醫療保障計劃 Schedule of Benefits 保障金額表 Effective from 1 January 2017 自 2017 年 1 月 1 日起生效 B Free Double Benefit for Serious Illnesses 免費嚴重疾病雙倍保障 If the Member receives treatment relating to the following Serious Illnesses, the Maximum Limit of items A1 to A10 under Standard Benefit of Hospital and Surgical Benefit will be doubledy, subject to the Maximum Annual Benefit Pool and Individual Overall Annual Limit. 如會員接受與下列有關病症的治療, 其 住院及手術保障 內的 標準保障 A1 - A10 保障項目之最高賠償額將雙倍提升 y, 以 每年最高通用賠償額 及 個人每年最高賠償額 為限 - Cancer 癌症 - Coronary artery disease requiring angioplasty or bypass graft surgery 冠心病 ( 須接受俗稱 通波仔 的冠狀血管成形術或搭橋手術 ) - End-stage liver disease 末期肝病 - Kidney failure 腎衰竭 - Tuberculosis 結核病 C Free Bupa Wellness Programme u 免費保柏保健計劃 u Every Member can enjoy one of the following complimentary wellness services provided by the designated wellness centres once every year starting from the second Contract Year. 每位會員可於指定之保健中心享用以下任何一項免費保健服務, 由第二個合約年度開始, 每年一次 Healthy body 身體健康 Optical Check 眼科檢查 Comprehensive eye examination plus contact lens care (For age 3 or above) / diabetes eye exam (For age 18 or above) / glaucoma package (For age 18 or above) 全面眼科視光檢查及隱形眼鏡護理 ( 適合 3 歲或以上人士 ) / 糖尿眼檢查 ( 適合 18 歲或以上人士 ) / 青光眼檢查 ( 適合 18 歲或以上人士 ) Dental Service 洗牙服務 Scaling and polishing (For age 5 or above) 去除牙石 牙漬 ( 適合 5 歲或以上人士 ) Hepatitis Screening 肝炎測試 Hepatitis A or B Vaccine 甲型或乙型肝炎預防疫苗 Hepatitis A virus antibody - total / Hepatitis B surface antigen and surface antibody (For any ages) 總甲型肝炎抗體測試 / 乙型肝炎表面抗原及抗體測試 ( 適合所有人士 ) Two doses of Hepatitis A vaccine (For age 19 or above) / three doses of Hepatitis B vaccine (For age 16 or above) 甲型肝炎預防疫苗兩針 ( 適合 19 歲或以上人士 ) / 乙型肝炎預防疫苗三針 ( 適合 16 歲或以上人士 ) General Health Assessment (For age 18 or above) 普通全身檢查 ( 適合 18 歲或以上人士 ) Full physical examination 體格檢查 Blood pressure check 血壓檢查 Chest X-ray 胸肺 X 光檢查 CBP 血全圖 Creatinine 肌酸酐 Glucose 血葡萄糖 ALT/SGPT 谷丙轉氨酵素 Uric acid 尿酸 Urine routine 尿常規檢查 Electrocardiogram 心電圖 Total cholesterol 總膽固醇 Triglycerides 三酸甘油脂 Well Man Health Assessment (For age 18 or above) 男性專科檢查 ( 適合 18 歲或以上人士 ) Full physical examination 體格檢查 Blood pressure check 血壓檢查 Lipid profile 血脂分析 (Total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides 總膽固醇 低密度膽固醇 高密度膽固醇 三酸甘油脂 ) Total PSA test 總前列腺特異抗原測試 (Prostate cancer screen 前列腺癌測試 ) Well Woman Health Assessment (For age 18 or above) 女性專科檢查 ( 適合 18 歲或以上人士 ) Full physical examination 體格檢查 Blood pressure check 血壓檢查 Lipid profile 血脂分析 (Total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides 總膽固醇 低密度膽固醇 高密度膽固醇 三酸甘油脂 ) Pap smear test 柏氏抹片檢查 (Cervical cancer screen 子宮頸癌測試 ) Healthy family 家庭健康 Pre-marital / Pre-pregnancy Check-up (For age 18 or above) 婚前 / 懷孕前檢查 ( 適合 18 歲或以上人士 ) Body Mass Index, blood pressure and pulse rate 體重指標 血壓及脈博 Urine glucose and protein 尿糖及尿蛋白 Complete blood picture 血全像 Blood group and Rhesus factor 血型及恆河猴 Rh(D) 因子 VDRL test for syphilis 梅毒血清測試 Hepatitis B antigen and antibody tests 乙型肝炎表面抗原及抗體 Rubella antibody test (For female) 德國麻疹抗體 ( 為女性而設 ) Seminal analysis (For male) 精液常規檢驗 ( 為男性而設 ) Examination of thyroid, breast and abdomen 甲狀腺 胸部及腹部檢查 Visual inspection of external genitalia 目視檢查外生殖器官 Contraceptive advice 避孕建議 Explanation on laboratory reports 解釋化驗報告 Healthy lifestyle 健康生活 Fitness Management Programme (For age years) 體適能管理計劃 ( 適合 18 至 65 歲人士 ) Healthy Eating Programme (For age 6 17 years) 健康飲食計劃 ( 適合 6 至 17 歲人士 ) Being overweight or having excessive body fat can lead to illnesses such as high blood pressure, diabetes and heart disease. To help you maintain a healthy level of weight and fitness, this programme offers consultations with a doctor, registered dietitian and physiotherapist. They will provide personalised advice about healthy eating and physical fitness based on your physical and dietary assessments. The programme will give you a better understanding of how to: 1) improve your physique and maintain a healthy weight 2) devise a healthy lifestyle plan to avoid weight-related health problems If you have any chronic illnesses, please consult your physician first. 過重或身體脂肪過多可引致各種疾病如高血壓 糖尿病及心臟病等 此計劃可助您保持健康的體重及體能, 醫生 註冊營養師及物理治療師將會根據您的飲食習慣及體能評估提供建議, 包括個人化的健康飲食和制定體適能目標 計劃助您了解如何 : 1) 改善體態及保持健康體重 2) 設計個人健康計劃以預防因體重引致的健康問題患有慢性疾病的人士, 請先向您的醫生查詢 Overeating or poor eating habits may cause obesity in children and teenagers. This programme offers personalised dietary recommendations by a registered dietitian to give you a better understanding of how to help your child achieve a healthy weight. If you have any chronic illnesses, please consult your physician first. 飲食過量或不良飲食習慣容易令兒童及青少年患上肥胖症 此計劃透過註冊營養師提供的飲食建議, 助您了解如何幫子女保持健康體重 患有慢性疾病的人士, 請先向您的醫生查詢 D Free Bupa Worldwide Assistance Programme (Each Contract Year) 免費保柏國際援助計劃 ( 每合約年度計 ) Provides 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 HK$120,000 after repatriation to Hong Kong. A 24-hour hotline for travel, medical or legal information and assistance is also available. 提供海外及國內住院按金墊支服務, 全數支付緊急醫療運送費用及送返香港後高達港幣 12 萬元的額外住院保障, 並設有 24 小時熱線提供旅遊 醫療或法律資訊及支援 MP168/6/1116/22K Printed on recycled paper 以再造紙印刷 2

3 Bupa Together Health Insurance Scheme 保柏互通保額醫療保障計劃 Schedule of Benefits 保障金額表 Effective from 1 January 2017 自 2017 年 1 月 1 日起生效 Maximum Limit per Member (HK$) 每位會員最高賠償額 ( 港幣 ) E Supplementary Major Medical Benefit (Optional) i 附加醫療保障 ( 自選保障 ) i Ward 大房 Reimbursement percentage 賠償率 80% Maximum Limit (Each Contract Year) 最高賠償額 ( 每合約年度計 ) 130,000 Lifetime Limit (Only applicable to Members who attain the age of 65 or above) 218,000 終生最高賠償額 ( 只適用於年齡已屆 65 歲或以上的會員 ) This Benefit is payable after any one of the following items is exhausted: - Any item of A1 - A11 under Standard Benefit of Hospital and Surgical Benefit - Individual Overall Annual Limit of Hospital and Surgical Benefit - Free Double Benefit for Serious Illnesses Your Bupa HealthCare (BHC) Card can be used to settle payment for Hospital Confinement at any local private Hospitals, subject to a credit limit approved by Bupa. In case of overseas hospitalisation, only medical Emergency cases will be covered. Adjustment factors will be applied if you are confined in a higher room level than your chosen level: - From Ward to Semi-private Room : 50% - From Ward to Private Room : 25% 此保障將於以下任何一項已耗盡後才開始支付 : - 住院及手術保障內的標準保障 A1 - A11 任何一項 - 住院及手術保障的個人每年最高賠償額 - 免費嚴重疾病雙倍保障您可使用保柏康健卡支付本港任何私家醫院之住院費用, 以保柏批核之信用額為限 如身處海外, 只適用於因急症之住院治療 如您入住比原有保障級別更高的病房級別, 保障額將作出如下調整 : - 大房至半私家房 : 50% - 大房至私家房 : 25% F Clinical Benefit (Optional) 門診保障 ( 自選保障 ) 1 General Practitioner (Consultation fee only) 普通科醫生 ( 只限診症費 ) 每次 215 each visit 2 Specialist (Consultation fee only) 專科醫生 ( 只限診症費 ) Subject to written referral e from a Registered Medical Practitioner 須獲註冊西醫書面轉介 e 每次 430 each visit 3 Home Consultation (Consultation fee only) 家中應診 ( 只限診症費 ) 每次 430 each visit 4 Physiotherapist (Treatment fee only) 物理治療師 ( 只限診療費 ) Subject to written referral e from a Registered Medical Practitioner 須獲註冊西醫書面轉介 e 5 Chiropractor (Treatment fee only) 脊醫 ( 只限診療費 ) Subject to written referral e from a Registered Medical Practitioner 須獲註冊西醫書面轉介 e 6 Chinese Herbalist 中醫師 Consultation fee (Including basic Medically Necessary Chinese Medicines prescribed at the Registered Chinese Medicine Practitioner s clinic and obtained at a legitimate source on the same day of consultation) Payable for acupuncture performed by a Registered Chinese Medicine Practitioner 診症費 ( 包括於診治當日由註冊中醫在診所處方並由合法來源取得的基本醫療必需中藥費用 ) 此保障支付由註冊中醫進行的針灸治療 7 Chinese Bonesetter 跌打醫師 Consultation fee (Including basic Medically Necessary Chinese Medicines prescribed at the Registered Chinese Medicine Practitioner s clinic and obtained at a legitimate source on the same day of consultation) Payable for acupuncture performed by a Registered Chinese Medicine Practitioner 診症費 ( 包括於診治當日由註冊中醫在診所處方並由合法來源取得的基本醫療必需中藥費用 ) 此保障支付由註冊中醫進行的針灸治療 8 Prescribed Western Medication (Each Contract Year) 醫生處方西藥 ( 每合約年度計 ) Medically Necessary Western Medication prescribed by a Registered Medical Practitioner and obtained at a legitimate source 經由註冊西醫處方並由合法來源取得之醫療必需西藥費用 9 Diagnostic Imaging and Laboratory Tests (Each Contract Year) 診斷影像及化驗 ( 每合約年度計 ) Subject to written referral e from a Registered Medical Practitioner 須獲註冊西醫書面轉介 e 每次 380 each visit 每次 380 each visit 每次 200 each visit 每次 200 each visit Number of visits per Contract Year for items F1 F7 above is 30 in total and is subject to a maximum of one visit per item per day. Number of visits per Contract Year for items F6 - F7 above is 10 in total. 每一合約年度內有關上文 F1 至 F7 項之診治次數合共為 30 次, 每一項目並以每日一次診治為限 每一合約年度內有關上文 F6 至 F7 項之診治次數合共為 10 次 G Maternity Benefit (Optional) 產科保障 ( 自選保障 ) 2,100 1,850 Ward 大房 Normal Delivery (Per pregnancy) 順產 ( 每次懷孕計 ) 17,800 Caesarean Section (Per pregnancy) 剖腹生產 ( 每次懷孕計 ) 26,700 Miscarriage (Per pregnancy) 流產 ( 每次懷孕計 ) 8,900 The Maternity Benefit shall cover medical expenses incurred during pregnancy, including Hospital Confinement, consultation of a Registered Medical Practitioner and Prescribed Western Medication, diagnostic tests, prenatal check-up and postnatal check-up, as well as nursery care of newborn baby. This Benefit does not cover any medical expenses incurred by the newborn baby during Hospital Confinement. This Benefit is payable provided that the pregnancy commences after this Benefit takes effect and you have been continuously covered under this Benefit for 9 months or more. 產科保障將支付因懷孕引致之醫療費用, 包括住院 註冊西醫診症及醫生處方西藥 診斷化驗 產前檢查及產後檢查, 以及初生嬰兒護理費用 此保障不包括任何初生嬰兒在住院期間之醫療費用 您必須於此保障生效後懷孕, 並連續受保於此保障 9 個月或以上, 方可獲得賠償 3 MP168/6/1116/22K Printed on recycled paper 以再造紙印刷

4 Bupa Together Health Insurance Scheme 保柏互通保額醫療保障計劃 Schedule of Benefits 保障金額表 Effective from 1 January 2017 自 2017 年 1 月 1 日起生效 Notes 附註 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 mean Medically Necessary surgical procedures which 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. About Full Cover Benefit Please follow the requirements below to enjoy Full Cover Benefit: (i) You will need to choose a Bupa HealthCare Appointed Specialist and designated clinic for consultation. Always present your doctor s referral letter (except for gynaecology, paediatrics and family medicine) and your Bupa HealthCare (BHC) Card upon registration. (ii) Pre-authorisation confirmation must be obtained from Bupa for the following situations: - Hospital Confinement or Day Case Surgery - Clinical Operation(s) exceeding HK$4,000 - Specialist treatment for which the relevant specialty is not practised by any Bupa HealthCare Appointed Specialist. (iii) If you have received treatment outside our office hours, please obtain authorisation from Bupa on the next working day. (iv) Your treatment at any Bupa HealthCare Appointed Service Providers must be referred and attended by the Bupa HealthCare Appointed Specialist. (v) Please present your BHC Card with Bupa s Pre-authorisation Confirmation / Guarantee of Payment letter to the Bupa HealthCare Appointed Hospital upon admission and use it to pay the medical expenses. (vi) You must be confined at the restricted room level. Hospital Confinement to any class of room other than the ward level of a Bupa HealthCare Appointed Hospital shall be subject to the Maximum Limit of Standard Benefit. If the above requirements are not followed, your claims, if eligible, will be paid under Standard Benefit. Your BHC Card can be used to settle payment for Hospital Confinement or Clinical Operation(s) at the Bupa HealthCare Appointed Hospitals and Specialists clinics, subject to a credit limit approved by Bupa. If you receive treatment at the day-case centre of an appointed Hospital, there is no need to show your BHC Card. Please settle your expenses with the Hospital and submit your claim to us. Please settle your out-patient expenses at the Bupa HealthCare Appointed Specialist s clinic, unless Hospital Confinement, Day Case Surgery or Clinical Operation is Medically Necessary and pre-authorisation, if required, is obtained during the same clinic visit. e 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. r About In-patient Specialist s Fees Benefit A referral letter is not required for services performed by pathologist, radiologist and Physiotherapist during Hospital Confinement. t Maximum Annual Benefit Pool Maximum Annual Benefit Pool means the maximum amount of Benefits which the Member(s) under the Contract is/are entitled to receive in aggregate during a Contract Year as shown on the Membership Certificate pursuant to Hospital and Surgical Benefit and Free Double Benefit for Serious Illnesses. y Free Double Benefit for Serious Illnesses Please refer to the Contract for the definitions of the designated Serious Illnesses. u Free Bupa Wellness Programme For details of check-up items, please refer to the redemption letter which will be sent to you after renewal confirmation. i About Supplementary Major Medical (SMM) Benefit This Benefit is subject to the Maximum Limit per Contract Year or the Lifetime Limit (if applicable), whichever is lower. The SMM Benefit, which is paid from age 65 will be deducted from the Lifetime Limit and the balance will become the Lifetime Limit of the next Contract Year. After the Lifetime Limit is exhausted, this Benefit shall automatically terminate. This Benefit will not be payable for Hospital Confinement in the suite, VIP or deluxe room of a Hospital. 有關 住院及手術保障 合資格之診所手術或日症手術, 將於 住院及手術保障 下賠償 診所手術及日症手術指註冊西醫於診所或醫院日症房進行之醫療必需手術而無必要留院, 但該等手術須獲保柏分類為診所手術或日症手術 w 有關 全數賠償保障 要享有 全數賠償保障 的賠償, 請依循以下的規定 : (i) 您必須於保柏康健特選專科醫生及指定的診所求診, 請於登記時出示您的醫生轉介信 ( 婦科 兒科及家庭醫學科除外 ) 及 保柏康健卡 (ii) 在以下的情況, 必須獲得保柏初步保障審核確認 : - 住院或日症手術 - 超過港幣 4,000 元的診所手術 - 專科治療而該專科並不屬於保柏康健特選專科醫生可提供之專科 (iii) 如您於保柏辦公時間外接受治療, 請於下一個工作日向保柏補辦審核 (iv) 於保柏康健特選服務供應商接受的治療, 必須經由保柏康健特選專科醫生轉介 進行及提供 (v) 請於入住保柏康健特選醫院時, 向醫院出示 保柏康健卡 及保柏的 初步保障審核確認 / 付款保證信, 並以此卡繳付醫療費用 (vi) 您必須入住原有保障級別的病房 如您在住院時入住保柏康健特選醫院任何大房級別以外之任何等級的房間, 賠償以 標準保障 之最高賠償額為限 如沒有依循以上規定, 合資格的醫療費用將於 標準保障 下作出賠償 您可使用 保柏康健卡 支付保柏康健特選醫院及專科醫生收取之住院及診所手術費用, 以保柏批核之信用額為限 如於保柏康健特選醫院之日症中心接受治療, 無須出示 保柏康健卡 請先向醫院支付醫療費用, 然後再向保柏申請索償 請向保柏康健特選專科醫生之診所繳付您的門診費用, 如住院 日症手術或診所手術為醫療必需及於該次診症同時申請初步保障審核則除外 e 轉介信 會員可在轉介信發出日起計 6 個月內, 就相同或相關病症使用該轉介信 若須診治全新或不相關的病症, 則須提交新的轉介信 r 有關 住院專科醫生費保障 由病理學家 放射學家及物理治療師在住院期間所提供之服務, 無須提交轉介信 t 每年最高通用賠償額 每年最高通用賠償額 即合約內所有會員每合約年度在 住院及手術保障 及 免費嚴重疾病雙倍保障 下可享有的每合約年度最高賠償總額, 此賠償額載於會員證書上 y 免費嚴重疾病雙倍保障 有關指定之嚴重疾病定義, 請參閱合約 u 免費保柏保健計劃 有關檢查項目詳情, 請參考會籍確認後寄給您的換領信 i 有關 附加醫療保障 此保障的賠償以每合約年度 最高賠償額 或 終生最高賠償額 ( 如適用 ) 之較低者為上限 65 歲起支付的 附加醫療保障 將自 終生最高賠償額 中扣減, 餘額將成為下一合約年度的 終生最高賠償額 此保障將於 終生最高賠償額 耗盡後自動終止 此保障並不會就入住總統套房 / 貴賓房 / 豪華房的住院費用作出賠償 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. 中 英文之意思如有任何差別, 概以英文為準 所有條款及細則以合約為準 Bupa (Asia) Limited 保柏 ( 亞洲 ) 有限公司 Address: 18/F, Berkshire House, 25 Westlands Road, Quarry Bay, Hong Kong 地址 : 香港 魚涌華蘭路 25 號克大廈 18 樓 Telephone 電話 : (852) Facsimile 傳真 : (852) Website 網址 : Bupa Hong Kong 4 MP168/6/1116/22K Printed on recycled paper 以再造紙印刷

5 Bupa Together 保柏互通保額 Comprehensive care for every life stage 全面保障照顧人生每階段

6 Introduction to Bupa Together 保柏互通保額醫療保障計劃簡介 No matter which stage of life you are in, Bupa Together adapts its cover to give you and your loved ones the best care of health as well as lifelong discounts. If you enrol with your family, each of you can share a combined annual benefit pool of up to HK$1 million. What s more, all of you will enjoy free wellness services that are tailored to your needs, making sure that your health is truly well taken care of. 無論您在人生那個階段, 保柏互通保額 計劃的彈性設計均能全面保障您和家人的健康, 而且給您終生的保費折扣 如與家人投保, 各自的賠償額可合併互相通用, 每人可享高達港幣 100 萬的全年保障額 保障以外, 更可享有免費的全方位保健服務, 無論是身體健康 家庭健康或個人健康生活管理, 均照顧周到 4

7 Best deal ever Lifetime subscription discount for everyone. 每人都可享終生保費折扣, 實在超值 Overview of your cover 您的保障概要 Cover at a glance 保障一覽表 Basic benefit 基本保障 Free benefits 免費保障 Optional benefits 自選保障 Medical card 醫療卡 Benefit level 保障等級 Hospital and Surgical Benefit (Including Full Cover Benefit and Standard Benefit) 住院及手術保障 ( 包括全數賠償保障及標準保障 ) Free Double Benefit for Serious Illnesses 免費嚴重疾病雙倍保障 Free Bupa Wellness Programme 免費保柏保健計劃 Free Bupa Worldwide Assistance Programme 免費保柏國際援助計劃 Supplementary Major Medical Benefit 附加醫療保障 Clinical Benefit 門診保障 Maternity Benefit 產科保障 Yes (For all members) 有 ( 適用於所有會員 ) Ward 大房 Eligibility 投保資格 Eligible members and issue age 會員及投保年齡 Renewal 續保 Subscriber: 18 years or above 投保人 :18 歲或以上 Subscriber s children: 15 days or above 投保人之子女 : 出生 15 天或以上 Subscriber s spouse, parents, parents-in-law: 16 years or above 投保人之配偶 父母 配偶之父母 : 16 歲或以上 Guaranteed lifetime renewal regardless of claims 無論索償多少, 終生保證續保 Discounts 折扣優惠 Lifetime discount 終生折扣 Child discount (For members below the age of 18) 子女折扣 ( 適用於 18 歲以下子女 ) No claim renewal discount 無索償續保折扣 1 member: 5% 1 名會員 :95 折 2 members: 10% 2 名會員 :9 折 3 or more members: 15% 3 名會員或以上 :85 折 Enrolled with one parent: 25% Enrolled with both parents: 50% 父或母與子女一同投保 :75 折父母與子女一同投保 :5 折 No claims for: 連續無索償 : 2 or 3 consecutive years: 5% 2 年或 3 年 :95 折 4 or 5 consecutive years: 10% 4 年或 5 年 :9 折 6 consecutive years or more: 15% 6 年或以上 :85 折 Please refer to the Schedule of Benefits for more information. 詳情請參閱保障金額表 All discounts are only applicable to Bupa Together s Hospital and Surgical Benefit for contracts that come into effect from 1 January Children below the age of 18 are entitled to either lifetime discount or child discount, whichever is higher. For the original subscription of this scheme, please call our Health Insurance Consultants or use the online quotation engine on Bupa s website. 所有折扣優惠只適用於 保柏互通保額 醫療保障計劃之 住院及手術保障 及於 2017 年 1 月 1 日或之後生效的合約 18 歲以下的子女可享終生折扣或子女折扣, 以較高折扣者為準 有關計劃之原保費, 請聯絡我們的醫療保險顧問或透過保柏網站的網上報價器查詢 1

8 Multiplied cover for you and your family 與家人同享倍增保障 Full Cover Benefit for your peace of mind Our Full Cover Benefit removes the restriction of individual item limits and offers 100% reimbursement for hospital expenses up to the Maximum Annual Benefit Pool. Simply select an attending doctor from our Bupa HealthCare appointed specialists and clinics and use our medical card to receive quality treatment at one of the eight renowned private hospitals in Hong Kong without any payment or claims. Share a benefit pool of up to HK$1 million with your family When you enrol with your family members, each of you will share a combined benefit pool of up to HK$1 million. This generous and flexible benefit maximises reimbursement for those who need the cover most, especially if your family has elderly members or young children who tend to be more susceptible to illnesses. What s more, you will enjoy higher subscription discounts when enrolling with more family members. Maximum Annual Benefit Pool (HK$)(per contract): 1 member $250,000 2 members $500,000 3 members $750,000 4 members or above $1,000,000 The maximum annual benefit for member aged 65 or above is subject to the available Maximum Annual Benefit Pool or HK$500,000 whichever is lower. Free Double Benefit for Serious Illnesses If a member is diagnosed with the following conditions, we will immediately double the benefit limit for hospital expenses e such as surgeries, ICU and miscellaneous services under the Standard Benefit to help the member afford better and more advanced treatment during these crucial times. Cancer Coronary artery disease requiring angioplasty or bypass graft surgery End-stage liver disease Kidney failure Tuberculosis Top-up benefit to boost your cover Advanced treatment is usually available at a much higher cost. To enhance your protection, you can opt for the Supplementary Major Medical Benefit, which provides you with extra cover of HK$130,000 every year. This benefit will cover 80% of expenses that exceed your Hospital and Surgical Benefit. Members who opt for the Supplementary Major Medical Benefit can make use of our medical card for cashless treatment at all private hospitals in Hong Kong. Maximum Annual Benefit Pool refers to the total maximum benefits for Hospital and Surgical Benefit and Free Double Benefit for Serious Illnesses available to the member(s) in the same contract during a contract year. Please refer to the Question Time section for more details. e Your expenses will be reimbursed under the Standard Benefit whenever you receive treatment from non-bupa HealthCare Appointed Service Providers. The Free Double Benefit for Serious Illnesses applies to items 1-10 of the Standard Benefit as stated in Bupa Together s Schedule of Benefits. Please refer to your contract for the definition of the designated serious illnesses. 2

9 Enjoy great value with multiplied benefits shared among you and your family. 家人保額可相通, 保障更高更超值 全數賠償保障有病不怕 使用 全數賠償保障, 您的賠償額不受細項上限所限制, 在 每年最高通用賠償額 內之住院開支均可獲全數賠償 只要您選擇保柏康健特選專科醫生及診所求診, 便可憑醫療卡 w 於 8 間本港著名的特選私家醫院接受優質治療, 而不用繳費及索償 家人可通用高達港幣 100 萬賠償額凡與家人一起投保, 您們的 每年最高通用賠償額 便可合併並互相通用高達港幣 100 萬, 尤其年長父母或年幼子女可能患病與索償機會較大, 靈活而充裕的保障額讓最有需要的家人獲得最大保障 同時, 越多家人投保, 保費折扣越高 每年最高通用賠償額 ( 港幣 ) ( 每合約計 ): 1 名會員 $250,000 2 名會員 $500,000 3 名會員 $750,000 4 名會員或以上 $1,000, 歲或以上會員之每年最高賠償額按可享用的 每年最高通用賠償額 或港幣 500,000 元為限, 以較低者為準 罹患危疾可獲免費嚴重疾病雙倍賠償如會員被診斷患上以下任何一項病症, 我們將會把 標準保障 下如手術 深切治療及雜費等住院項目的賠償額倍增 e, 在這關鍵時刻送上最實際的支援, 讓會員接受更佳更先進的治療 癌症 冠心病 ( 須接受俗稱 通波仔 的冠狀血管成形術或搭橋手術 ) 末期肝病 腎衰竭 結核病 附加醫療保障給您額外保障先進科技造就嶄新治療, 但費用亦更高昂 將 附加醫療保障 加入基本計劃, 您便可獲每年港幣 130,000 元的額外保障額, 當您的醫療費用超出 住院及手術保障 的賠償額時, 附加醫療保障 便會賠償差額的 8 成 投保了 附加醫療保障 的會員, 可於全港私家醫院使用醫療卡, 免繳費免索償 每年最高通用賠償額 即合約內所有會員於 住院及手術保障 及 免費嚴重疾病雙倍保障 下可享有的每年最高賠償總額 詳情請參閱常見問題部分 e 凡向非保柏康健特選服務供應商求診, 會按 標準保障 賠償 免費嚴重疾病雙倍保障 適用於 保柏互通保額 計劃保障金額表上 標準保障 的 1 至 10 項 有關指定的嚴重疾病定義, 請參閱您的合約 3

10 Access comprehensive care for free 全面免費保健服務 Stay in good shape with our free annual wellness services As your healthcare partner, we do not just take care of your medical expenses but also look after your health comprehensively. Under our Free Bupa Wellness Programme, you can choose one of the services in the adjacent table to cater to your personal needs each contract year, starting from the second year of membership. 每年任選免費保健服務達致健與美作為您的健康夥伴, 我們不單支付您的醫療費用, 亦助您保持健康 由第二個合約年度開始, 每位會員可因應個人需要, 從右方之 免費保柏保健計劃, 自選其中一項服務 Free Bupa Wellness Programme 免費保柏保健計劃 Healthy body 身體健康 Optical Check 眼科檢查 Dental Service 洗牙服務 Hepatitis Screening 肝炎測試 Hepatitis A or B Vaccine 甲型或乙型肝炎預防疫苗 General Health Assessment 普通全身檢查 Well Man Health Assessment 男性專科檢查 Well Woman Health Assessment 女性專科檢查 Healthy family 家庭健康 Look good and feel good with our Free Bupa Wellness Programme. 每年免費保健服務, 助您時刻保持健與美 Pre-marital / Pre-pregnancy Check-up 婚前 / 懷孕前檢查 Healthy lifestyle 健康生活 Fitness Management Programme 體適能管理計劃 Healthy Eating Programme 健康飲食計劃 4

11 Claims service pledge No claims procedure is required if you use the Bupa medical card. All other hospitalisation and consultation claims will be settled within 5 7 working days after full documentation is received. 賠償服務承諾如您使用保柏醫療卡, 無需索償手續 其他住院及門診賠償, 於收妥所需文件後 5 7 個工作天內支付 Support throughout your life 每個人生階段守護在旁 Guaranteed lifetime renewal We guarantee that your cover can be renewed for life. And your subscription will be based on your age only no matter how much you claim on conditions arising after your membership starts. Get prepared for your newborn baby with Maternity Benefit To take care of mums-to-be, our optional Maternity Benefit covers medical expenses including obstetrician fees, hospitalisation charges, prenatal and postnatal check-ups for normal delivery, caesarean section and miscarriage, as well as nursery care for your newborn baby. You will receive reimbursement after your maternity cover takes effect for nine months or more. 保證終生續保我們保證終生續保您的保障, 無論您因會籍開始後所患疾病索償多少, 保費只會根據您的年齡而調整 產科保障為迎接新生命作好準備為照顧準媽媽, 我們提供自選的 產科保障, 賠償懷孕時的醫療費用, 包括順產 剖腹生產或流產的產科醫生費用 住院費用 產前及產後檢查費用, 以及初生嬰兒的護理費用 您將會在產科保障生效起 9 個月後開始獲得賠償 投保簡易無須驗身, 快捷簡單 Easy enrolment No medical examinations are required. Bupa reserves the right to amend the subscription, benefits, terms and conditions upon your contract renewal. Bupa guarantees that your cover can be renewed for life, unless you change your residency to the US after subscribing to this scheme. This is a restriction imposed by the US legislation where any offshore insurance company cannot provide health cover to US residents. 保柏保留在續保時更改保費 保障 條款及細則的權利 保柏保證終生續保您的保障, 除非您於投保後居住國家更改為美國, 這是美國法例的規定, 任何美國境外的保險公司均不能為美國居民提供醫療保障 5

12 The World of Bupa 環球保柏 Bupa Group Established in the UK in 1947, Bupa is a leading international healthcare group serving over 32 million customers in more than 190 countries. We are the largest health insurer in the UK. Our diversified healthcare services include health insurance, hospitals, primary care and diagnostic centres, dental centres, workplace health services, home healthcare, health assessments, chronic disease management services, nursing and residential care for elderly people. With no shareholders, we invest our profits to provide more and better healthcare and fulfill our purpose. We employ almost 84,000 people, principally in the UK, Australia, Spain, Poland, New Zealand and Chile, as well as Saudi Arabia, Hong Kong, India, Thailand, and the USA. 保柏集團保柏於 1947 年在英國成立, 至今已成為領先於同業的國際醫療保健集團, 在全球 190 多個國家為 3,200 萬名客戶服務 保柏是英國最大的醫療保險集團 我們提供多元化的醫療保健服務, 包括醫療保險 醫院服務, 基層醫護及診斷中心 牙科護理中心 職場健康 家居醫療護理 健康評估 慢性疾病管理服務 看護服務及長者家居護理服務 我們不設股東, 因此可將所有盈餘投資於業務當中, 以提供更廣及更佳的醫療保健服務, 實踐我們的目標 保柏擁有約 84,000 名員工, 主要市場包括英國 澳洲 西班牙 波蘭 新西蘭和智利, 以及沙特阿拉伯 香港 印度 泰國和美國 Bupa s purpose is helping people live longer, healthier, happier lives. 保柏的目標是助人活出更長壽 更健康和更愉快的人生 Bupa s presence in Hong Kong Bupa is a leading provider in healthcare funding and provision with two independent units, Bupa Hong Kong and Quality HealthCare. Bupa Hong Kong Bupa Hong Kong has been a health insurance specialist since Our expertise in healthcare has gained the trust of more than 400,000 individuals, 3,200 companies and the Hong Kong Government, who for 20 consecutive years has recommended Bupa as the provider of quality health insurance for civil servants. 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 in October 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 500 affiliated clinics offering Western Medicine, Traditional Chinese Medicine, Diagnostics & Imaging, Dental, Physiotherapy services, etc. It also operates a private nursing agency. QHMS is the largest provider of healthcare services to corporates in Hong Kong. In 2015, the Group recorded more than 2.8 million healthcare visits. QHMS continues to extend its existing portfolio into high end specialty services. For more information, please visit www. qhms.com. 保柏於香港的業務 保柏透過旗下兩間獨立營運的公司 保柏香港及卓健醫療, 為市民提供醫療保險及醫療保健服務, 兩者皆具領導地位 保柏香港保柏香港自 1976 年成立, 為本港首間及唯一專注醫療保險的公司 植根香港逾 40 載, 我們的專業醫療保險服務為超過 40 萬名會員及 3,200 間公司所信賴 我們更連續 20 年獲香港政府推薦, 為本港公務員提供醫療保險 憑藉專業知識, 我們為會員提供全面而靈活的醫療保險計劃, 切合您人生每一階段的需要 透過擁有龐大本港醫療網絡, 我們讓會員有更多醫生選擇 卓健醫療卓健醫療服務有限公司 ( 卓健醫療 ) 於 2013 年 10 月正式加入保柏 卓健醫療的服務涵蓋診斷 基層保健及專科服務 自 1868 年起植根香港, 卓健醫療透過約 100 間多項專科設施齊備的醫療中心及 500 多間聯營診所, 為香港市民及訪港旅客提供西醫 中醫 放射診斷 牙科及物理治療等服務 卓健醫療並營運護理介紹所, 是為香港最大規模為企業提供醫療服務的機構 於 2015 年度, 卓健醫療錄得超過 280 萬求診人次, 並繼續拓展其服務版圖至高質專科服務 詳情請瀏覽 6

13 Health Coaching Services 健康支援服務 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. 保柏時刻伴您左右, 讓您安枕無憂 除支付您的醫療費用外, 保柏在您患病時給您貼身支援, 減輕您的憂慮 Assisting you at all times 時刻為您提供協助 Our 24/7 Customer Care helpdesk operates 24 hours every day, with a live person to directly answer your queries. Our 24/7 Healthline is staffed with a team of qualified nurses and healthcare professionals, supported by doctors, providing assistance and guidance from how to care for a sick child or elderly to discussing your symptoms, diagnosis and treatment options. 我們的 24 小時客戶服務專線由專人每天 24 小時, 即時解答您的查詢 我們的 24 小時健康專線由合資格護士及健康管理團隊為您提供協助及指導, 例如怎樣照顧患病小孩或長者, 以至助您了解病徵 診斷及治療方案, 背後更有醫生作為顧問 Supporting you personally 給您個人支援服務 A dedicated Care Manager can be in touch with you to follow up on your claims, and can make a courtesy call or visit, with your consent, when you are admitted into a local private hospital in the event of cancer or heart disease. 個人健康顧問可與您緊密聯絡, 跟進您的索償 ; 如因患上癌症或心臟病入住本港私家醫院時, 在得到您的同意下, 我們可前往醫院探望您或致電慰問您 The use of Health Coaching Services is free of charge. If the services suggested by us are not covered under your Bupa Together Health Insurance Scheme, you will be responsible for the fees incurred. 使用健康支援服務並不需額外費用 若我們建議的服務不在您的 保柏互通保額 醫療保障計劃之賠償範圍內, 您便須支付有關費用 Doctors will be available during scheduled office hours to support the nurses for answering enquiries. Office hours: Mon Fri, from 9am to 7pm (Hong Kong time), except public holidays. 醫生會於辦公時間內支援護士解答問題 辦公時間為星期一至五, 上午 9 時至下午 7 時 ( 香港時間 ), 公眾假期除外 7

14 Question Time 常見問題 1 Is there any minimum length of hospital stay? There is no minimum length of stay, meaning that procedures such as endoscopy, a plaster cast, wound sutures, radiotherapy and chemotherapy, which do not require hospital confinement, are covered. 2 How do I use my Bupa medical card to get the most from my Full Cover Benefit? You will need to visit a specialist and clinic appointed by Bupa and present your medical card upon registration. The specialist will then get pre-authorisation of the medical expenses for you if hospital confinement is required. You can choose from one of the Bupa HealthCare Appointed Hospitals where your specialist is registered. Once the pre-authorisation is confirmed, we will issue you with a Pre-authorisation Confirmation / Guarantee of Payment Letter for your hospital confinement. You will need to show your medical card and this letter to your selected hospital to enjoy cashless treatment. Upon discharge, all you need to do is sign on the claim form provided by the hospital. You are not required to submit any claims as Bupa will directly settle your expenses with the hospital. You can also use the medical card to settle the expenses for medical procedures taken at the appointed specialist s designated clinic. If the expenses are under HK$4,000, pre-authorisation is not required. For emergency hospital confinement outside our office hours, the pre-authorisation can be arranged on the next working day. Step-by-step details will be provided in your Membership Guide. 3 How do I use my Bupa medical card to make use of the Supplementary Major Medical Benefit? Call us and submit a registration form before you are admitted to hospital. We will then give you a Pre-authorisation Confirmation / Guarantee of Payment Letter. For emergency hospital confinement outside our office hours, the registration can be submitted on the next working day. 1 是否設有最低住院時數? 此計劃沒有最低住院時數限制, 因此無須住院的常見治療如照胃鏡 打石膏 傷口縫合 電療 化療等, 均可獲賠償 2 如何以保柏醫療卡盡享 全數賠償保障 賠償? 您須向保柏特選的專科醫生及診所求診, 並於登記時出示您的醫療卡 如須入院治療, 專科醫生會代您向保柏為有關的醫療費用索取初步保障審核 您可選擇入住專科醫生已掛單的保柏康健特選私家醫院 當初步保障審核確認後, 您將會獲發 初步保障審核確認 / 付款保證信 以作入院之用 入院時, 請向醫院出示您的醫療卡及此信以享住院免繳費服務 出院時您只須於醫院為您填妥的住院賠償申請表上簽署, 保柏便會代您向醫院繳付費用, 您無須申請索償 您亦可使用您的醫療卡支付由特選專科醫生於指定的診所提供的手術治療 如費用不超過港幣 4,000 元, 您便無須索取初步保障審核 如在辦公時間外入院進行緊急治療, 您可於下一個工作天補辦審核 您可於您的 會員指引 中細閱有關詳情 3 如我有 附加醫療保障, 我應如何使用我的保柏醫療卡? 您只須於入院前致電保柏, 並填妥登記表格, 您將獲發 初步保障審核確認 / 付款保證信 如在我們的辦公時間外入院進行緊急治療, 您可於下一個工作天補辦登記 4 當我的家庭狀況轉變, 如何加減合約內的家庭成員? 當您結婚或新生命出生時, 只須於 3 個月內遞交申請及有關證明文件便可將配偶或子女加入計劃內 新會員的保障將會於申請後下一個月生效, 您亦可於每年續保時加減家庭成員 5 如我自己曾經索償, 會否影響家人的無索償續保折扣? 不會 每位會員的無索償續保折扣均獨立計算, 即使其中一名成員曾經索償, 其他無索償之會員仍可享有折扣 4 How can I add or take away members from my contract when my family situation changes? When you get married or have a newborn baby, you can easily add your spouse or child to the same Bupa Together contract. Simply submit the enrolment application and supporting documents to Bupa within three months of your wedding date or child s date of birth. The new member s cover will take effect on the first day of the following month upon application. You can also apply to add or take away family members from your contract at each yearly renewal. 5 Will my individual claim affect the no claim renewal discount for my family members under the same contract? No, the no claim renewal discount is calculated independently for each member so if you have made a claim, it will not affect the discount for your family members under the same contract. Applications are subject to underwriting and approval by Bupa. 申請須經保柏核保及批准 8

15 General Exclusions 不受保障項目 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). 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 such treatment has been approved by Bupa). Congenital conditions, developmental conditions or hereditary conditions. Treatment that commenced during the first five years of the member s coverage commencement date of this 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 (unless benefit is available); 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, selfinflicted 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. 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. If you have any pre-existing medical conditions, special exclusions may be added after underwriting. 我們想讓您在投保前清楚了解保障範圍, 因此列出所有不受保障項目如下 : 已存在病症 ( 已於申請表披露並於登記加入時獲保柏接納為承保範圍內則除外 ) 不是醫療必需的治療 醫療服務 藥物或檢驗 任何在法例下或其他保險計劃內或從其他途徑可獲賠償之治療疾病或損傷費用, 除非此等費用未能在該等補償 保險計劃或途徑獲得賠償 在水療中心 天然治療中心 康復院 療養院 老人院或類似機構所提供之住宿 護理或服務的費用 手術性或非手術性整容或整形治療 聽覺測驗 常規驗血 例行檢驗 預防注射或接種疫苗 毛髮礦物質含量分析 健康補品或體重控制, 及因視力不正常而引致之治療, 包括但不限於常規視力測驗或所需之眼鏡或鏡片費用 ( 經保柏批准則除外 ) 先天性疾病 發育異常或遺傳性疾病 由保障開始日起首 5 年內, 因感染人體免疫力缺損病毒所引致的治療 性病及其後遺症 與懷孕有關的治療, 包括診斷性產科檢查 生育 墮胎或小產 ( 計劃內已包括之保障除外 ); 與男女任何一方的節育或絕育有關的治療 ; 由於不育而直接或間接進行的治療, 包括體外受孕, 任何非自然受孕或人工受孕 ; 與性機能失常有關之治療, 包括但不限於陽萎 不舉 早泄 ( 不論任何原因導致 ) 誤用或服用過量藥物或受酒精影響 蓄意自傷身體或意圖自殺而直接或間接引致的治療 任何因參與犯罪活動而引致之疾病或損傷 另類治療, 包括但不限於中藥治療 針灸 穴位按摩 推拿 催眠治療 羅爾夫按摩療法 按摩治療 香薰治療 ( 計劃內已包括之保障除外 ) 老年性痴呆 ( 包括亞爾茲海默氏病 ) 帕金森氏病 心理病或精神病症, 包括但不限於精神病 神經機能病 抑鬱 焦慮 神經性厭食 精神分裂 行為失常 譫妄症 失眠 神經衰弱等直接或間接引致的治療 購買或使用輔助器具, 包括但不限於眼鏡 助聽器及其他設備例如輪椅 枴杖的費用 任何與牙齒或牙肉疾病有關的治療或檢查 ( 計劃內已包括之保障除外 ), 因意外引致緊急入院治療或住院脫除阻生智慧齒則除外 但不包括該住院後之跟進治療 因戰爭 入侵 外敵行動 開戰 ( 不論是否已宣戰 ) 內戰 暴動 革命 叛亂或軍人奪權 恐怖活動等直接或間接引致的治療 非醫療性服務, 包括但不限於客人膳食 收音機 電話 影印 稅項 ( 就醫療服務所徵收的增值稅或商品及服務稅除外 ) 醫療報告等費用 所有未經保柏批准之實驗性及 / 或最新治療 如您有任何已存在病症, 核保後可能加入除外條款 9

16 Bupa (Asia) Limited 保柏 ( 亞洲 ) 有限公司 18/F, Berkshire House 25 Westlands Road, Quarry Bay, Hong Kong 香港鰂魚涌華蘭路 25 號克大廈 18 樓 Telephone 電話 :(852) Facsimile 傳真 :(852) MP171/5/1116/8K Printed on recycled paper 以再造紙印刷 Care homes Cash plans Dental insurance Health analytics Health assessments Health at work services Health centres Health coaching Health information Health insurance Home healthcare Hospitals International health insurance Personal medical alarms Retirement villages Travel insurance Bupa Hong Kong