← Back to ''TopCare'' Medical Insurance Plan - Benefit Level series

VHIS Flexi · F00037-01-000-03

''TopCare'' Medical Insurance Plan - Benefit Level 1 with SMM (HKD)

「摯康保」醫療保障計劃 - 保障級別 1+超額醫療保障 (港元)

Chow Tai Fook Life Insurance Co Ltd

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Your premium

HK$5,195 /yr

age

Ward class

Ward

Coverage region

Worldwide

Deductible

—

Annual benefit limit

—

Per-illness annual limit

—

Lifetime benefit limit

—

SMM Supplemental Major Medical

HK$100,000

Benefits

Full benefit schedule · grouped by basic / extra / cash / event

Benefit Item	Limit
Basic Benefits
(a) Room and board (a) 病房及膳食	$1,200 per day, maximum 180 days per Policy Year
(b) Miscellaneous charges (b) 雜項開支	$16,000 per Policy Year
(c) Attending doctor's visit fee (c) 主診醫生巡房費	$950 per day, maximum 180 days per Policy Year
(d) Specialist's fee (d) 專科醫生費	$6,000 per Policy Year
(e) Intensive care (e) 深切治療	$6,000 per day, maximum 90 days per Policy Year
Surgeon's fee — Minor 外科醫生費 — 小型	$5,000
Surgeon's fee — Intermediate 外科醫生費 — 中型	$12,500
Surgeon's fee — Major 外科醫生費 — 大型	$30,000
Surgeon's fee — Complex 外科醫生費 — 複雜	$70,000
(g) Anaesthetist's fee (g) 麻醉科醫生費	35% of Surgeon's fee payable
(h) Operating theatre charges (h) 手術室費	35% of Surgeon's fee payable
(i) Prescribed Diagnostic Imaging Tests (i) 訂明診斷成像檢測	$25,000 per Policy YearWhen performed during Confinement: subject to 30% CoinsuranceWhen performed in a facility providing day-patient medical services: subject to 20% Coinsurance
(j) Prescribed Non-surgical Cancer Treatments (j) 訂明非手術癌症治療	$120,000 per Policy Year
(k) Pre- and post-Confinement / Day Case Procedure outpatient care (k) 入院前或出院後／日間手術前後的門診護理	$800, per visit, $5,000 per Policy YearUp to 1 prior outpatient visit(s) or Emergency consultation(s) per Confinement/Day Case ProcedureUp to 6 follow-up outpatient visits per Confinement/Day Case Procedure within 90 days after discharge from Hospital or completion of Day Case Procedure
(l) Psychiatric treatments (l) 精神科治療	$50,000 per Policy Year
Room and board (i) 病房及膳食	$1,200 per day (Eligible Expenses under basic benefit (a) from the day of Confinement after the day-limit in each Policy Year × reimbursement ratio)
Miscellaneous charges (ii) 雜項開支	Eligible Expenses exceeding the benefit limit under basic benefit (b) Miscellaneous Charges × reimbursement rate
Attending doctor's visit fee (iii) 主診醫生巡房費	$950 per day (Eligible Expenses under basic benefit (c) from the day of Confinement after the day-limit in each Policy Year × reimbursement ratio)
Specialist's fee (iv) 專科醫生費	Eligible Expenses exceeding the benefit limit under basic benefit (d) Specialist's fee × reimbursement rate
Intensive care (v) 深切治療	$6,000 per day, payable starting from the 91st day of Confinement in a Policy Year for Eligible Expenses under basic benefit (e) Intensive care × reimbursement rate
Surgeon's fee (vi) 外科醫生費 (按手術表劃分的手術分類)	Eligible Expenses exceeding the benefit limit under basic benefit (f) Surgeon's fee × reimbursement rate
Anaesthetist's fee (vii) 麻醉科醫生費	Eligible Expenses exceeding the benefit limit under basic benefit (g) Anaesthetist's fee × reimbursement rate
Operating theatre charges (viii) 手術室費	Eligible Expenses exceeding the benefit limit under basic benefit (h) Operating theatre charges × reimbursement rate
Prescribed Diagnostic Imaging Tests (ix) 訂明診斷成像檢測	Eligible Expenses exceeding the benefit limit under basic benefit (i) Prescribed Diagnostic Imaging Tests × reimbursement rate
Extra Benefits
Isolation ward charges benefit 隔離病房	$1,200 per day, maximum 180 days per Policy Year
Hospital companion bed fee reimbursement 陪伴附加床位費	Full reimbursement of Eligible Expenses, maximum 180 days per Policy YearR&C
Daily post-surgery home nursing benefit 每日家居看護費	$800 per visit. Up to 1 per day within the post-discharge window after Confinement or Day Case Procedure. Maximum 30 visits per Policy Year.
Chinese Medicine Practitioner outpatient care 住院/門診中醫保障	1) Chinese medicine treatments and Chinese medicines administered during Confinement: subject to the same benefit limit listed under I) Basic Benefits (b) Miscellaneous charges in the Benefit Schedule 2) Attending Chinese medicine practitioner's visit fee during Confinement: subject to the same benefit limit listed under I) Basic Benefits (c) Attending doctor's visit fee in the Benefit Schedule 3) Chinese medicine treatments before and after discharge from Hospital or Day Case Procedure: $600, per visit, $2,000 per Policy Year. Up to 3 follow-up outpatient visits within 90 days after discharge from Hospital or completion of Day Case Procedure
Major Cancer supplementary benefit 主要癌症額外保障	$120,000 per Benefit Period (i.e. every 6 consecutive Policy Years)
Outpatient kidney dialysis 腎臟透析	$50,000 per Policy Year
Emergency outpatient treatment for Accident 急症門診治療(只限意外) — 急症門診	$10,000 per Policy Year, including Emergency dental treatment within 24 hours of the Accident
Emergency dental benefit (Accident only) 急症門診治療(只限意外) — 急症牙科治療	$10,000 per Policy Year, within 30 days of the Accident
Complications of pregnancy 妊娠期併發症	Eligible Expenses or actual charges paid for the covered pregnancy complications are subject to the benefit limits under benefit items (a) – (i), (k) of I) Basic Benefits and (a) – (d) of II) Additional Benefits
Hospice and palliative care benefit 善終服務	$30,000 per Policy Year
Organ transplant donor benefit 捐贈器官	$100,000 per Policy Year
Cash Benefits
Day surgery cash benefit 日間手術現金津貼	$800 per Day Case Procedure, 1 per Policy Year
Hospital transport cash allowance 住院交通現金津貼	Not applicable
Lower ward class cash benefit 住院現金津貼	Not applicable
Second-claim cash allowanceAfter other pays 特別現金津貼	5% of the amount reimbursed by other insurers, $3,000 per Policy Year
Post-donation health supplement cash allowance 器官捐贈後健康補品現金津貼	$20,000 per Policy Year
Event Benefits
Income-loss medical upgrade benefit 收入損失升級醫療保障	Coinsurance under Supplemental Major Medical Benefits is reduced to 0% (i.e. 100% reimbursement rate)
Compassionate death benefit 恩恤身故賠償	$20,000
Additional death benefit for organ donor 器官捐贈者額外身故津貼	$100,000
Medical accident and incident extension benefit 醫療疏忽事故保障	$100,000

Basic Benefits

(a) Room and board
(a) 病房及膳食
$1,200 per day, maximum 180 days per Policy Year
(b) Miscellaneous charges
(b) 雜項開支
$16,000 per Policy Year
(c) Attending doctor's visit fee
(c) 主診醫生巡房費
$950 per day, maximum 180 days per Policy Year
(d) Specialist's fee
(d) 專科醫生費
$6,000 per Policy Year
(e) Intensive care
(e) 深切治療
$6,000 per day, maximum 90 days per Policy Year
Surgeon's fee — Minor
外科醫生費 — 小型
$5,000
Surgeon's fee — Intermediate
外科醫生費 — 中型
$12,500
Surgeon's fee — Major
外科醫生費 — 大型
$30,000
Surgeon's fee — Complex
外科醫生費 — 複雜
$70,000
(g) Anaesthetist's fee
(g) 麻醉科醫生費
35% of Surgeon's fee payable
(h) Operating theatre charges
(h) 手術室費
35% of Surgeon's fee payable
(i) Prescribed Diagnostic Imaging Tests
(i) 訂明診斷成像檢測
$25,000 per Policy YearWhen performed during Confinement: subject to 30% CoinsuranceWhen performed in a facility providing day-patient medical services: subject to 20% Coinsurance
(j) Prescribed Non-surgical Cancer Treatments
(j) 訂明非手術癌症治療
$120,000 per Policy Year
(k) Pre- and post-Confinement / Day Case Procedure outpatient care
(k) 入院前或出院後／日間手術前後的門診護理
$800, per visit, $5,000 per Policy YearUp to 1 prior outpatient visit(s) or Emergency consultation(s) per Confinement/Day Case ProcedureUp to 6 follow-up outpatient visits per Confinement/Day Case Procedure within 90 days after discharge from Hospital or completion of Day Case Procedure
(l) Psychiatric treatments
(l) 精神科治療
$50,000 per Policy Year
Room and board
(i) 病房及膳食
$1,200 per day (Eligible Expenses under basic benefit (a) from the day of Confinement after the day-limit in each Policy Year × reimbursement ratio)
Miscellaneous charges
(ii) 雜項開支
Eligible Expenses exceeding the benefit limit under basic benefit (b) Miscellaneous Charges × reimbursement rate
Attending doctor's visit fee
(iii) 主診醫生巡房費
$950 per day (Eligible Expenses under basic benefit (c) from the day of Confinement after the day-limit in each Policy Year × reimbursement ratio)
Specialist's fee
(iv) 專科醫生費
Eligible Expenses exceeding the benefit limit under basic benefit (d) Specialist's fee × reimbursement rate
Intensive care
(v) 深切治療
$6,000 per day, payable starting from the 91st day of Confinement in a Policy Year for Eligible Expenses under basic benefit (e) Intensive care × reimbursement rate
Surgeon's fee
(vi) 外科醫生費 (按手術表劃分的手術分類)
Eligible Expenses exceeding the benefit limit under basic benefit (f) Surgeon's fee × reimbursement rate
Anaesthetist's fee
(vii) 麻醉科醫生費
Eligible Expenses exceeding the benefit limit under basic benefit (g) Anaesthetist's fee × reimbursement rate
Operating theatre charges
(viii) 手術室費
Eligible Expenses exceeding the benefit limit under basic benefit (h) Operating theatre charges × reimbursement rate
Prescribed Diagnostic Imaging Tests
(ix) 訂明診斷成像檢測
Eligible Expenses exceeding the benefit limit under basic benefit (i) Prescribed Diagnostic Imaging Tests × reimbursement rate

Extra Benefits

Isolation ward charges benefit
隔離病房
$1,200 per day, maximum 180 days per Policy Year
Hospital companion bed fee reimbursement
陪伴附加床位費
Full reimbursement of Eligible Expenses, maximum 180 days per Policy YearR&C
Daily post-surgery home nursing benefit
每日家居看護費
$800 per visit. Up to 1 per day within the post-discharge window after Confinement or Day Case Procedure. Maximum 30 visits per Policy Year.
Chinese Medicine Practitioner outpatient care
住院/門診中醫保障
1) Chinese medicine treatments and Chinese medicines administered during Confinement: subject to the same benefit limit listed under I) Basic Benefits (b) Miscellaneous charges in the Benefit Schedule 2) Attending Chinese medicine practitioner's visit fee during Confinement: subject to the same benefit limit listed under I) Basic Benefits (c) Attending doctor's visit fee in the Benefit Schedule 3) Chinese medicine treatments before and after discharge from Hospital or Day Case Procedure: $600, per visit, $2,000 per Policy Year. Up to 3 follow-up outpatient visits within 90 days after discharge from Hospital or completion of Day Case Procedure
Major Cancer supplementary benefit
主要癌症額外保障
$120,000 per Benefit Period (i.e. every 6 consecutive Policy Years)
Outpatient kidney dialysis
腎臟透析
$50,000 per Policy Year
Emergency outpatient treatment for Accident
急症門診治療(只限意外) — 急症門診
$10,000 per Policy Year, including Emergency dental treatment within 24 hours of the Accident
Emergency dental benefit (Accident only)
急症門診治療(只限意外) — 急症牙科治療
$10,000 per Policy Year, within 30 days of the Accident
Complications of pregnancy
妊娠期併發症
Eligible Expenses or actual charges paid for the covered pregnancy complications are subject to the benefit limits under benefit items (a) – (i), (k) of I) Basic Benefits and (a) – (d) of II) Additional Benefits
Hospice and palliative care benefit
善終服務
$30,000 per Policy Year
Organ transplant donor benefit
捐贈器官
$100,000 per Policy Year

Cash Benefits

Day surgery cash benefit
日間手術現金津貼
$800 per Day Case Procedure, 1 per Policy Year
Hospital transport cash allowance
住院交通現金津貼
Not applicable
Lower ward class cash benefit
住院現金津貼
Not applicable
Second-claim cash allowanceAfter other pays
特別現金津貼
5% of the amount reimbursed by other insurers, $3,000 per Policy Year
Post-donation health supplement cash allowance
器官捐贈後健康補品現金津貼
$20,000 per Policy Year

Event Benefits

Income-loss medical upgrade benefit
收入損失升級醫療保障
Coinsurance under Supplemental Major Medical Benefits is reduced to 0% (i.e. 100% reimbursement rate)
Compassionate death benefit
恩恤身故賠償
$20,000
Additional death benefit for organ donor
器官捐贈者額外身故津貼
$100,000
Medical accident and incident extension benefit
醫療疏忽事故保障
$100,000

Premium Schedule

Annual premium · Premium varies by gender (smoking-agnostic) · HKD

Age	Male	Female
0	HK$6,836	HK$5,219
1	HK$6,836	HK$5,219
2	HK$6,836	HK$5,219
3	HK$6,836	HK$5,219
4	HK$6,836	HK$5,219
5	HK$3,992	HK$4,194
6	HK$3,992	HK$4,194
7	HK$3,992	HK$4,194
8	HK$3,992	HK$4,194
9	HK$3,992	HK$4,194
10	HK$3,865	HK$3,707
11	HK$3,865	HK$3,686
12	HK$3,875	HK$3,690
13	HK$3,893	HK$3,721
14	HK$3,918	HK$3,775
15	HK$3,951	HK$3,857
16	HK$4,024	HK$3,996
17	HK$4,113	HK$4,174
18	HK$4,218	HK$4,388
19	HK$4,343	HK$4,638
20	HK$4,485	HK$4,924
21	HK$4,558	HK$5,119
22	HK$4,631	HK$5,314
23	HK$4,699	HK$5,507
24	HK$4,763	HK$5,702
25	HK$4,821	HK$5,894
26	HK$4,893	HK$6,120
27	HK$4,968	HK$6,358
28	HK$5,040	HK$6,610
29	HK$5,118	HK$6,869
30	HK$5,195	HK$7,138
31	HK$5,326	HK$7,429
32	HK$5,468	HK$7,718
33	HK$5,618	HK$8,011
34	HK$5,779	HK$8,306
35	HK$5,950	HK$8,604
36	HK$6,108	HK$8,901
37	HK$6,269	HK$9,204
38	HK$6,433	HK$9,504
39	HK$6,601	HK$9,808
40	HK$6,770	HK$10,117
41	HK$7,015	HK$10,401
42	HK$7,292	HK$10,686
43	HK$7,595	HK$10,969
44	HK$7,931	HK$11,248
45	HK$8,295	HK$11,529
46	HK$8,667	HK$11,787
47	HK$9,058	HK$12,036
48	HK$9,475	HK$12,279
49	HK$9,914	HK$12,512
50	HK$10,373	HK$12,738
51	HK$10,893	HK$13,061
52	HK$11,448	HK$13,406
53	HK$12,032	HK$13,775
54	HK$12,651	HK$14,167
55	HK$13,302	HK$14,580
56	HK$14,004	HK$14,955
57	HK$14,745	HK$15,332
58	HK$15,524	HK$15,712
59	HK$16,343	HK$16,092
60	HK$17,201	HK$16,476
61	HK$18,295	HK$17,315
62	HK$19,480	HK$18,298
63	HK$20,760	HK$19,418
64	HK$22,131	HK$20,685
65	HK$23,599	HK$22,095
66	HK$25,168	HK$23,533
67	HK$26,835	HK$25,082
68	HK$28,604	HK$26,739
69	HK$30,474	HK$28,506
70	HK$32,445	HK$30,385
71	HK$33,952	HK$31,790
72	HK$33,952	HK$31,790
73	HK$33,952	HK$31,790
74	HK$33,952	HK$31,790
75	HK$33,952	HK$31,790
76	HK$33,952	HK$31,790
77	HK$33,952	HK$31,790
78	HK$33,952	HK$31,790
79	HK$33,952	HK$31,790
80	HK$33,952	HK$31,790
81	HK$33,952	HK$31,790
82	HK$33,952	HK$31,790
83	HK$33,952	HK$31,790
84	HK$33,952	HK$31,790
85	HK$33,952	HK$31,790
86	HK$33,952	HK$31,790
87	HK$33,952	HK$31,790
88	HK$33,952	HK$31,790
89	HK$33,952	HK$31,790
90	HK$33,952	HK$31,790
91	HK$33,952	HK$31,790
92	HK$33,952	HK$31,790
93	HK$33,952	HK$31,790
94	HK$33,952	HK$31,790
95	HK$33,952	HK$31,790
96	HK$33,952	HK$31,790
97	HK$33,952	HK$31,790
98	HK$33,952	HK$31,790
99	HK$33,952	HK$31,790
100	HK$33,952	HK$31,790
101	HK$33,952	HK$31,790
102	HK$33,952	HK$31,790
103	HK$33,952	HK$31,790
104	HK$33,952	HK$31,790
105	HK$33,952	HK$31,790
106	HK$33,952	HK$31,790
107	HK$33,952	HK$31,790
108	HK$33,952	HK$31,790
109	HK$33,952	HK$31,790
110	HK$33,952	HK$31,790
111	HK$33,952	HK$31,790
112	HK$33,952	HK$31,790
113	HK$33,952	HK$31,790
114	HK$33,952	HK$31,790
115	HK$33,952	HK$31,790
116	HK$33,952	HK$31,790
117	HK$33,952	HK$31,790
118	HK$33,952	HK$31,790
119	HK$33,952	HK$31,790
120	HK$33,952	HK$31,790
121	HK$33,952	HK$31,790
122	HK$33,952	HK$31,790
123	HK$33,952	HK$31,790
124	HK$33,952	HK$31,790
125	HK$33,952	HK$31,790
126	HK$33,952	HK$31,790
127	HK$33,952	HK$31,790

Other deductible options in this series

8 deductibles — same benefit schedule, premium scales with deductible

1 with SMM (HKD)

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Official benefit schedule: VHIS.gov.hk benefit schedule PDF
Official premium schedule: VHIS.gov.hk premium schedule PDF
Schedule effective date: Nov 23, 2025
Last verified: 2026-04-25

Terms and premiums on this page reflect the latest documents published by each insurer and the Insurance Authority's VHIS platform. In case of any discrepancy, the official PDF prevails. VHISGuide makes no warranty as to accuracy and does not constitute a purchase recommendation.