← Back to ''TopCare'' Medical Insurance Plan - Benefit Level series
VHIS Flexi · F00037-05-000-03
''TopCare'' Medical Insurance Plan - Benefit Level 1 with SMM (USD)
「摯康保」醫療保障計劃 - 保障級別 1+超額醫療保障 (美元)
Your premium
US$670 /yr
age
US$Ward class
Ward
Coverage region
Worldwide
Deductible
—
Annual benefit limit
—
Per-illness annual limit
—
Lifetime benefit limit
—
SMM Supplemental Major Medical
US$101,295
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 | $155 per day, maximum 180 days per Policy Year |
(b) Miscellaneous charges (b) 雜項開支 | $2,065 per Policy Year |
(c) Attending doctor's visit fee (c) 主診醫生巡房費 | $125 per day, maximum 180 days per Policy Year |
(d) Specialist's fee (d) 專科醫生費 | $775 per Policy Year |
(e) Intensive care (e) 深切治療 | $775 per day, maximum 90 days per Policy Year |
Surgeon's fee — Minor 外科醫生費 — 小型 | $650 |
Surgeon's fee — Intermediate 外科醫生費 — 中型 | $1,615 |
Surgeon's fee — Major 外科醫生費 — 大型 | $3,875 |
Surgeon's fee — Complex 外科醫生費 — 複雜 | $9,035 |
(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 | $3,230 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 | $15,485 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 | $105, per visit, $650 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 | $6,455 per Policy Year |
Room and board (i) 病房及膳食 | $155 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 | $125 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 | $775 per day (Eligible Expenses under basic benefit (e) Intensive Care from the day of Confinement after the day-limit in each Policy Year × reimbursement ratio) |
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 | $155 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 | $105 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 treatment and Chinese medicine used during Confinement: subject to the same benefit limit as I) Basic Benefits (b) Miscellaneous Charges in the Benefit Schedule.
2) Attending Chinese medicine practitioner's ward visit fee during Confinement: subject to the same benefit limit as I) Basic Benefits (c) Attending Doctor's Visit in the Benefit Schedule.
3) Chinese medicine treatment before/after discharge or Day Case Procedure: $80 per visit, $260 per Policy Year. Up to 3 follow-up outpatient visits within the post-discharge window after Confinement or Day Case Procedure. |
Major Cancer supplementary benefit 主要癌症額外保障 | $15,485 per Benefit Period (i.e. every 6 consecutive Policy Years) |
Outpatient kidney dialysis 腎臟透析 | $6,455 per Policy Year |
Emergency outpatient treatment for Accident 急症門診治療(只限意外) — 急症門診 | $1,295 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 | $1,295 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 | $3,875 per Policy Year |
Organ transplant donor benefit 捐贈器官 | $12,905 per Policy Year |
Supplementary Major Medical Benefit 超額醫療保障每保單年度最高賠償限額共同保險 | $12,905; 15% Coinsurance (i.e. 85% reimbursement rate) |
| Cash Benefits | |
Day surgery cash benefit 日間手術現金津貼 | $105 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, $390 per Policy Year |
Post-donation health supplement cash allowance 器官捐贈後健康補品現金津貼 | $2,585 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 | $2,585 |
Additional death benefit for organ donor 器官捐贈者額外身故津貼 | $12,905 |
Medical accident and incident extension benefit 醫療疏忽事故保障 | $12,905 |
Basic Benefits
- (a) Room and board(a) 病房及膳食$155 per day, maximum 180 days per Policy Year
- (b) Miscellaneous charges(b) 雜項開支$2,065 per Policy Year
- (c) Attending doctor's visit fee(c) 主診醫生巡房費$125 per day, maximum 180 days per Policy Year
- (d) Specialist's fee(d) 專科醫生費$775 per Policy Year
- (e) Intensive care(e) 深切治療$775 per day, maximum 90 days per Policy Year
- Surgeon's fee — Minor外科醫生費 — 小型$650
- Surgeon's fee — Intermediate外科醫生費 — 中型$1,615
- Surgeon's fee — Major外科醫生費 — 大型$3,875
- Surgeon's fee — Complex外科醫生費 — 複雜$9,035
- (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$3,230 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$15,485 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$105, per visit, $650 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$6,455 per Policy Year
- Room and board(i) 病房及膳食$155 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$125 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$775 per day (Eligible Expenses under basic benefit (e) Intensive Care from the day of Confinement after the day-limit in each Policy Year × reimbursement ratio)
- 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$155 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$105 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 treatment and Chinese medicine used during Confinement: subject to the same benefit limit as I) Basic Benefits (b) Miscellaneous Charges in the Benefit Schedule. 2) Attending Chinese medicine practitioner's ward visit fee during Confinement: subject to the same benefit limit as I) Basic Benefits (c) Attending Doctor's Visit in the Benefit Schedule. 3) Chinese medicine treatment before/after discharge or Day Case Procedure: $80 per visit, $260 per Policy Year. Up to 3 follow-up outpatient visits within the post-discharge window after Confinement or Day Case Procedure.
- Major Cancer supplementary benefit主要癌症額外保障$15,485 per Benefit Period (i.e. every 6 consecutive Policy Years)
- Outpatient kidney dialysis腎臟透析$6,455 per Policy Year
- Emergency outpatient treatment for Accident急症門診治療(只限意外) — 急症門診$1,295 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$1,295 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$3,875 per Policy Year
- Organ transplant donor benefit捐贈器官$12,905 per Policy Year
- Supplementary Major Medical Benefit超額醫療保障每保單年度最高賠償限額共同保險$12,905; 15% Coinsurance (i.e. 85% reimbursement rate)
Cash Benefits
- Day surgery cash benefit日間手術現金津貼$105 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, $390 per Policy Year
- Post-donation health supplement cash allowance器官捐贈後健康補品現金津貼$2,585 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$2,585
- Additional death benefit for organ donor器官捐贈者額外身故津貼$12,905
- Medical accident and incident extension benefit醫療疏忽事故保障$12,905
Premium Schedule
Annual premium · Premium varies by gender (smoking-agnostic) · USD
Other deductible options in this series
8 deductibles — same benefit schedule, premium scales with deductible
- 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.