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

VHIS Flexi · F00037-07-000-03

''TopCare'' Medical Insurance Plan - Benefit Level 3 with SMM (USD)

「摯康保」醫療保障計劃 - 保障級別 3+超額醫療保障 (美元)

Chow Tai Fook Life Insurance Co Ltd

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Your premium

US$1,181 /yr

age

Ward class

Semi-Private Room

Coverage region

Worldwide

Deductible

—

Annual benefit limit

—

Per-illness annual limit

—

Lifetime benefit limit

—

SMM Supplemental Major Medical

US$182,355

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	$300 per day, maximum 180 days per Policy Year
(b) Miscellaneous charges (b) 雜項開支	$2,970 per Policy Year
(c) Attending doctor's visit fee (c) 主診醫生巡房費	$260 per day, maximum 180 days per Policy Year
(d) Specialist's fee (d) 專科醫生費	$1,165 per Policy Year
(e) Intensive care (e) 深切治療	$1,165 per day, maximum 90 days per Policy Year
Surgeon's fee — Minor 外科醫生費 — 小型	$1,295
Surgeon's fee — Intermediate 外科醫生費 — 中型	$3,230
Surgeon's fee — Major 外科醫生費 — 大型	$6,455
Surgeon's fee — Complex 外科醫生費 — 複雜	$12,905
(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	$3,875 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	$18,065 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	$155, per visit, $1,035 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	$7,745 per Policy Year
Room and board (i) 病房及膳食	$300 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	$260 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	$1,165 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	$300 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	$155 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: $120 per visit, $390 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	$18,065 per Benefit Period (i.e. every 6 consecutive Policy Years)
Outpatient kidney dialysis 腎臟透析	$10,325 per Policy Year
Emergency outpatient treatment for Accident 急症門診治療(只限意外) — 急症門診	$2,585 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	$2,585 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	$6,455 per Policy Year
Organ transplant donor benefit 捐贈器官	$25,810 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	$23,230; 15% Coinsurance (i.e. 85% reimbursement rate)
Cash Benefits
Day surgery cash benefit 日間手術現金津貼	$155 per Day Case Procedure, 1 per Policy Year
Hospital transport cash allowance 住院交通現金津貼	$40 per Confinement, maximum 1 Confinements per Policy Year
Lower ward class cash benefit 住院現金津貼	$130 per day, maximum 15 days per Policy Year
Second-claim cash allowanceAfter other pays 特別現金津貼	5% of the amount reimbursed by other insurers, $775 per Policy Year
Post-donation health supplement cash allowance 器官捐贈後健康補品現金津貼	$3,875 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	$3,875
Additional death benefit for organ donor 器官捐贈者額外身故津貼	$25,810
Medical accident and incident extension benefit 醫療疏忽事故保障	$25,810

Basic Benefits

(a) Room and board
(a) 病房及膳食
$300 per day, maximum 180 days per Policy Year
(b) Miscellaneous charges
(b) 雜項開支
$2,970 per Policy Year
(c) Attending doctor's visit fee
(c) 主診醫生巡房費
$260 per day, maximum 180 days per Policy Year
(d) Specialist's fee
(d) 專科醫生費
$1,165 per Policy Year
(e) Intensive care
(e) 深切治療
$1,165 per day, maximum 90 days per Policy Year
Surgeon's fee — Minor
外科醫生費 — 小型
$1,295
Surgeon's fee — Intermediate
外科醫生費 — 中型
$3,230
Surgeon's fee — Major
外科醫生費 — 大型
$6,455
Surgeon's fee — Complex
外科醫生費 — 複雜
$12,905
(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
$3,875 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
$18,065 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
$155, per visit, $1,035 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
$7,745 per Policy Year
Room and board
(i) 病房及膳食
$300 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
$260 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
$1,165 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
$300 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
$155 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: $120 per visit, $390 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
$18,065 per Benefit Period (i.e. every 6 consecutive Policy Years)
Outpatient kidney dialysis
腎臟透析
$10,325 per Policy Year
Emergency outpatient treatment for Accident
急症門診治療(只限意外) — 急症門診
$2,585 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
$2,585 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
$6,455 per Policy Year
Organ transplant donor benefit
捐贈器官
$25,810 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
$23,230; 15% Coinsurance (i.e. 85% reimbursement rate)

Cash Benefits

Day surgery cash benefit
日間手術現金津貼
$155 per Day Case Procedure, 1 per Policy Year
Hospital transport cash allowance
住院交通現金津貼
$40 per Confinement, maximum 1 Confinements per Policy Year
Lower ward class cash benefit
住院現金津貼
$130 per day, maximum 15 days per Policy Year
Second-claim cash allowanceAfter other pays
特別現金津貼
5% of the amount reimbursed by other insurers, $775 per Policy Year
Post-donation health supplement cash allowance
器官捐贈後健康補品現金津貼
$3,875 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
$3,875
Additional death benefit for organ donor
器官捐贈者額外身故津貼
$25,810
Medical accident and incident extension benefit
醫療疏忽事故保障
$25,810

Premium Schedule

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

Age	Male	Female
0	US$1,568	US$1,238
1	US$1,568	US$1,238
2	US$1,568	US$1,238
3	US$1,568	US$1,238
4	US$1,568	US$1,238
5	US$921	US$876
6	US$921	US$876
7	US$921	US$876
8	US$921	US$876
9	US$921	US$876
10	US$829	US$757
11	US$823	US$751
12	US$823	US$751
13	US$826	US$757
14	US$835	US$769
15	US$846	US$787
16	US$863	US$815
17	US$883	US$851
18	US$908	US$894
19	US$937	US$944
20	US$969	US$1,001
21	US$988	US$1,044
22	US$1,006	US$1,086
23	US$1,023	US$1,130
24	US$1,040	US$1,174
25	US$1,056	US$1,219
26	US$1,079	US$1,264
27	US$1,102	US$1,311
28	US$1,127	US$1,358
29	US$1,154	US$1,406
30	US$1,181	US$1,455
31	US$1,210	US$1,506
32	US$1,237	US$1,555
33	US$1,264	US$1,602
34	US$1,289	US$1,650
35	US$1,314	US$1,695
36	US$1,348	US$1,752
37	US$1,382	US$1,812
38	US$1,419	US$1,875
39	US$1,458	US$1,940
40	US$1,500	US$2,010
41	US$1,552	US$2,062
42	US$1,613	US$2,112
43	US$1,677	US$2,158
44	US$1,750	US$2,204
45	US$1,827	US$2,245
46	US$1,918	US$2,310
47	US$2,015	US$2,380
48	US$2,123	US$2,455
49	US$2,237	US$2,536
50	US$2,360	US$2,624
51	US$2,476	US$2,696
52	US$2,596	US$2,768
53	US$2,718	US$2,838
54	US$2,844	US$2,907
55	US$2,971	US$2,974
56	US$3,145	US$3,085
57	US$3,336	US$3,211
58	US$3,543	US$3,351
59	US$3,767	US$3,505
60	US$4,008	US$3,673
61	US$4,260	US$3,870
62	US$4,521	US$4,083
63	US$4,796	US$4,313
64	US$5,082	US$4,560
65	US$5,380	US$4,821
66	US$5,665	US$5,087
67	US$5,955	US$5,363
68	US$6,249	US$5,652
69	US$6,545	US$5,954
70	US$6,845	US$6,268
71	US$7,215	US$6,651
72	US$7,215	US$6,651
73	US$7,215	US$6,651
74	US$7,215	US$6,651
75	US$7,215	US$6,651
76	US$7,215	US$6,651
77	US$7,215	US$6,651
78	US$7,215	US$6,651
79	US$7,215	US$6,651
80	US$7,215	US$6,651
81	US$7,215	US$6,651
82	US$7,215	US$6,651
83	US$7,215	US$6,651
84	US$7,215	US$6,651
85	US$7,215	US$6,651
86	US$7,215	US$6,651
87	US$7,215	US$6,651
88	US$7,215	US$6,651
89	US$7,215	US$6,651
90	US$7,215	US$6,651
91	US$7,215	US$6,651
92	US$7,215	US$6,651
93	US$7,215	US$6,651
94	US$7,215	US$6,651
95	US$7,215	US$6,651
96	US$7,215	US$6,651
97	US$7,215	US$6,651
98	US$7,215	US$6,651
99	US$7,215	US$6,651
100	US$7,215	US$6,651
101	US$7,215	US$6,651
102	US$7,215	US$6,651
103	US$7,215	US$6,651
104	US$7,215	US$6,651
105	US$7,215	US$6,651
106	US$7,215	US$6,651
107	US$7,215	US$6,651
108	US$7,215	US$6,651
109	US$7,215	US$6,651
110	US$7,215	US$6,651
111	US$7,215	US$6,651
112	US$7,215	US$6,651
113	US$7,215	US$6,651
114	US$7,215	US$6,651
115	US$7,215	US$6,651
116	US$7,215	US$6,651
117	US$7,215	US$6,651
118	US$7,215	US$6,651
119	US$7,215	US$6,651
120	US$7,215	US$6,651
121	US$7,215	US$6,651
122	US$7,215	US$6,651
123	US$7,215	US$6,651
124	US$7,215	US$6,651
125	US$7,215	US$6,651
126	US$7,215	US$6,651
127	US$7,215	US$6,651

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4 with SMM (USD)

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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.