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VHIS Flexi · F00037-04-000-03

''TopCare'' Medical Insurance Plan - Benefit Level 4 with SMM (HKD)

「摯康保」醫療保障計劃 - 保障級別 4+超額醫療保障 (港元)

Chow Tai Fook Life Insurance Co Ltd

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Your premium

HK$16,712 /yr

age

Ward class

Standard Private Room

Coverage region

Worldwide

Deductible

—

Annual benefit limit

—

Per-illness annual limit

—

Lifetime benefit limit

—

SMM Supplemental Major Medical

HK$280,000

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	$5,200 per day, maximum 180 days per Policy Year
(b) Miscellaneous charges (b) 雜項開支	$36,000 per Policy Year
(c) Attending doctor's visit fee (c) 主診醫生巡房費	$4,500 per day, maximum 180 days per Policy Year
(d) Specialist's fee (d) 專科醫生費	$15,000 per Policy Year
(e) Intensive care (e) 深切治療	$15,000 per day, maximum 90 days per Policy Year
Surgeon's fee — Minor 外科醫生費 — 小型	$15,000
Surgeon's fee — Intermediate 外科醫生費 — 中型	$32,500
Surgeon's fee — Major 外科醫生費 — 大型	$75,000
Surgeon's fee — Complex 外科醫生費 — 複雜	$160,000
(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	$40,000 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	$160,000 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	$1,600, per visit, $10,000 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	$80,000 per Policy Year
Room and board (i) 病房及膳食	$5,200 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	$4,500 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	$15,000 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	$5,200 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	$2,000 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: $1,200 per visit, $4,000 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	$160,000 per Benefit Period (i.e. every 6 consecutive Policy Years)
Outpatient kidney dialysis 腎臟透析	$150,000 per Policy Year
Emergency outpatient treatment for Accident 急症門診治療(只限意外) — 急症門診	$30,000 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	$30,000 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	$80,000 per Policy Year
Organ transplant donor benefit 捐贈器官	$300,000 per Policy Year
Cash Benefits
Day surgery cash benefit 日間手術現金津貼	$2,000 per Day Case Procedure, 1 per Policy Year
Hospital transport cash allowance 住院交通現金津貼	$300 per Confinement, maximum 1 Confinements per Policy Year
Lower ward class cash benefit 住院現金津貼	$1,200 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, $12,000 per Policy Year
Post-donation health supplement cash allowance 器官捐贈後健康補品現金津貼	$40,000 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	$50,000
Additional death benefit for organ donor 器官捐贈者額外身故津貼	$400,000
Medical accident and incident extension benefit 醫療疏忽事故保障	$400,000

Basic Benefits

(a) Room and board
(a) 病房及膳食
$5,200 per day, maximum 180 days per Policy Year
(b) Miscellaneous charges
(b) 雜項開支
$36,000 per Policy Year
(c) Attending doctor's visit fee
(c) 主診醫生巡房費
$4,500 per day, maximum 180 days per Policy Year
(d) Specialist's fee
(d) 專科醫生費
$15,000 per Policy Year
(e) Intensive care
(e) 深切治療
$15,000 per day, maximum 90 days per Policy Year
Surgeon's fee — Minor
外科醫生費 — 小型
$15,000
Surgeon's fee — Intermediate
外科醫生費 — 中型
$32,500
Surgeon's fee — Major
外科醫生費 — 大型
$75,000
Surgeon's fee — Complex
外科醫生費 — 複雜
$160,000
(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
$40,000 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
$160,000 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
$1,600, per visit, $10,000 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
$80,000 per Policy Year
Room and board
(i) 病房及膳食
$5,200 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
$4,500 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
$15,000 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
$5,200 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
$2,000 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: $1,200 per visit, $4,000 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
$160,000 per Benefit Period (i.e. every 6 consecutive Policy Years)
Outpatient kidney dialysis
腎臟透析
$150,000 per Policy Year
Emergency outpatient treatment for Accident
急症門診治療(只限意外) — 急症門診
$30,000 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
$30,000 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
$80,000 per Policy Year
Organ transplant donor benefit
捐贈器官
$300,000 per Policy Year

Cash Benefits

Day surgery cash benefit
日間手術現金津貼
$2,000 per Day Case Procedure, 1 per Policy Year
Hospital transport cash allowance
住院交通現金津貼
$300 per Confinement, maximum 1 Confinements per Policy Year
Lower ward class cash benefit
住院現金津貼
$1,200 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, $12,000 per Policy Year
Post-donation health supplement cash allowance
器官捐贈後健康補品現金津貼
$40,000 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
$50,000
Additional death benefit for organ donor
器官捐贈者額外身故津貼
$400,000
Medical accident and incident extension benefit
醫療疏忽事故保障
$400,000

Premium Schedule

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

Age	Male	Female
0	HK$20,476	HK$14,956
1	HK$20,476	HK$14,956
2	HK$20,476	HK$14,956
3	HK$20,476	HK$14,956
4	HK$20,476	HK$14,956
5	HK$12,754	HK$12,045
6	HK$12,754	HK$12,045
7	HK$12,754	HK$12,045
8	HK$12,754	HK$12,045
9	HK$12,754	HK$12,045
10	HK$11,465	HK$10,411
11	HK$11,393	HK$10,329
12	HK$11,382	HK$10,329
13	HK$11,435	HK$10,411
14	HK$11,549	HK$10,576
15	HK$11,726	HK$10,821
16	HK$12,021	HK$11,349
17	HK$12,398	HK$12,029
18	HK$12,854	HK$12,857
19	HK$13,394	HK$13,835
20	HK$14,013	HK$14,963
21	HK$14,282	HK$15,521
22	HK$14,507	HK$16,013
23	HK$14,689	HK$16,436
24	HK$14,829	HK$16,788
25	HK$14,930	HK$17,073
26	HK$15,218	HK$17,621
27	HK$15,542	HK$18,213
28	HK$15,901	HK$18,844
29	HK$16,290	HK$19,514
30	HK$16,712	HK$20,223
31	HK$17,096	HK$20,929
32	HK$17,461	HK$21,621
33	HK$17,801	HK$22,307
34	HK$18,121	HK$22,983
35	HK$18,423	HK$23,651
36	HK$18,930	HK$24,454
37	HK$19,490	HK$25,295
38	HK$20,105	HK$26,174
39	HK$20,776	HK$27,094
40	HK$21,502	HK$28,052
41	HK$22,367	HK$28,943
42	HK$23,325	HK$29,848
43	HK$24,374	HK$30,769
44	HK$25,513	HK$31,702
45	HK$26,742	HK$32,654
46	HK$28,113	HK$33,787
47	HK$29,593	HK$34,995
48	HK$31,179	HK$36,273
49	HK$32,870	HK$37,621
50	HK$34,674	HK$39,044
51	HK$36,319	HK$40,361
52	HK$37,980	HK$41,685
53	HK$39,650	HK$43,008
54	HK$41,336	HK$44,336
55	HK$43,032	HK$45,668
56	HK$45,488	HK$47,370
57	HK$48,206	HK$49,196
58	HK$51,187	HK$51,151
59	HK$54,429	HK$53,233
60	HK$57,935	HK$55,439
61	HK$62,025	HK$58,820
62	HK$66,443	HK$62,639
63	HK$71,194	HK$66,894
64	HK$76,279	HK$71,595
65	HK$81,705	HK$76,744
66	HK$86,812	HK$81,481
67	HK$92,040	HK$86,380
68	HK$97,394	HK$91,442
69	HK$102,868	HK$96,669
70	HK$108,464	HK$102,064
71	HK$114,573	HK$108,642
72	HK$114,573	HK$108,642
73	HK$114,573	HK$108,642
74	HK$114,573	HK$108,642
75	HK$114,573	HK$108,642
76	HK$114,573	HK$108,642
77	HK$114,573	HK$108,642
78	HK$114,573	HK$108,642
79	HK$114,573	HK$108,642
80	HK$114,573	HK$108,642
81	HK$114,573	HK$108,642
82	HK$114,573	HK$108,642
83	HK$114,573	HK$108,642
84	HK$114,573	HK$108,642
85	HK$114,573	HK$108,642
86	HK$114,573	HK$108,642
87	HK$114,573	HK$108,642
88	HK$114,573	HK$108,642
89	HK$114,573	HK$108,642
90	HK$114,573	HK$108,642
91	HK$114,573	HK$108,642
92	HK$114,573	HK$108,642
93	HK$114,573	HK$108,642
94	HK$114,573	HK$108,642
95	HK$114,573	HK$108,642
96	HK$114,573	HK$108,642
97	HK$114,573	HK$108,642
98	HK$114,573	HK$108,642
99	HK$114,573	HK$108,642
100	HK$114,573	HK$108,642
101	HK$114,573	HK$108,642
102	HK$114,573	HK$108,642
103	HK$114,573	HK$108,642
104	HK$114,573	HK$108,642
105	HK$114,573	HK$108,642
106	HK$114,573	HK$108,642
107	HK$114,573	HK$108,642
108	HK$114,573	HK$108,642
109	HK$114,573	HK$108,642
110	HK$114,573	HK$108,642
111	HK$114,573	HK$108,642
112	HK$114,573	HK$108,642
113	HK$114,573	HK$108,642
114	HK$114,573	HK$108,642
115	HK$114,573	HK$108,642
116	HK$114,573	HK$108,642
117	HK$114,573	HK$108,642
118	HK$114,573	HK$108,642
119	HK$114,573	HK$108,642
120	HK$114,573	HK$108,642
121	HK$114,573	HK$108,642
122	HK$114,573	HK$108,642
123	HK$114,573	HK$108,642
124	HK$114,573	HK$108,642
125	HK$114,573	HK$108,642
126	HK$114,573	HK$108,642
127	HK$114,573	HK$108,642

Other deductible options in this series

8 deductibles — same benefit schedule, premium scales with deductible

1 with SMM (HKD)

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2 with SMM (HKD)

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3 with SMM (HKD)

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4 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.