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

VHIS Flexi · F00037-08-000-03

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

「摯康保」醫療保障計劃 - 保障級別 4+超額醫療保障 (美元)

Chow Tai Fook Life Insurance Co Ltd

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Your premium

US$2,156 /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

US$283,620

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	$675 per day, maximum 180 days per Policy Year
(b) Miscellaneous charges (b) 雜項開支	$4,650 per Policy Year
(c) Attending doctor's visit fee (c) 主診醫生巡房費	$585 per day, maximum 180 days per Policy Year
(d) Specialist's fee (d) 專科醫生費	$1,940 per Policy Year
(e) Intensive care (e) 深切治療	$1,940 per day, maximum 90 days per Policy Year
Surgeon's fee — Minor 外科醫生費 — 小型	$1,940
Surgeon's fee — Intermediate 外科醫生費 — 中型	$4,195
Surgeon's fee — Major 外科醫生費 — 大型	$9,680
Surgeon's fee — Complex 外科醫生費 — 複雜	$20,650
(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	$5,165 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	$20,650 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	$210, per visit, $1,295 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	$10,325 per Policy Year
Room and board (i) 病房及膳食	$675 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	$585 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	$1,940 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	$675 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	$260 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: $155 per visit, $520 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	$20,650 per Benefit Period (i.e. every 6 consecutive Policy Years)
Outpatient kidney dialysis 腎臟透析	$19,355 per Policy Year
Emergency outpatient treatment for Accident 急症門診治療(只限意外) — 急症門診	$3,875 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	$3,875 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	$10,325 per Policy Year
Organ transplant donor benefit 捐贈器官	$38,710 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	$36,130; 15% Coinsurance (i.e. 85% reimbursement rate)
Cash Benefits
Day surgery cash benefit 日間手術現金津貼	$260 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	$155 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, $1,550 per Policy Year
Post-donation health supplement cash allowance 器官捐贈後健康補品現金津貼	$5,165 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	$6,455
Additional death benefit for organ donor 器官捐贈者額外身故津貼	$51,615
Medical accident and incident extension benefit 醫療疏忽事故保障	$51,615

Basic Benefits

(a) Room and board
(a) 病房及膳食
$675 per day, maximum 180 days per Policy Year
(b) Miscellaneous charges
(b) 雜項開支
$4,650 per Policy Year
(c) Attending doctor's visit fee
(c) 主診醫生巡房費
$585 per day, maximum 180 days per Policy Year
(d) Specialist's fee
(d) 專科醫生費
$1,940 per Policy Year
(e) Intensive care
(e) 深切治療
$1,940 per day, maximum 90 days per Policy Year
Surgeon's fee — Minor
外科醫生費 — 小型
$1,940
Surgeon's fee — Intermediate
外科醫生費 — 中型
$4,195
Surgeon's fee — Major
外科醫生費 — 大型
$9,680
Surgeon's fee — Complex
外科醫生費 — 複雜
$20,650
(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
$5,165 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
$20,650 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
$210, per visit, $1,295 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
$10,325 per Policy Year
Room and board
(i) 病房及膳食
$675 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
$585 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
$1,940 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
$675 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
$260 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: $155 per visit, $520 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
$20,650 per Benefit Period (i.e. every 6 consecutive Policy Years)
Outpatient kidney dialysis
腎臟透析
$19,355 per Policy Year
Emergency outpatient treatment for Accident
急症門診治療(只限意外) — 急症門診
$3,875 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
$3,875 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
$10,325 per Policy Year
Organ transplant donor benefit
捐贈器官
$38,710 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
$36,130; 15% Coinsurance (i.e. 85% reimbursement rate)

Cash Benefits

Day surgery cash benefit
日間手術現金津貼
$260 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
$155 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, $1,550 per Policy Year
Post-donation health supplement cash allowance
器官捐贈後健康補品現金津貼
$5,165 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
$6,455
Additional death benefit for organ donor
器官捐贈者額外身故津貼
$51,615
Medical accident and incident extension benefit
醫療疏忽事故保障
$51,615

Premium Schedule

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

Age	Male	Female
0	US$2,642	US$1,930
1	US$2,642	US$1,930
2	US$2,642	US$1,930
3	US$2,642	US$1,930
4	US$2,642	US$1,930
5	US$1,645	US$1,555
6	US$1,645	US$1,555
7	US$1,645	US$1,555
8	US$1,645	US$1,555
9	US$1,645	US$1,555
10	US$1,480	US$1,343
11	US$1,470	US$1,332
12	US$1,469	US$1,332
13	US$1,475	US$1,343
14	US$1,490	US$1,364
15	US$1,513	US$1,396
16	US$1,551	US$1,464
17	US$1,600	US$1,552
18	US$1,658	US$1,660
19	US$1,729	US$1,785
20	US$1,808	US$1,931
21	US$1,843	US$2,002
22	US$1,871	US$2,067
23	US$1,895	US$2,120
24	US$1,913	US$2,167
25	US$1,926	US$2,202
26	US$1,963	US$2,274
27	US$2,006	US$2,350
28	US$2,051	US$2,431
29	US$2,102	US$2,518
30	US$2,156	US$2,610
31	US$2,206	US$2,700
32	US$2,254	US$2,789
33	US$2,296	US$2,879
34	US$2,338	US$2,965
35	US$2,377	US$3,051
36	US$2,443	US$3,155
37	US$2,515	US$3,264
38	US$2,594	US$3,377
39	US$2,681	US$3,496
40	US$2,775	US$3,620
41	US$2,886	US$3,735
42	US$3,010	US$3,851
43	US$3,145	US$3,970
44	US$3,292	US$4,090
45	US$3,450	US$4,213
46	US$3,627	US$4,360
47	US$3,818	US$4,515
48	US$4,023	US$4,680
49	US$4,242	US$4,855
50	US$4,474	US$5,038
51	US$4,687	US$5,208
52	US$4,901	US$5,379
53	US$5,117	US$5,550
54	US$5,333	US$5,720
55	US$5,552	US$5,893
56	US$5,869	US$6,112
57	US$6,220	US$6,348
58	US$6,605	US$6,600
59	US$7,023	US$6,869
60	US$7,475	US$7,154
61	US$8,004	US$7,589
62	US$8,574	US$8,082
63	US$9,187	US$8,631
64	US$9,843	US$9,238
65	US$10,543	US$9,902
66	US$11,201	US$10,513
67	US$11,876	US$11,145
68	US$12,567	US$11,799
69	US$13,274	US$12,474
70	US$13,995	US$13,169
71	US$14,783	US$14,018
72	US$14,783	US$14,018
73	US$14,783	US$14,018
74	US$14,783	US$14,018
75	US$14,783	US$14,018
76	US$14,783	US$14,018
77	US$14,783	US$14,018
78	US$14,783	US$14,018
79	US$14,783	US$14,018
80	US$14,783	US$14,018
81	US$14,783	US$14,018
82	US$14,783	US$14,018
83	US$14,783	US$14,018
84	US$14,783	US$14,018
85	US$14,783	US$14,018
86	US$14,783	US$14,018
87	US$14,783	US$14,018
88	US$14,783	US$14,018
89	US$14,783	US$14,018
90	US$14,783	US$14,018
91	US$14,783	US$14,018
92	US$14,783	US$14,018
93	US$14,783	US$14,018
94	US$14,783	US$14,018
95	US$14,783	US$14,018
96	US$14,783	US$14,018
97	US$14,783	US$14,018
98	US$14,783	US$14,018
99	US$14,783	US$14,018
100	US$14,783	US$14,018
101	US$14,783	US$14,018
102	US$14,783	US$14,018
103	US$14,783	US$14,018
104	US$14,783	US$14,018
105	US$14,783	US$14,018
106	US$14,783	US$14,018
107	US$14,783	US$14,018
108	US$14,783	US$14,018
109	US$14,783	US$14,018
110	US$14,783	US$14,018
111	US$14,783	US$14,018
112	US$14,783	US$14,018
113	US$14,783	US$14,018
114	US$14,783	US$14,018
115	US$14,783	US$14,018
116	US$14,783	US$14,018
117	US$14,783	US$14,018
118	US$14,783	US$14,018
119	US$14,783	US$14,018
120	US$14,783	US$14,018
121	US$14,783	US$14,018
122	US$14,783	US$14,018
123	US$14,783	US$14,018
124	US$14,783	US$14,018
125	US$14,783	US$14,018
126	US$14,783	US$14,018
127	US$14,783	US$14,018

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4 with SMM (USD)

Current page

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.