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health protection
保柏-您的健康保障之選
Bupa – A global health and care organisation Bupa Hong Kong – A health insurance specialist
• Bupa was founded in 1947. Since then, it has gone for over three decades
from a UK company to a major global name in private
health and care, with over 34 million customers
• Over the past 30 years, Bupa Hong Kong has
become well known for its quality health insurance
around the world. service. It is now one of the top three medical
•
insurers in Hong Kong2.
Bupa operates in the UK, America, Australia, New
Zealand, Spain, Denmark, Northern Europe, Latin
America, Hong Kong, China, Thailand, Malta, India,
• As a leading provider, we are trusted by 200,000
individuals and over 2,000 companies, safeguarding
Saudi Arabia and Egypt. individual’s and employees’ health. For 13 years in
•
a row, we have been recommended by the Hong
Our businesses range from health insurance to
Kong Government to provide quality health insurance
care homes for the elderly, from hospitals to health
schemes to civil servants.
assessments and chronic disease management.
Business turnover in 2008 was approximately
£5.9 billion (HK$73 billion) . 1
• Bupa is the first insurer to offer lifelong guaranteed
renewal of individual health insurance to ensure
•
members are covered at their old age.
As a provident association, Bupa has no shareholders
and all profits are reinvested to improve our
healthcare services.
• Bupa’s medical network boasts over 2,400 clinics and
health facilities, making it the largest in Hong Kong.
We pioneered medical card service, enabling members
to receive treatment without cash payment and the
hassle of submitting claims.
1
Source: Bupa Annual Report 2008; Exchange rate: £1 = HK$12.412 (last update: October 2009)
2
Source: Medical Insurance Business Statistics 2008 by Hong Kong Federation of Insurers
�“ Taking care
of the lives
in our hands
”
保柏-環球醫療保健集團
•
保柏成立於1947年,至今已由一所英國公司發展
為全球知名的私營醫療保健機構,全球客戶人數
超過3,400萬名。
•
保柏業務遍佈英國、美國、澳洲、新西蘭、西班
牙、丹麥、北歐、拉丁美洲、香港、中國、泰國、
馬爾他、印度、沙特阿拉伯和埃及等。
•
業務範圍包括醫療保險、護老院、醫院、健康診斷
中心和長期疾病管理等服務。2008年的業務收入約
59億英鎊(730億港元)1。
•
作為一間福利機構,保柏不設股東,因此可將所有
收入盈餘全用於改善我們的醫療保健服務上。
保柏香港-逾30年的醫療保險專家
•
保柏香港在過去30年,素以優質醫療保險服務
見稱,目前為本港三大醫療保險機構之一2。
•
作為業界之翹楚,保柏為全港20萬名會員及超過
2,000間企業所信賴,保障個人及僱員的健康。
我們更連續13年獲政府推薦,為本港公務員提供
優質的醫療保險計劃。
•
保柏是業內首間為個人客戶提供終生續保保證的
保險公司,確保會員年老時仍享有保障。
•
保柏的醫療網絡診所及設施超過2,400間,全港
最大。我們最先推出醫療卡服務,讓會員可預先
獲得治療而無須支付現金,免卻辦理索償的煩惱。
1
資料來源:保柏2008年度年報;兌換率:1英鎊 = 12.412港元(最後更新:2009年10月)
2
資料來源:香港保險業聯會2008年度香港醫療保險業務統計
3
1
Bupa CarePro – Easy steps to health
保柏卓康健 - 保障無價健康 輕而易舉
Bupa CarePro provides excellent medical protection Extra Cancer Treatment and Kidney Dialysis
to members and offers a subscription discount. For Benefit
a very reasonable fee, you and your family can enjoy At Bupa, we understand that cancer or kidney failure
comprehensive health protection, and receive quality often requires prolonged treatment, so we offer
medical treatment without any additional worries. additional coverage of up to HK$100,000 per year,
making it easier for members to afford more costly
No pre-payment to make, no claims to submit
advanced treatment options. If this coverage is fully
Bupa CarePro members who also apply for
claimed in any one year, it will be reinstated in the
Supplementary Major Medical Benefit will receive
following year for the rest of your lifetime.
the Bupa HealthCare Card. When you use the Bupa
HealthCare Card at any local private hospital, no Up to 50 percent discount on child subscriptions
admission deposit is required and no payment is If parents enrol with Bupa together with their children,
necessary upon discharge. Simply call Bupa and each child can enjoy a discount on Hospital and Surgical
complete the quick and easy registration process before Benefit3 for as long as the parent’s membership
admission. Bupa will pay all eligible medical expenses for continues.
you directly. Number of insured parents Child discount
“
Contract years of Renewal discount
no claim record The medical card makes things more
2-3 consecutive years 5% convenient. I can seek medical
4-5 consecutive years 10%
treatment without paying in advance,
6 or more consecutive years 15%
and I need not bother with the bill or
“
claim procedures. There’s no need
to worry.
3
Only applicable to unmarried children aged 15 days to 17 years who enrol in
Bupa Care Kid Mr Kwok has been a Bupa member for 13 years
2
「保柏卓康健」計劃為會員提供卓越的醫療
保障,而且設有保費優惠。所費無幾,您和家人
的健康便得到全面的保障,安心接受優質治療。 “Bupa CarePro
住院免繳費、免索償服務 offers
投保「保柏卓康健」並自選「附加醫療保障」,可獲發
「保柏康健卡」。憑卡入住本港任何一間私家醫院,無
worldwide
需入院按金,出院時不用繳費。您只須在入院前致電保
柏完成簡單的登記程序,我們便會直接向醫院支付合資
coverage
”
格的醫療費用。
額外癌症治療及洗腎保障
因應癌症或洗腎病者長期治療的需要,保柏特別提供高
達每年港幣10萬元之額外保障,讓會員能負擔較昂貴
“
的最新療法,加速康復,每年賠償額倘已耗盡亦可於翌
年還原,保障直至終生。 醫療卡真的很方便,我不用自己
先付醫療費,可即時尋求醫治,
“
出院時又無須繳費及辦理索償手續,
令我無須費神。
3
適用於出生15天至17歲的未婚子女投保「保柏童康健」 郭先生 擁有保柏會籍13年
3
Exclusive privileges for
Bupa CarePro members
保柏卓康健會員專享權益
Easy enrolment
Enrolment is quick and simple. No medical examinations
are required.
4
Scheme options
計劃選擇
4
Supplementary Major Medical Benefit is not applicable to the Pre-admission and
Post-hospitalisation Out-patient Care under the Hospital and Surgical Benefit and
small deductible is required
5
Scheme options
計劃選擇
基本住院及手術保障
可按自己預算選擇大房、半私家房及私家房保障級
別,保障範圍包括住院及膳食、住院雜費、深切治
療、私家看護、醫生及巡房、麻醉師、手術室、住院 Top-up benefit payable from the
加床、入院前及出院後的門診護理等。 1st day of admission giving the best
possible coverage
自選附加醫療保障
當住院費用超出基本計劃的限額時4,可獲賠償差額 Supplementary Major Medical Benefit means
的八成,賠償由住院首天計算。此附加醫療保障與基 claims will be settled from the very first day of
本計劃同樣可續保至終生,而於續保時不收取個人額 hospitalisation, provided that the actual medical
外保費,全港獨有。
expenses have exceeded the upper limit of basic
免費保障 「保柏卓康健」計劃的「附加醫療保障」,即
保柏國際援助計劃 使在住院第一天,若實際醫療支出超過基本
提供海外及國內住院按金墊支服務,全數支付緊急醫
「住院及手術保障」上限時4,便會作出賠
療運送費用,並提供送返港後高達港幣12萬元的額外
住院保障。 償。而市場上有很多醫療保險計劃,要求投保
人須住院90日甚至120日後,才可索償附加醫
基本保障 住院及手術保障 療保障的病房費用。
自選保障 附加醫療保障
門診保障
住院現金保障
免費保障 保柏國際援助計劃
4
「附加醫療保障」不適用於「住院及手術保障」之「入院前及出院後之門診護理」,
並設有小額墊底費
6
Case Study: How to get the most
from your plan?
個案分享:怎樣才可獲得較足夠的賠償?
Generally speaking, you will enjoy greater health cover from a plan which pays out “per operation” rather than “per
disability”. The following example demonstrates why:
Mr Leung slipped on the stairs and had two operations for his ankle fracture in one year, incurring the following medical
expenses.
賠償以「每手術計」比以「每病症計」的計劃一般能給您更高保障。請參看以下例子。
梁先生因意外不慎由樓梯滑下引致足踝骨折。他於一年內,入住私家醫院共進行了兩次連環手術,費用如下:
Actual claims paid 1st claim 首次: HK$9,765 1st claim 首次: HK$8,100
實際賠償金額 2nd claim 第二次: HK$7,000 2nd claim 第二次: HK$0
The above figures are for illustrative purposes only. Actual treatment costs vary and figures may differ.
以上數字只供說明用途,實際治療費用視乎情況而定,有可能不同。
claims will be settled within 5 - 7 working days after full documentation is received
賠償服務承諾 使用醫療卡入院,無須索償
其他住院及門診賠償,於收妥所需文件5-7個工作天內支付
FAQs
常見問題
2. Is my membership transferable if I
move abroad?
If Bupa has a business operation in your new place of
residence, we will try our best to arrange the transfer of
your membership so that you may continue to enjoy 1. 適合哪類人士投保?
our cover. 凡年滿18歲人士均歡迎投保,並不設投保年齡上限。
9
Major Exclusions
主要不受保障項目
Though you will be covered for most eventualities, there 儘管在大部分情況下,保柏都可為您的醫療費用作出
are certain things that Bupa will exclude. To enhance 賠償,但仍有一些事項屬除外責任。為提高合約透明
the transparency of our contract, some of the key
度,我們列出以下主要不受保障項目以供參考:
things we cannot cover are listed below:
•
membership (unless approved by Bupa)
•
不是醫療必需的治療或檢驗
Treatment or investigation which is not Medically
•
Necessary
AIDS or HIV-related conditions which originate •
成為會員首五年內,由愛滋病或有關人體免疫力
缺損病毒引致的疾病;或性傳染疾病
during your first 5 years of membership, or Sexually
•
Transmitted (Venereal) Diseases
Congenital, Developmental or Hereditary Conditions •
先天性疾病、發育異常或遺傳性疾病
10
Bupa free online health
information
保柏免費網上健康資訊
As a health insurance specialist, Bupa has introduced an 作為醫療保險專家,保柏推出
online health portal – Bupa Health Gallery which provides 健康資訊網站 -「保柏健康雅
regular free and practical health tips on nutrition and 集」,定期提供免費而實用的健康資
diet, sport and fitness, women and children’s health and 訊,內容廣及營養飲食、運動健體、女士及子女
more – all designed to safeguard the health of you and 健康等,為您及家人的健康作後盾。
your family.
「保柏健康雅集」內的健康及疾病資訊,主要由保柏
Most of the health and disease information available in 英國及香港專業的醫療專家撰寫及核實。
the Gallery is written and verified by the Bupa’s medical
professionals in the United Kingdom and Hong Kong. 成為「保柏健康雅集」會員,您可享有以下各項免費
服務:
•
You can enjoy the following free services after becoming
網上向特約專科醫生請教健康問題
a member of this Gallery:
• • 每月收取電子健康通訊
Get online advice from approved specialists on
• 獲享健康檢查、健體、飲食、訂購書籍等優惠
health questions
• 健康食譜、講座資料及健康測試
www.bupa.com.hk
MP052/5/1109/12K Printed on recycled paper 以再造紙印刷
Bupa CarePro Health Insurance Scheme
保柏卓康健醫療保障計劃 Schedule of Benefits 保障金額表
Maximum Limit (HK$)
Effective from 1 January 2010 自2010年1月1日起生效 最高賠償額(港幣)
Maximum Limit (each Contract Year) 最高賠償額 (每合約年度計) 550,000 280,000 110,000
Lifetime Limit 終生最高賠償額 3
800,000 400,000 200,000
• apply after any item of Section A1 to A11 under Hospital and Surgical Benefit is exhausted
• in case of overseas hospitalisation, only medical Emergency case will be covered
• this benefit will3 not be payable for Hospital Confinement in class of suite / V.I.P. / deluxe room of a Hospital
• Lifetime Limit is applicable to Member who attain the age of 65 or above. This benefit shall automatically terminate upon the Contract Anniversary immediately after the Lifetime Limit 3
Printed on recycled paper 以再造紙印刷
is exhausted
• adjustment factors for room upgrade will be applied if Member is hospitalised not in accordance with plan level:
- from Semi-private Room to Private Room : 50%
- from Ward to Semi-private Room : 50%
- from Ward to Private Room : 25%
• 必須於住院及手術保障下A1至A11任何一項已耗盡後才適用
• 如身處海外,只適用於因急症之住院治療
• 此保障並不會就入住總統套房 / 貴賓房 / 豪華房的住院費用作出賠償
• 終生最高賠償額 3 只適用於年齡已屆65歲或以上的會員,而附加醫療保障將會於終生最高賠償額 3 耗盡後緊接之合約週年日自動終止
• 如會員住院時並非根據原有之計劃住房,保障額將因應升級住房而作出調整 :
- 半私家房至私家房 : 50%
- 大房至半私家房 : 50%
- 大房至私家房 : 25%
MP054/4/1109/32K
Bupa CarePro Health Insurance Scheme
保柏卓康健醫療保障計劃 Schedule of Benefits 保障金額表
Maximum Limit (HK$)
Effective from 1 January 2010 自2010年1月1日起生效 最高賠償額(港幣)
In the event of any discrepancy in respect of the meaning between the Chinese version and the English version, the English version shall prevail. All terms and conditions are subject to the Contract.
中、英文之意思如有任何差別,概以英文為準。所有條款及細則以合約為準。
Printed on recycled paper 以再造紙印刷
MP054/4/1109/32K
Telephone 電話: (852) 2517 5175 Facsimile 傳真: (852) 2548 1848
Website 網址: www.bupa.com.hk