"ChampCare" Medical Insurance Plan

Full coverage¹ of eligible medical expenses under the key benefit items with no itemised benefit sublimit

Medical expenses involve a myriad of items. The Plan offers comprehensive medical protection with multiple key benefit items, including room and board charges, daily doctor's visit fee, miscellaneous hospital expenses and outpatient surgical expenses etc, which are all fully covered¹ with no itemised benefit sublimit¹. Additionally, we cover the expenses for pre- and post-confinement /surgery outpatient consultation and medication, as well as the post-confinement ancillary treatment and rehabilitation. Please refer to the Benefit Schedule for details.

Full coverage of Unknown Pre-existing Conditions from the 31^st day after Policy Effective Date

"ChampCare" covers Unknown Pre-existing Conditions at the time of application. The Plan provides full reimbursement of Eligible Expenses subject to the benefit limits, starting from the 31^st day after the Policy Effective Date, which is superior to the requirements of VHIS Standard Plan and provides you with better peace of mind.

The above conditions also apply to congenital conditions manifested or Unequivocally Diagnosed when or after the Insured Person attains age 8 or after. For details of Pre-existing Conditions, please refer to “Important Notice” – “Pre-existing Conditions” from Product Brochure.

3 Territorial Scopes of Cover¹¹to flexibly match life planning

Comprehensive medical protection gives you peace of mind against unexpected medical needs wherever you are. The Plan offers 3 Territorial Scopes of Cover¹¹, ranging from Asia (including Australia and New Zealand) to worldwide coverage, allowing you to opt for the best choice according to personal needs and future development.

First-in-market⁴ reimbursement mechanism

The Plan features the First-in-market⁴ reimbursement mechanism, offering a total of 7 Benefit Levels, allowing you to choose the most suitable protection solution based on your preferred Territorial Scope of Cover¹¹ with applicable options of Deductible² and Benefit Contribution Amount³. Both the Deductible² and Benefit Contribution Amount³ are subject to a maximum limit per Policy Year, so you can enjoy comprehensive medical protection within your budget.

Tips:

• Deductible² is a fixed amount of Eligible Expenses that the Policy Holder must pay before the Plan reimburses the remaining Eligible Expenses in a Policy Year., its maximum limit varies according to the benefit level.
• If Eligible Expenses have been reimbursed by any third party, such reimbursed amount can be used to offset the Deductible² and Benefit Contribution Amount³ (if applicable).
• After the Deductible Balance² reaches zero in a year, even though the Policy Holder has to contribute the Benefit Contribution Amount³, 80% of the Eligible Expenses will still be reimbursed^@ (if applicable) until the Benefit Contribution Amount³ reaches the annual maximum limit.
  Subsequent claims within the same Policy Year will no longer be subject to the Benefit Contribution Amount³.
• If the Insured Person is unfortunately diagnosed with Major Cancer, Severe Heart Attack or Stroke and requires treatment, the Deductible Balance and Benefit Contribution Amount for Eligible Expenses incurred for receiving the related medical services shall be waived⁵.

^@ Eligible Expenses and / or expenses payable shall also be subject to limitations and specified calculation formula. Please refers to Part 4 and Part 5 of the Supplement of the Plan for details.

Wavier of Deductible Balance and/or Benefit Contribution Amount upon Unequivocal Diagnosis of Major Cancer, Severe Heart Attack or Stroke⁵

To alleviate Insured Person’s financial burden when facing major illnesses, in the unfortunate event that the Insured Person is diagnosed with and requires treatment for Major Cancer, Severe Heart Attack or Stroke, we shall waive⁵ the applicable Deductible Balance² and/or Benefit Contribution Amount³ for the medical services related to such illnesses, allowing the Insured Person to focus on treatment for speedy recovery with peace of mind.

Reduction of Deductible and Benefit Contribution Amount at specific age without additional underwriting¹²

Protection needs may change with different stages of life. Therefore, you may choose to reduce the annual Deductible² and Benefit Contribution Amount³ (not applicable to benefit levels with zero annual Deductible²) when the Insured Person reaches Age 50, 55, 60, 65, 70, 75 or 80 without providing proof of insurability¹², allowing flexible adjustment to suitable medical protection.

Outpatient care benefit for Covered SEN Conditions in Hong Kong ⁶  

We understand that parents are very concerned about their children’s growth and development, and that mental health is equally important as physical health. The Plan specifically provides Insured Persons aged 6 to 17 with coverage of outpatient care benefit up to 5 visits per Policy Year  which cover the Eligible Expenses incurred for outpatient treatment with an Occupational Therapist, Speech Therapist, Specialist (in neurology, pediatrics or psychiatry) and/or Psychologist in Hong Kong for diagnosed Autism Spectrum Disorder at Severity Level 3, Severe Attention-Deficit/Hyperactivity Disorder (ADHD) or Tourette’s Disorder.

Outpatient care benefit for Covered Mental Conditions in Hong Kong⁷

Mental health is often overlooked by many people. However, in severe cases, it not only affects one’s quality of life but also significantly impacts the family. In view of this , in case the Insured Person receives outpatient treatment with a Specialist in psychiatry or a Psychologist in Hong Kong for diagnosed Severe Major Depressive Disorder, Severe Schizophrenia or Severe Bipolar I Disorder between age 18 and 55, the Plan will provide benefit for up to 5 visits per Policy Year before the Insured Person attaining age 56, so he/she can receive treatment without worries.

Coverage of inpatient and outpatient Chinese medical treatments ⁸

Chinese medical treatments emphasize coordinating overall body functions to help patients recover as quickly as possible, making the integration of Chinese and Western treatment a major trend in recent years. The Hong Kong Government is also actively promoting Chinese medicine development with integrated Chinese-Western medicine clinical services, Chinese medicine inpatient and outpatient services to be provided in the Chinese Medicine Hospital of Hong Kong. In view of this, “ChampCare” specifically provides coverage for the expenses incurred by Chinese medical consultation, acupuncture treatment and Chinese medicines prescribed during confinement; as well as Post-Confinement/Day Case Procedure Chinese medicine follow-up outpatient visits, allowing the Insured Person to flexibly choose the appropriate treatment for a speedy recovery.

Premium Discount⁹

Total discount rate of up to 20%⁹

16% upfront no claim discount upon successful application

Unlike average medical plans on the market, “ChampCare” offers an upfront 16% no claim discount⁹ on first year premium. You can enjoy this discount for every subsequent Policy Years until the Renewal Date following your first claim. Outpatient claims under Outpatient care benefit for Covered SEN Conditions in Hong Kong  or Outpatient care benefit for Covered Mental Conditions in Hong Kong will not affect your no claim discount^6,7. You remain entitled to the 8% no claim discount for the Policy Year immediately after the first claim, and shall pay full premium for subsequent Policy Years. Until no claim is made for 3 consecutive Policy Years, then you are entitled to the 16% no claim discount again based on the above mechanism in the Policy Years immediately afterwards till the next claim, as a constant reward for you to stay healthy.

Extra discounts for family application

CTF Life encourages you to not only care for yourself, but also enroll insurance for your family members to equip them with more comprehensive protection. If you hold more than one effective “ChampCare” policies as the Policy Holder when renewing a “ChampCare” policy (the “Policy”), as long as the Policy i) remains effective for 3 or more consecutive Policy Years before the relevant Renewal Date; and ii) entitles you to a 16% no claim discount on the above Renewal Date, regardless of the claim status or effective period of other policies, the Policy is entitled to up to 4% extra no claim discount⁹ and a total discount rate of up to 20% together with the original no claim discount.

Tax Deduction¹⁰

Whether you enroll in a VHIS plan for yourself or for your family members, the qualifying premiums paid for the VHIS plan will be allowed for tax deduction each taxable year. Each Insured Person is entitled to a tax deductible limit of up to HKD 8,000 per taxable year, with no cap on the number of family members eligible for tax deduction. Therefore, you can prepare suitable medical protection for family members and enjoy more affordable premium through tax deduction.

Medical Support Service¹³

To address your medical needs besides protection, this service renders you with one-stop medical services which includes:

• PrimeChamp Doctor Network and 24-hour Helpline
• Chinese and Western Medicine Cancer Treatment in mainland China and Case Management Services
• Claimable Amount Estimate Service
• Pre-authorization and Direct Billing Service
• Second Medical Opinion Service
• China Accompany & VIP Channel Service

For details and terms and condition of Medical Support Service, please refer to CTF Life website or contact your financial consultant.

Free Worldwide Emergency Assistance Services¹³

You will have access to free 24-hour worldwide emergency assistance services for immediate support wherever you may be. The maximum benefit (per incident) reaches up to USD 1,000,000, including arrangements and payment for emergency medical evacuation or repatriation, as well as repatriation of mortal remains and compassionate visits etc., providing you with support at any time.

1. Eligible medical expenses and/or Eligible Expenses mentioned in this product brochure refer to the amount of Eligible Expenses and/or expenses payable for the benefit items under the Terms and Benefits of the Plan which also includes the VAT and GST (if any) charged or imposed on the Medical Services rendered with respect to a Disability. Unless otherwise specified, the Eligible Expenses and/or expenses incurred in respect of the same item shall not be recoverable under more than one benefit item in the Benefit Schedule. Fully covered shall mean no itemised benefit sublimit. The actual amount of Eligible Expenses and/or expenses payable (after deduction of Deductible and Benefit Contribution Amount, if applicable) shall be subject to the Annual Benefit Limit and Lifetime Limit. Eligible Expenses and/or expenses payable shall also be subject to limitations and specified calculation formula. Claims of any Eligible Expenses and/or expenses must comply with the principles of “Reasonable and Customary” and “Medically Necessary”. For details, please refer to Important Notice 7 and the Standard Plan Terms and Benefits, which are published from time to time and subject to regular review by the Government. For details, please refer to the Terms and Benefits.

2. Deductible is a fixed amount of Eligible Expenses that the Policy Holder must pay before the Plan reimburses the remaining Eligible Expenses in a Policy Year. Deductible Balance is the amount of Deductible per Policy Year, reduced by (i) the total amount of Deductible applied for previous claims in the same Policy Year (if any); and (ii) the amount of Eligible Expenses Reimbursed by Third Party of the same Policy Year (if any); should the calculated amount result in a value below zero, the Deductible Balance shall be deemed as zero.

3. Benefit Contribution Amount is 20% of the amount of Eligible Expenses and/or expenses payable for benefit items under the Terms and Benefits of the Plan after deducing the Deductible Balance (and applied adjustment for (i) ward class (if applicable), (ii) treatment in the USA (if applicable), (iii) exclusions (including the amount of Eligible Expenses Reimbursed By Third Party (if any)) (if applicable) and/or (iv) the remaining balance of the benefit limit of individual benefit item(s) per Policy Year (if any)), which is subject to (i) the maximum limit of Benefit Contribution Amount of its Benefit Level per Policy Year; and (ii) further reduced by the difference between the Eligible Expenses Reimbursed By Third Party and the previous Deductible Balance before the assessment of the processing claim (only applicable if the amount of Eligible Expenses Reimbursed By Third Party for the processing claim exceeds such previous Deductible Balance). Should the calculated amount result in a value below zero, the Benefit Contribution Amount shall be deemed as zero. For details, please refer to the Terms and Benefits.

4. Plan features as “Special-in-market”, and “First-in-market” are based on a comparison of major VHIS products offered by key life insurance companies in Hong Kong, as of 10 January 2025. For Chinese medical coverage, “Special-in-market” refers to the Chinese medical benefits during Confinement.

5. For Benefit Levels 1, 2, 4, and 6, if (i) the Insured Person is Unequivocally Diagnosed with Major Cancer, Severe Heart Attack or Stroke while the Policy is in force; and (ii) the Insured Person receives Medical Services as a direct result of such Major Cancer, Severe Heart Attack or Stroke upon recommendation from an attending Registered Medical Practitioner in writing; and (iii) benefits shall be payable by the Plan for such Medical Services, applicable Deductible Balance and/or Benefit Contribution Amount in the calculation of overall benefit payable shall be reduced to zero, such reduced amount shall not be reduced from the Deductible Balance or construed as part of the Benefit Contribution Amount of the relevant Policy Year. For the avoidance of doubt, such waiver shall not be applicable to the amount of coinsurance to be contributed by the Policy Holder for Prescribed Diagnostic Imaging Tests payable under benefit item (i) of I) Basic Benefit of the Benefit Schedule. For definitions of covered Major Cancer, Severe Heart Attack or Stroke and details of such calculation, please refer to the Terms and Benefits.

6. This benefit shall mean the outpatient care benefit for Covered SEN Conditions in Hong Kong. Deductible and Benefit Contribution Amount are not applicable to this benefit. If the Insured Person is Unequivocally Diagnosed with Autism Spectrum Disorder at Severity Level 3, Severe Attention-Deficit/Hyperactivity Disorder (ADHD) or Tourette’s Disorder by a Specialist in psychiatry in Hong Kong at or after age of 6 and before age of 18 and therefore receive outpatient consultation in  Hong Kong, the expenses incurred for (i) diagnostic tests to support the Unequivocal Diagnosis of the Covered SEN Conditions; (ii) treatments provided by an Occupational Therapist, Speech Therapist or Psychologist; and (iii) consultation with, medical treatment performed and western medication prescribed by a Specialist in neurology, pediatrics or psychiatry, will be covered subject to our then prevailing rules and 1-year waiting period. The Insured Person receives the Medical Services as specified in (i) to (iii) above must before attaining the Age 18 while Medical Services specified in (ii) and (iii) above must be recommended and referred in writing by a Specialist in psychiatry. For details, please refer to the Terms and Benefits.

7. This benefit shall mean the outpatient care benefit for Covered Mental Conditions in Hong Kong Deductible and Benefit Contribution Amount are not applicable to this benefit. If the Insured Person is Unequivocally Diagnosed with Severe Major Depressive Disorder, Severe Schizophrenia or Severe Bipolar I Disorder by a Specialist in psychiatry in Hong Kong at or after age of 18 and before age of 56 and therefore receive outpatient consultation in Hong Kong, the expenses incurred for (i) diagnostic tests to support the Unequivocal Diagnosis of the Covered Mental Conditions; (ii) treatments provided by a Psychologist; and (iii) consultation with, medical treatment performed and western medication prescribed by a Specialist in psychiatry, will be covered subject to our then prevailing rules and 1-year waiting period. The Insured Person receives the Medical Services as specified in (i) to (iii) above must before attaining the Age 56 while Medical Services specified in (ii) and (iii) above must be recommended and referred in writing by a Specialist in psychiatry. For details, please refer to the Terms and Benefits.

8. For expenses charged on follow-up outpatient visits to Chinese Medical Practitioner after discharge from Hospital or Day Case Procedure, such outpatient visits must be directly related to the condition arising from the same Disability (including any and all complications thereof) necessitating such Confinement/ Day Case Procedure. If the Insured Person has received more than one outpatient visit on the same day, only the visit with the highest Eligible Expenses incurred shall be payable. This benefit will not cover the following Chinese medicines: (i) agaricus blazei murill and agaricus blazei murill powder, (ii) antelope horn powder, (iii) antler, (iv) cordyceps, (v) cubilose, (vi) donkey-hide gelatin, (vii) ganoderma, (viii) all kinds of ginseng, (ix) hippocampus, (x) moschus, (xi) pearl powder and (xii) placenta hominis.

9. The extra no claim discount amount is calculated based on the Renewal premium before deducting the no claim discount. If a claim for a previous Policy Year (claims incurred by III)Other Benefits of the Benefit Schedule should not impact this discount) is paid after the no claim discount and the extra no claim discount (if applicable) are paid, CTF Life will re-assess the Policy’s eligibility for the no claim discount and the extra no claim discount (if applicable) for that Policy Year. All no claim discounts and the extra no claim discount (if applicable) provided since that Policy Year will be recalculated, and CTF Life will clawback the difference between the recalculated no claim discount and the no claim discount and the extra no claim discount (if applicable) already provided for the Renewal premium payable. When the no claim discount for any Policy Year is no longer equivalent to 16% after recalculation, the Renewal premium payable in that Policy Year will not be entitled to the extra no claim discount, and the amount of the extra no claim discount already accessed within the Policy Year will be clawed back. For the avoidance of doubt, if any claim of specified benefit is incurred but the actual amount of Eligible Expenses and/or expenses paid is zero due to the reason of the Deductible, it shall not be considered as specified benefits paid.

10. Tax deduction is applicable to VHIS premiums paid by you or your domestic spouse as the Policy Holder for yourself / specified relatives (who must be a Hong Kong resident in the year of assessment). Eligible specified relatives include your spouse, and your and your spouse’s children, parents, grandparents, maternal grandparents, and siblings. The insurance eligibility of the specified relatives is subject to the then prevailing administrative regulations of the Company. Eligible premiums paid for VHIS plans are tax deductible each year, subject to a cap of HKD 8,000 per Insured Person per year of assessment. Please refers to Cap. 112 of the Inland Revenue Ordinance (https://www.elegislation.gov.hk/hk/cap112).

11. Asia shall mean Afghanistan, Australia, Bangladesh, Bhutan, Brunei, Cambodia, Hong Kong, India, Indonesia, Japan, Kazakhstan, Kyrgyzstan, Laos, Macau, Mainland China, Malaysia, Maldives, Mongolia, Myanmar, Nepal, New Zealand, North Korea, Pakistan, Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Tajikistan, Thailand, Timor-Leste, Turkmenistan, Uzbekistan and Vietnam. Worldwide excluding USA shall mean worldwide excluding the United States of America (“USA”) and US Minor Outlying Islands. Worldwide shall mean worldwide.

Outside the applicable Territorial Scope of Cover, if the Insured Person covered by Benefit Levels 1 to 5 receives (i) any Emergency treatment, the Eligible Expenses and/or expenses incurred shall be payable in accordance with the Terms and Benefit of this Plan; (ii) any non-Emergency treatment, the Eligible Expenses incurred shall be payable in accordance with the the Standard Plan Terms and Benefits, no benefit shall be payable under (II) Enhanced Benefit (a)-(j) and (III) Other Benefit of the Benefit Schedule. For details, please refer to the Terms and Benefits.

12. Subject to our then prevailing rules and this Plan having been in force for at least 3 consecutive years, Policy Holder may submit a written request to reduce the Deductible and Benefit Contribution Amount by using our prescribed form within 31 days before the Renewal Date that is on or immediately following the Insured Person’s 50^th, 55^th, 60^th, 65^th, 70^th, 75^th or 80^thbirthday without providing further proof of insurability of the Insured Person, subject to the Benefit Levels available at that time (which must include Benefit Levels with zero Deductible and Benefit Contribution Amount, i.e. Benefits Levels of 3, 5 and 7).  This right can only be exercised once during the lifetime of the Insured Person. From the relevant Renewal Date, the premium shall be adjusted according to the then prevailing Standard Premium schedule adopted by the Company for such Benefit Level, and any Premium Loading the Policy Holder has agreed for the Policy; and any claims for Eligible Expenses and/or expenses incurred shall be subject to the reduced or zero Deductible and Benefit Contribution Amount. For the avoidance of doubt, the Policy Holder may submit a written request to the Company by using the prescribed form to increase the Deductible and Benefit Contribution Amount upon any Renewal Date, without providing further proof of insurability of the Insured Person.

13. Medical Support Service and Free Worldwide Emergency Assistance Services are provided by the third party service providers and does not constitute part of this Plan. Chow Tai Fook Life Insurance Company Limited reserves the right to change the terms and conditions of Medical Support Service and Free Worldwide Emergency Assistance Services without prior notice and assumes no responsibility of the services provided by the third party service providers. These services do not require additional premium. For details of Medical Support Service, please refer to CTF Life's website or consult your financial consultant.

14. If the Insured Person has stayed in the USA for a period aggregating 183 days or more within 12 consecutive months immediately prior to the Insured Person receiving non-Emergency Treatment which takes place in the USA, an adjustment factor of 60% will be applied to the related Eligible Expenses and/or expenses. This limitation is only applicable to Benefit Levels of 6 and 7. For details, please refer to the Terms and Benefits.

15. Standard Private Room is a standard single occupancy room with adjoining bathroom for the Insured Person ’s use during his/her Confinement, but excluding any room of upper class with its own kitchen, dining or sitting rooms in a Hospital. Standard Semi-private Room is a single-bedded with a shared bath/shower room or a room shared by 2 people for the Insured Person’s use during his/her Confinement. Hospitals offer various accommodation options with different facilities, and the categorization used by the Hospitals may be different from the definitions above. If you have any doubts, please contact the Company before Confinement.

16. Tests covered here only include computed tomography (“CT” scan), magnetic resonance imaging (“MRI” scan), positron emission tomography (“PET” scan), PET-CT combined and PET-MRI combined.

17. Treatments covered here only include radiotherapy (including proton therapy), chemotherapy, targeted therapy, immunotherapy and hormonal therapy.

18. This benefit shall be payable for the Eligible Expenses incurred for psychiatric treatments received by the Insured Person during Confinement in Hong Kong as recommended by a Specialist. Where the Eligible Expenses involve both psychiatric and non-psychiatric treatments and apportionment of the expenses is not available, the expenses in entirety shall be payable under this benefit if the Confinement is initially for the purpose of psychiatric treatments. If the Confinement initially is not for the purpose of psychiatric treatments, the expenses in entirety shall be payable under the benefit items (a) – (k) of I) Basic Benefits, if applicable. For the avoidance of doubt, where a Confinement is not solely for the purpose of psychiatric treatments, this benefit shall only be payable for the Eligible Expenses charged on the Medical Services related to psychiatric treatments.

19.Covered Pregnancy Complications shall mean ectopic pregnancy, molar pregnancy, disseminated intravascular coagulopathy, pre-eclampsia, miscarriage, threatened abortion, medically prescribed induced abortion, foetal death, postpartum hemorrhage requiring hysterectomy, eclampsia, amniotic fluid embolism, or pulmonary embolism of pregnancy. The date of Unequivocal Diagnosis of Covered Pregnancy Complications must be after 12 months from the Policy Effective Date. For details, please refer to the Terms and Benefits.

20. This benefit shall be payable for the Eligible Expenses charged for haemodialysis or peritoneal dialysis performed on the Insured Person due to Kidney Failure in a setting for providing Medical Services to a Day Patient. For the avoidance of doubt, relevant expenses incurred during Confinement shall be payable under miscellaneous charges. No benefit shall be payable under benefit item (k) of I) Basic Benefits in Benefit Schedule if this benefit is paid or payable. For details, please refer to the Terms and Benefits.

21. This benefit covers (i) reconstructive oral and maxillofacial surgery for beautification or cosmetic purposes during the period from the 91^st  day to 12 months after the date of accident which causes damage or defect to a body part of the Insured Person and Surgeon’s fee is payable for such Injury; or (ii) breast reconstruction surgery to restore one or both of the Insured Person’s breasts for beautification or cosmetic purposes which occurs at the same time or within 12 months from the date of the surgical procedure for breast cancer. For details, please refer to the Terms and Benefits.

22. This benefit shall be payable for the Eligible Expenses incurred for the following medical implants upon benefit item (f) of I) Basic Benefits is payable for such surgical procedure. Specified items refer to the following medical implants implanted inside the Insured Person’s body during such surgical procedure: (1) pace maker; (2) stents for percutaneous transluminal coronary angioplasty; (3) intraocular lens; (4) artificial cardiac valve; (5) metallic or artificial joint for joint replacement; (6) prosthetic ligaments for replacement or implantation between bones; and (7) prosthetic intervertebral disc. For the avoidance of doubt, the Eligible Expenses payable under this benefit shall not be payable under (b) Miscellaneous charges of I) Basic Benefits in the Benefit Schedule. For details, please refer to the Terms and Benefits.

23. Emergency outpatient treatment due to Accident benefit shall be payable for the Eligible Expenses for Emergency Treatment received in the outpatient unit of a Hospital within 24 hours of an Accident; whereas emergency outpatient dental treatment due to Accident benefit shall be payable for the Reasonable and Customary charges for Emergency Treatment (including consultation, staunch bleeding, tooth extraction, root canals and x-ray) to the Insured Person’s natural teeth(solely as a direct result of an Injury) by a registered dentist in a legally registered dental clinic within 30 days of the Accident. For details, please refer to the Terms and Benefits.

24. If the Insured Person is voluntarily Confined in a ward class of Hospital accommodation higher than his / her entitled ward class as specified in the Benefit Schedule, the ward class adjustment factor set out below shall be applied to the calculation of benefit amount payable: