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Bupa – Your choice for health protection保柏－您的健康保障之選
Bupa – A global health and care organisation
Bupa was founded in 1947. Since then, it has gone •from a UK company to a major global name in private
health and care, with over 34 million customers
around the world.
Bupa operates in the UK, America, Australia, New •Zealand, Spain, Denmark, Northern Europe, Latin
America, Hong Kong, China, Thailand, Malta, India,
Saudi Arabia and Egypt.
Our businesses range from health insurance to •care homes for the elderly, from hospitals to health
assessments and chronic disease management.
Business turnover in 2008 was approximately
£5.9 billion (HK$73 billion)1.
As a provident association, Bupa has no shareholders •and all profits are reinvested to improve our
healthcare services.
Bupa Hong Kong – A health insurance specialist for over three decades
Over the past 30 years, Bupa Hong Kong has •become well known for its quality health insurance
service. It is now one of the top three medical
insurers in Hong Kong2.
As a leading provider, we are trusted by 200,000 •individuals and over 2,000 companies, safeguarding
individual’s and employees’ health. For 13 years in
a row, we have been recommended by the Hong
Kong Government to provide quality health insurance
schemes to civil servants.
Bupa is the first insurer to offer lifelong guaranteed •renewal of individual health insurance to ensure
members are covered at their old age.
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
3
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
1
�
”“Taking care
ofthelives�inourhands�
2
Bupa CarePro – Easy steps to health保柏卓康健－保障無價健康輕而易舉
The spread of serious diseases, new viruses and food contamination are all threats to our health.隨著危疾年輕化、各類新病毒及食物安全問題湧現，我們的健康
難免受到威脅。
Bupa CarePro provides excellent medical protection
to members and offers a subscription discount. For
a very reasonable fee, you and your family can enjoy
comprehensive health protection, and receive quality
medical treatment without any additional worries.
No pre-payment to make, no claims to submit
Bupa CarePro members who also apply for
Supplementary Major Medical Benefit will receive
the Bupa HealthCare Card. When you use the Bupa
HealthCare Card at any local private hospital, no
admission deposit is required and no payment is
necessary upon discharge. Simply call Bupa and
complete the quick and easy registration process before
admission. Bupa will pay all eligible medical expenses for
you directly.
No claim renewal discount (NCB)
Members who have made no claims within a specific
period can enjoy a discount on their Hospital and
Surgical Benefit.
Contract years of Renewal discountno claim record
2-3 consecutive years 5%
4-5 consecutive years 10%
6 or more consecutive years 15%
Extra Cancer Treatment and Kidney Dialysis Benefit
At Bupa, we understand that cancer or kidney failure
often requires prolonged treatment, so we offer
additional coverage of up to HK$100,000 per year,
making it easier for members to afford more costly
advanced treatment options. If this coverage is fully
claimed in any one year, it will be reinstated in the
following year for the rest of your lifetime.
Up to 50 percent discount on child subscriptions
If parents enrol with Bupa together with their children,
each child can enjoy a discount on Hospital and Surgical
Benefit3 for as long as the parent’s membership
continues.
Number of insured parents Child discount
1 person 25%
2 persons 50%
3 Only applicable to unmarried children aged 15 days to 17 years who enrol in Bupa Care Kid
“
“
The medical card makes things more
convenient. I can seek medical
treatment without paying in advance,
and I need not bother with the bill or
claim procedures. There’s no need
to worry.
Mr Kwok has been a Bupa member for 13 years
「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。
住院免繳費、免索償服務
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
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
格的醫療費用。
無索償保費折扣 (NCB)
若您在指定期間未曾提出索償，即可在續保時享有「住
院及手術保障」的保費折扣優惠。
無賠償紀錄之合約年度 續保折扣
連續2至3年 5%
連續4至5年 10%
連續6年或以上 15%
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。
3 適用於出生15天至17歲的未婚子女投保「保柏童康健」
3
子女保費半價
父母與子女同時向保柏投保，每位子女均可享「住院
及手術保障」的保費折扣優惠3。在父母計劃生效期
間，便可一直享有子女保費折扣。
父母投保人數 子女折扣優惠
1位 25%
2位 50%
“
”
offers worldwide
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。
“
“
郭先生 擁有保柏會籍13年
coverage
Bupa CarePro
Exclusive privileges for Bupa CarePro members保柏卓康健會員專享權益
Comprehensive and flexible worldwide cover
Bupa CarePro offers worldwide cover for medical
expenses. In addition to extensive cover from Hospital
and Surgical Benefit, you can even tailor your health
insurance package with an optional Clinical Benefit and
Hospital Cash Benefit. You may also opt to top up your
in-patient cover by choosing the Supplementary Major
Medical Benefit.
Higher cover thanks to per-surgery benefit
You can claim up to the maximum benefit amount of
surgical cover for each operation. As a result, you can
enjoy higher cover than other schemes, which pay
out claims against one benefit limit for all operations
undertaken to treat the same disability.
Lifelong guaranteed renewal
Bupa guarantees that your cover can be renewed for life,
regardless of any changes in your health after joining.
No additional charges on individual basis
Regardless of your claims history and state of health,
there will be no increase in subscription on an individual
basis upon contract renewal.
No waiting period
There is no waiting period, meaning you are covered as
soon as your membership starts.
Easy enrolment
Enrolment is quick and simple. No medical examinations
are required.
環球保障 靈活全面
計劃提供環球醫療保障，除全面之「住院及手術保
障」外，您更可自選額外「門診保障」及「住院現金
保障」，設計個人醫療保障組合。如須增加住院保障
金額，可同時選擇「附加醫療保障」。
手術費用賠償按每次手術計算
有關手術費用的最高賠償額，均以每次手術獨立計
算，比其他以每宗病症計算的計劃，即將相同病症引
起之所有手術費用，都在同一項保障額內扣除，實際
上提供更高保額。
保證一世續保
投保後無論您的健康狀況有任何變化，保柏均保證續
保您的會籍，直至終生。
不收個人額外保費
不論您的索償紀錄或健康狀況如何，在您續保時保柏
絕不收取個人額外保費。
不設等候期
在會籍生效後引致的醫療支出，即可索償，無須等
候。
投保簡易
無須驗身，快捷簡單。
4
5
Scheme options計劃選擇
Basic Hospital and Surgical Benefit
You may opt for a ward, semi-private or private room
according to your budget. Cover includes Room and
Board and Miscellaneous Hospital Services expenses,
Intensive Care, Private Nursing, In-patient Physician’s
Fees, Anaesthetist’s Fees, Operating Theatre Fees,
Companion Bed, Pre-admission and Post-hospitalisation
Out-patient Care.
Optional Supplementary Major Medical Benefit
For hospital charges in excess of the maximum basic
benefit limit4, you will be reimbursed up to 80% of the
difference, starting from the date of your admission.
Same as the basic cover, the Supplementary Major
Medical Benefit can be renewed for life. It is unique
in the market that no additional subscription will be
charged on an individual basis upon contract renewal.
Optional Clinical Benefit
You can feel free to choose the most appropriate
practitioner for you. This benefit covers treatments
provided by general practitioners, specialists,
physiotherapists, chiropractors, Chinese herbalists and
Chinese bonesetters, as well as diagnostic imaging and
laboratory tests, etc.
This scheme offers the following flexible cover options:此計劃提供以下靈活的保障選擇：
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
Optional Hospital Cash Benefit
An additional cash allowance will be paid for any hospital
stay, starting from the third day after admission.
Free coverBupa Worldwide Assistance Programme
Provides emergency overseas services such as admission
deposit in the event of hospitalisation overseas and in
Mainland China, unlimited cover for emergency medical
escort, and an extra hospital benefit of HK$120,000
after repatriation to Hong Kong.
Basic cover
Optional cover
Free cover
Hospital and Surgical Benefit
Supplementary Major Medical Benefit
Clinical Benefit
Hospital Cash Benefit
Bupa Worldwide Assistance Programme
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
加床、入院前及出院後的門診護理等。
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
的八成，賠償由住院首天計算。此附加醫療保障與基
本計劃同樣可續保至終生，而於續保時不收取個人額
外保費，全港獨有。
自選門診保障
包括普通科西醫、專科、物理治療、脊醫治療、中醫及
跌打、診斷影像及化驗等，可自由選擇醫生。
自選住院現金保障
按住院日數額外支付每日定額賠償，由住院第3天起
開始支付。
免費保障
保柏國際援助計劃
提供海外及國內住院按金墊支服務，全數支付緊急醫
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。
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
Top-up benefit payable from the 1st day of admission giving the best possible coverage
Supplementary Major Medical Benefit means
claims will be settled from the very first day of
hospitalisation, provided that the actual medical
expenses have exceeded the upper limit of basic
Hospital and Surgical Benefit4. Many other
plans in the market only allow members to claim
extra room expenses after 90 or even 120 days
of hospitalisation.
附加醫療保障 由首天賠償最好
「保柏卓康健」計劃的「附加醫療保障」，即
使在住院第一天，若實際醫療支出超過基本
「住院及手術保障」上限時4，便會作出賠
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
療保障的病房費用。
6
Scheme options計劃選擇
基本保障
自選保障
免費保障
住院及手術保障
附加醫療保障
門診保障
住院現金保障
保柏國際援助計劃
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:
1st operation: Closed reduction of ankle fracture with external HK$14,000 fixation including screws 首次手術: 足踝骨折脫位後之閉合性復位及外固定手術
2nd operation: Fixation and screws removal HK$7,000 第二次手術: 足踝骨折之針及螺絲取出手術
Total cost 合共 HK$21,000
Claim basis賠償方法
Plan 計劃
Surgical Benefit limit 手術保障額(ward, intermediate operation) (大房/中型手術)
Actual claims paid實際賠償金額
Difference分別
(A) per operation 以「每手術計」
Bupa CarePro 保柏卓康健
HK$9,765 per operation每手術
1st claim 首次: HK$9,7652nd claim 第二次: HK$7,000
Total 總額：HK$16,765
Here is the difference of claim result: 賠償結果截然不同:
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。
Plan A paid out twice as much as Plan B.(A)的賠償額是(B)的200%
(B) per disability 以「每病症計」
Some other plans in the market 市場上部分計劃
HK$8,100 per disability每病症
1st claim 首次: HK$8,1002nd claim 第二次: HK$0
Total 總額：HK$8,100
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
No claim procedure is required for admission with a medical card.
For other hospitalisation and consultations,
claims will be settled within 5 - 7 working days after full documentation is received
Claim Service pledge
9
1. 適合哪類人士投保?
凡年滿18歲人士均歡迎投保，並不設投保年齡上限。
2. 若我永久移居海外，我的會籍可轉移嗎？
若您移居的國家有保柏的醫療保險業務在當地營運，
我們會盡力協助您轉移會籍，讓您可延續保障。
3. 成為保柏會員後，若要查詢會籍資料或索償
情況可怎辦？
您可登入保柏網站內的「保柏互動網」，使用24小時
網上服務，隨時更新個人資料及查閱索償申請進度。
您亦可致電我們的客戶服務專線，由客戶服務主任為
您服務。
4. 保費繳付方法如何？
可按自己的財務需要選擇月供或年供。
5. 要享用「保柏康健卡」服務，有甚麼要注意？
要享用這項服務，只須於入院前填妥住院表格並交回
保柏，以便保柏批核有關信用額。成功批核後，您會
獲發一封住院付款保證信。出院時，賠償表格由院方
代勞填妥，快捷方便。請注意所批核的信用額並不代
表合資格賠償額。
這項服務不適用於由不保事項引致的住院費用，出院
時您仍須向醫院繳付有關費用。保柏將會在會員出院
後向其收取住院費用與合資格賠償額的差額(如有)。
1. Who is eligible to enrol?
Anyone reaching the age of 18 is eligible to apply. There
is no upper age limit.
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
our cover.
3. How can I check my Bupa membership details or the progress of a claim?
Simply visit Bupa Active on our corporate website to
access a host of online services. You will be able to
update personal data and track your claims around
the clock. Alternatively, you can call our Customer Care
helpdesk to obtain assistance from our customer
service advisers.
4. How can I pay my subscription?
You can pay your subscription monthly or annually,
according to your preference.
5. What should I note when using Bupa HealthCare Card?
In order to enjoy this service, you need to complete a
Hospitalisation Pre-admission Form and send it back
prior to hospital admission so we can approve your credit
limit. Upon approval, a Guarantee of Payment letter will
be issued. The claim form should be completed by the
hospital before discharge. Please note that the approved
credit does not reflect the final claim amount.
This service is not applicable to excluded items, which
must be paid for upon discharge. Bupa will charge
members the difference between the hospital bills and
eligible claim entitlements following hospital discharge (if
applicable).
FAQs常見問題
10
Though you will be covered for most eventualities, there are certain things that Bupa will exclude. To enhance the transparency of our contract, some of the key things we cannot cover are listed below:
Conditions which exist before your effective date of •membership (unless approved by Bupa)
Treatment or investigation which is not Medically •Necessary
AIDS or HIV-related conditions which originate •during your first 5 years of membership, or Sexually Transmitted (Venereal) Diseases
Congenital, Developmental or Hereditary Conditions•Senile Dementia (including Alzheimer’s disease), •Parkinson’s disease, psychological or psychiatric condition(s) of any and all kinds, including but not limited to psychoses, neuroses, depression, anxiety, anorexia nervosa, schizophrenia, behavioural disorders, delirium, insomnia, neurasthenia
Treatment related to pregnancy, infertility, •sterilisation, sexual dysfunction
Cosmetic treatment, any treatment or investigation •related to dental or gum conditions except for Emergency treatment arising from Accidents or the extraction of impacted wisdom teeth during Hospital Confinement
Treatment arising from war, terrorism, criminal •acts, misuse or overdose of drugs or being under the influence of alcohol, self-inflicted injuries or attempted suicide
Rest cure, general check-ups, hearing or eye tests, •vaccinations, inoculations, Hair Mineral Analysis (HMA), health supplements, body weight control, or alternative treatments (eg Chinese Medicines treatment, acupuncture, acupressure, Tui Nai, hypnotism, rolfing, massage therapy, aromatherapy, etc) unless benefit is available
Use of special braces or other equipment (eg •wheelchairs, crutches), blood or blood plasma, non-medical services (eg medical reports, telephone charges, etc), experimental or new medical technology (unless approved by Bupa)
In the event of any discrepancy in respect of the meaning between the Chinese and English version, the English version shall prevail. All terms and conditions are subject to the Contract.
儘管在大部分情況下，保柏都可為您的醫療費用作出
賠償，但仍有一些事項屬除外責任。為提高合約透明
度，我們列出以下主要不受保障項目以供參考：
•在會籍生效日期前已存在之病症(除非經保柏批核)
•不是醫療必需的治療或檢驗
•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
•先天性疾病、發育異常或遺傳性疾病
•老年性痴呆(包括亞爾茲海默氏病)、帕金森氏病、
心理病或精神病症，包括但不限於精神病、神經機
能病、抑鬱、焦慮、神經性厭食、精神分裂、行為
失常、譫妄症、失眠、神經衰弱等直接或間接引致
的治療
•與懷孕、節育、不育或性機能失常等有關之治療
•整容或整形治療、任何與牙齒或牙肉疾病有關的治
療或檢查，因意外引致緊急入院治療或住院脫除阻
生智慧齒則除外
•戰爭、恐怖活動、刑事行為、誤用或服用過量藥物
或受酒精影響、蓄意自傷身體或意圖自殺而直接或
間接引致的治療
•休養或療養、一般體格檢查、聽覺或視力測驗、
預防注射、毛髮礦物質含量分析、健康補品、體重
控制、或另類治療(例如中藥治療、針灸、穴位
按摩、推拿、催眠治療、羅爾夫按摩療法、按摩
治療、香薰治療等)，計劃內已包括之保障除外
•使用輔助器具或其他設備(例如輪椅、柺杖)、血或
血漿、非醫療性服務(例如醫療報告、電話費等)、
試驗性或新治療技術(除非經保柏批核）
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。
Major Exclusions主要不受保障項目
Bupa free online health information保柏免費網上健康資訊
As a health insurance specialist, Bupa has introduced an
online health portal – Bupa Health Gallery which provides
regular free and practical health tips on nutrition and
diet, sport and fitness, women and children’s health and
more – all designed to safeguard the health of you and
your family.
Most of the health and disease information available in the Gallery is written and verified by the Bupa’s medical professionals in the United Kingdom and Hong Kong.
You can enjoy the following free services after becoming a member of this Gallery:
•Get online advice from approved specialists on
health questions
•A monthly electronic health digest
•Special offer for health screenings, fitness
programmes, diets and book subscription
•Healthy recipes, health talks and health tests
To search for reliable and practical health tips,
please visit Bupa Health Gallery anytime
作為醫療保險專家，保柏推出
健康資訊網站－「保柏健康雅
集」，定期提供免費而實用的健康資
訊，內容廣及營養飲食、運動健體、女士及子女
健康等，為您及家人的健康作後盾。
「保柏健康雅集」內的健康及疾病資訊，主要由保柏
英國及香港專業的醫療專家撰寫及核實。
成為「保柏健康雅集」會員，您可享有以下各項免費
服務：
•網上向特約專科醫生請教健康問題
•每月收取電子健康通訊
•獲享健康檢查、健體、飲食、訂購書籍等優惠
•健康食譜、講座資料及健康測試
想搜尋可靠實用的健康資訊，請隨時登入
「保柏健康雅集」
www.bupa.com.hk
www.bupa.com.hk
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Schedule of Benefits 保障金額表Maximum Limit (HK$)最高賠償額（港幣）
Plan 計劃 1Private私家房
Plan 計劃 2Semi-private
半私家房
Plan 計劃 3Ward大房
1 Room and Board (maximum 270 days each Contract Year)住房及膳食費 (每合約年度最多270日)
每日2,750 each day 每日1,400 each day 每日650 each day
2 Miscellaneous Hospital Services (each Contract Year)住院雜費 (每合約年度計)
33,000 19,600 12,700
3 Intensive Care (supplement to Room and Board) (each Contract Year)深切治療 (住房及膳食費之補足) (每合約年度計)
24,500 21,500 20,000
4 Private Nursing (maximum 120 days each Contract Year) 私家看護費 (每合約年度最多120日)••
nursing services during Hospital Confinement or at home after discharge from Hospital rendered by a Qualified Nurse 每日790 each day 每日470 each day 每日280 each dayupon recommendation by the attending Registered Medical Practitioner經主診註冊西醫建議下由合資格護士於住院期間或出院後在家中提供之護理服務
5 Surgeon and Attendance Fees (for surgical case only) (each operation)外科醫生費及巡房費 (只適用於外科手術) (每次手術計)• complex 複雜 72,000 46,000 34,650• major 大型 46,200 31,500 24,150• intermediate 中型 19,950 13,230 9,765• minor 小型 6,825 5,565 4,620
6 Anaesthetist’s Fees (each operation)麻醉科醫生費 (每次手術計)• complex 複雜 22,700 13,400 10,150• major 大型 12,500 8,500 6,680• intermediate 中型 5,850 3,820 2,880• minor 小型 3,050 1,980 1,760
7 Operating Theatre Fees (each operation)手術室費用 (每次手術計)• complex 複雜 25,800 15,500 11,400• major 大型 14,100 9,800 7,720• intermediate 中型 6,700 4,400 3,380• minor 小型 3,750 2,250 2,030
9 In-patient Specialist’s Fees (each Contract Year)住院專科醫生費 (每合約年度計)
11 Companion Bed (maximum 270 days each Contract Year) 住院加床費 (每合約年度最多270日)
•
•
subject to written referral from the attending Registered Medical Practitioner (except for services performed by9,600 3,350 1,980pathologist, radiologist or Physiotherapist during Hospital Confinement)
須獲主診註冊西醫以書面轉介 (病理學家、放射學家及物理治療師在住院期間所提供之服務除外)
Pre-admission and Post-hospitalisation Out-patient Care
Maximum Limit (each Contract Year) 最高賠償額 (每合約年度計)
Lifetime Limit 終生最高賠償額
(each Contract Year)入院前及出院後之門診護理 (每合約年度計)• including two pre-admission visits and all related post-hospitalisation follow-up visits on an out-patient basis within 4,250 2,390 1,580
6 weeks right after discharge from Hospital包括2次入院前及出院後6星期內所有與住院治療有關之跟進療程門診費用
Below attained age of 65 on the Contract Effective Date 於合約生效日未滿65歲之會員
Attained age of 65 or above on the Contract Effective Date - Annual Limit 於合約生效日年滿65歲或以上之會員—每年限額
•
•••••
•••
•
apply after any item of Section A1 to A11 under Hospital and Surgical Benefit is exhaustedin case of overseas hospitalisation, only medical Emergency case will be coveredthis benefit will not be payable for Hospital Confinement in class of suite / V.I.P. / deluxe room of a HospitalLifetime 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 is exhaustedadjustment 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 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 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%
Plan 計劃 1Private私家房
Plan 計劃 2Semi-private
半私家房
Plan 計劃 3Ward大房
Supplementary Major Medical Benefit (Optional) 附加醫療保障附加醫療保障（（自選保障自選保障））(subject to 80% reimbursement and HK$500 deductible per claim 80％ 賠償及每次索償墊底費港幣500元)
Unlimited 不設上限
550,000 280,000 110,000
800,000 400,000 200,000
8 In-patient Physician’s Fees (for non-surgical case only) (maximum 270 days each Contract Year)住院醫生巡房費 (只適用於非手術治療) (每合約年度最多270日)
每日2,200 each day
每日1,375 each day 每日700 each day 每日325 each day
每日970 each day 每日540 each day
Hospital and Surgical Benefit 住院及手術保障住院及手術保障
10 Cancer Treatment and Kidney Dialysis (each Contract Year)癌症治療及洗腎 (每合約年度計)•
•
•
chemotherapy, radiotherapy, cyberknife or gamma knife for cancer treatment or kidney dialysis during Hospital Confinement or in day case unit of a Hospital or clinic upon recommendation by the attending Registered 100,000 75,000 50,000Medical Practitioner經主診註冊西醫建議下於住院期間或醫院日症房或診所進行之化療、電療、使用數碼導航刀或伽碼刀以治療癌症或洗腎
Bupa CarePro Health Insurance Scheme
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保柏卓康健醫療保障計劃
700,000 350,000 165,000
3
3 3
3 3
2
2
1
1
Effective from 1 January 2010 自2010年1月1日起生效
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Bupa CarePro Health Insurance Scheme保柏卓康健醫療保障計劃 Schedule of Benefits 保障金額表
•
•
Provides admission deposit in the event of hospitalisation overseas and in Mainland China, unlimited cover for emergency medical evacuation and repatriation, and a 24-hour hotline for travel, medical or legal information and assistance. 提供海外及國內住院按金墊支服務，全數支付緊急醫療運送費用，以及24小時旅遊、醫療或法律諮詢及援助熱線。
Free Bupa Worldwide Assistance Programme (each Contract Year) 免費保柏國際援助計劃免費保柏國際援助計劃（每合約年度計)
In the event of any discrepancy in respect of the meaning between the Chinese version and the English version, the English version shall prevail. All terms and conditions are subject to the Contract. 中、英文之意思如有任何差別，概以英文為準。所有條款及細則以合約為準。
Maximum Limit (HK$)最高賠償額（港幣）
Clinical Benefit (Optional)門診保障門診保障 （自選保障）自選保障）
7 Chinese Bonesetter跌打醫師
••
consultation fee (including basic Medically Necessary Chinese Medicines prescribed at the Registered Chinese Medicine Practitioner's clinic and obtained at a legitimate source on the same day of consultation)
8 Prescribed Western Medication (each Contract Year)醫生處方西藥（每合約年度計)••
Medically Necessary Western Medication prescribed by a Registered Medical Practitioner and obtained at a 4,700 2,850 1,800
legitimate source經由註冊西醫處方並由合法來源取得之醫療必需西藥費用
9 Diagnostic Imaging and Laboratory Tests (each Contract Year)診斷影像及化驗（每合約年度計) 3,300 1,850 1,400•subject to written referral from a Registered Medical Practitioner 須獲註冊西醫書面轉介
5 Chiropractor (treatment fee only)脊醫（只限診療費） 每次620 each visit 每次420 each visit 每次300 each visit
subject to written referral • from a Registered Medical Practitioner
subject to written referral from a Registered Medical Practitioner
subject to written referral from a Registered Medical Practitioner
須獲註冊西醫書面轉介
6 Chinese Herbalist中醫師
consultation fee (including basic Medically Necessary Chinese Medicines prescribed at the Registered Chinese Medicine 每次210 each visit
每次210 each visit
每次170 each visit 每次135 each visit
每次170 each visit 每次135 each visit
Practitioner's clinic and obtained at a legitimate source on the same day of consultation)診症費（包括於診治當日由註冊中醫在診所處方並由合法來源取得的基本醫療必需中藥費用）
•• 診症費（包括於診治當日由註冊中醫在診所處方並由合法來源取得的基本醫療必需中藥費用）
每次360 each visit 每次225 each visit 每次165 each visit1 General Practitioner (consultation fee only)
普通科醫生（只限診症費）
2 Specialist (consultation fee only)專科醫生（只限診症費）
3 Home Consultation (consultation fee only) 家中應診（只限診症費）
每次640 each visit 每次440 each visit 每次320 each visit
每次700 each visit 每次500 each visit 每次330 each visit
須獲註冊西醫書面轉介
4 Physiotherapist (treatment fee only)物理治療師（只限診療費） 每次620 each visit 每次420 each visit 每次300 each visit
須獲註冊西醫書面轉介
Address 地址: 18/F, DCH Commercial Centre, 25 Westlands Road, Quarry Bay, Hong Kong
Telephone 電話: (852) 2517 5175 Facsimile 傳真: (852) 2548 1848 Website 網址: www.bupa.com.hk
Bupa (Asia) Limited 保柏 (亞洲) 有限公司
1
2
Notes 附註 : 1
3
3
2
4
4
Clinical Operation or Day Case Surgery, if eligible, will be paid under Hospital and Surgical Benefit. Clinical Operation and Day Case Surgery mean Medically Necessary surgical procedures which may be carried out at a clinic or day case unit of a Hospital by a Registered Medical Practitioner and a stay in Hospital is not required, provided that the surgical procedure is classified as such by Bupa.A referral letter is only valid for the same or related condition for a period of six (6) months from the date of issuance. Treatment received for a new or unrelated condition will require another referral letter. The Supplementary Major Medical Benefit (SMM) is subject to the Maximum Limit per Contract Year or the Lifetime Limit (if applicable), whichever is lower. The SMM Benefit paid on or after age 65 will be deducted from the Lifetime Limit and the balance will become the Lifetime Limit of the next Contract Year.Number of visits per Contract Year for items D1 – D7 above is 30 in total and is subject to a maximum of 1 visit per item per day. Number of visits per Contract Year for items D6 – D7 above is 10 in total.
合資格之診所手術或日症手術，將於住院及手術保障下賠償。診所手術及日症手術指註冊西醫於診所或醫院日症房進行之醫療必需手術而無必要留院，但該等手術須獲保柏分類為診所手術或日症手術。轉介信在發出後6個月內診治與該信有關之病症，方為有效。而當診治病症被診斷為一新症，或診治與該轉介信無關之病症，則需另一轉介信。 附加醫療保障的賠償以「每合約年度最高賠償額」或「終生最高賠償額」(如適用)之較低者為上限。65歲起支付的附加醫療保障賠償將自「終生最高賠償額」中扣減，餘額將成為下一合約年度的「終生最高賠償額」。每一合約年度內有關上文D1至D7項之診治次數合共為30次，每一項目並以每日一次診治為限。每一合約年度內有關上文D6至D7項之診治次數合共為10次。
22
22
• 22
• 22
4
4
Hospital Cash Benefit (Optional)住院現金保障住院現金保障（自選保障）自選保障）
Plan 計劃 1 Plan Plan 計劃 3計劃 2
Plan 計劃 1 Plan Plan 計劃 3計劃 2
••
pay from the 3rd day of Hospital Confinement (maximum 182 days each Contract Year)每日1,000 each day 每日500 each day 每日300 each day由住院第3天起開始支付（每合約年度最多182日)
Effective from 1 January 2010 自2010年1月1日起生效
