Bupa Hero VHIS

If you're diagnosed with a critical illness, you may need to take time off work or even quit your job. This combined with the costs of treatment may affect your budget, your quality of life and even your family. Therefore, apart from medical protection, you should also consider adding the Supplementary Critical Illness Benefit to make up for any lost income and pay for your living expenses, such as mortgage, daily bills, child's tuition fees, etc. if you have a covered critical illness.

Bupa Supplementary Critical Illness Benefit provides worldwide coverage for up to 98% of all serious critical illnesses (see Remark 19), including 80 major critical illnesses (such as cancer, heart attack, stroke) and 5 early stage critical illnesses (see Remark 20). It also pays for an additional cancer claim if you're diagnosed with cancer (including recurrence or distant metastasis) after the major critical illness has been paid, so you can be worry-free and prepared for the unexpected. This benefit offers triple protection for up to 3 separate conditions at different times throughout your life—Major Critical Illness Benefit, Early Stage Critical Illness Benefit and Additional Cancer Benefit, with a lifetime benefit amount up to HK$3,300,000 in aggregate (see Remark 21).

Based on the benefits of the Gold plan. Please refer to the Schedule of Critical Illness Benefits for the lifetime benefit amount of other plan options.

We know that patients who are diagnosed with cancer can be overwhelmed by ongoing treatments, complicated medical procedures and so on. The new Cancer Care Programme in our Health Coaching Services is designed to support members covered by Supplementary Critical Illness Benefit. Our qualified nurses and health management professionals will provide personalised follow-up throughout your cancer journey, emotional support and a variety of health information such as cancer care and dietary tips.

This plan provides three optional benefits that you may choose to enjoy coverage in your chosen area of cover (see Remark 11):

Our Clinical Benefit is specially designed to include coverage for psychiatric-related treatments and psychological counselling, such as outpatient treatments for psychiatric, psychological, mental or behavioural conditions, senile dementia (including Alzheimer’s disease) and Parkinson’s disease. The Clinical Benefit also includes other items such as general practitioners, specialists, diagnostic imaging and laboratory tests, prescribed Western medication, physiotherapists, chiropractors, Chinese herbalists, Chinese bonesetters, etc.

If you’ve enrolled in the Clinical Benefit, you can also enjoy cashless treatment and full cover at network clinics and service providers (see Remark 18). What's more, you can enjoy video consultation services to consult our selected general practitioners through a video call comfortably and safely at home.

Includes dental treatments such as scaling and polishing, fillings and extractions, as well as optical expenses for consultation and contact lenses or one pair of glasses for optical correction per policy year (see Remark 12).

Covers obstetrician's fees, hospitalisation charges, prenatal and postnatal check-up costs and nursery care for a newborn baby during hospital confinement.

This service is provided by Bupa's selected service providers and their team of qualified and experienced counsellors and clinical psychologists. Through the hotline, counsellors offer free emotional support and personalised advice. They can also arrange face-to-face counselling services with a clinical psychologist if needed (four times per Policy Year). Rest assured that all information provided will be kept in strict confidence (see Remark 4).

Our health coaching services offer a variety of personal healthcare support delivered by a team of appointed doctors, qualified nurses and health management professionals to minimise your worries (see Remark 13):

1. 24/7 Healthline
   

   A team of qualified health management professionals will provide guidance on your health-related questions over the phone, with the support of doctors (see Remark 14).

2. Care Manager
   

   Our Care Manager can be in touch with you to follow up on claims and assist you throughout treatment and recovery, from explaining your treatment plan and overseeing costs to arranging follow-up consultations. If you’re admitted to a local private hospital, our Care Manager will make a courtesy call or visit, with your consent.

3. Second medical opinion
   

   We'll arrange for you to get medical advice from a panel of medical specialists to clarify your doubts and make informed decisions about treatment.

4. Healthcare centre choices
   

   We can provide a list of clinics and hospitals based on your specific condition or needs for your reference.

5. Chronic Conditions Programme
   

   Offers lifestyle coaching and management, including personal phone calls to help you manage any chronic condition such as diabetes.

6. Non-emergency global healthcare support
   

   Locate suitable doctors, arrange medical appointments and support language translation either when you are in need overseas, or plan to travel for treatment.

7. Appointment making
   

   We can help to make appointments with your selected healthcare service providers.

8. Cancer Care Programme (only applicable to members covered under Supplementary Critical Illness Benefit)
   

   Our qualified nurses and health management professionals will provide personalised follow-up throughout your cancer journey, emotional support and a variety of health information such as cancer care and dietary tips.

With the Bupa Hero VHIS Plan, you’ll also receive our free worldwide assistance programme. It provides medical support and assistance if you need help while overseas or in mainland China (see Remark 15).

Available 24 hours every day, our Customer Service team will directly answer your policy-related questions (see Remark 16).

• Up to 15% lifetime family discount (see Remark 17)
• No minimum length of hospital stay
• No waiting period, cover starts immediately after your policy takes effect (except for complications of pregnancy, Medical Check-up Benefit, certain dental items under Dental and Optical Benefit and Maternity Benefit)
• No claims-based charges - Your premium will be based on your age only, no matter how many claims you've made.

All terms and benefits are subject to the Policy. Please refer to the Policy for details.

Bupa has set up a series of treatment programmes for members focusing on different specialities, providing personalised care and guidance through network providers and a health coaching team. Through these programmes, you can enjoy the following benefits:

• Multiple specialties to meet different medical needs
• Experienced health professionals to guide you from consultation through treatment and follow-up
• Quality assured network clinics and facilities
• Cashless treatment with eligible medical card

Bupa's one-stop specialist treatment programmes include:
Bupa DAY series

• Eye day surgeries
• Day-case gynaecological procedures

Bupa WAY series

• Clinical treatments for musculoskeletal pain
• Guidance and treatments to support breast health

For each programme's eligibility and details, please check out Bupa's one-stop specialist treatment programmes page.

1. Asia, Australia and New Zealand means Hong Kong, Australia, New Zealand, Thailand, Japan, Malaysia, Macau, Taiwan, South Korea, Singapore, Afghanistan, Bangladesh, Bhutan, Brunei, Cambodia, mainland China, India, Indonesia, Kazakhstan, Kyrgyzstan, Laos, Maldives, Mongolia, Myanmar, Nepal, North Korea, Pakistan, the Philippines, Sri Lanka, Tajikistan, Timor-Leste, Turkmenistan, Uzbekistan and Vietnam.
2. For eligible expenses covered under the certified plan but incurred outside your chosen area of cover, benefits shall only be payable according to the VHIS Standard Plan Terms and Benefits. Please refer to the Policy for details.
3. Please refer to the Summary of Benefits for the items eligible for full cover. Full cover is only applicable to covered expenses and subject to the annual benefit limit, deductible and restricted ward class set out in the Summary of Benefits.
4. The 24-hour Mental Health Service Hotline is applicable to insured persons aged 18 or above. Insured persons aged below 18 must be accompanied by the Policy Holder or guardian to use this service. Terms and conditions apply.
5. Cashless treatment is not applicable to items (k) and (l) listed under 1) Basic Benefits and items (c) – (j) listed under 2) Enhanced Benefits in the Summary of Benefits for the Certified Plan. Your medical card is not applicable to the outpatient department of a local private hospital. For overseas hospitalisation, you can enjoy cashless treatment by calling Bupa to make the necessary arrangements. You need to follow the required procedures and obtain pre-authorisation from Bupa to enjoy cashless treatment.
6. Designated private hospitals for cashless treatment include Canossa Hospital (Caritas), CUHK Medical Centre, Evangel Hospital, Gleneagles Hong Kong Hospital, Hong Kong Adventist Hospital - Stubbs Rd., Hong Kong Adventist Hospital - Tsuen Wan, Hong Kong Baptist Hospital, Hong Kong Sanatorium & Hospital, Matilda International Hospital, Precious Blood Hospital (Caritas), St. Paul's Hospital, St. Teresa's Hospital and Union Hospital. This list is subject to change from time to time.
7. Please log in to Bupa's customer service portal to view the latest list of Bupa Hero appointed service providers. This list is subject to change from time to time.
8. Bupa will directly pay your eligible medical expenses to the hospitals and service providers subject to the credit limit stated in your pre-authorisation letter and the benefit limit available under your Policy. You will need to reimburse Bupa for any ineligible medical expenses and selected deductible, if any.
9. Bupa guarantees that your cover can be renewed every year for life, as long as you meet the requirements as stated in the renewal provisions of your policy terms and conditions.
10. Any Hong Kong taxpayer who has purchased an eligible health insurance plan (certified by the Food and Health Bureau as VHIS) can claim a tax deduction on qualifying premiums up to HK$8,000 per insured person each year. The relationship between the taxpayer and the insured person must be included in the list of “specified relatives” in Inland Revenue Ordinance (Cap. 112). You can claim the deduction in the same tax year when the premium was paid. The deduction is available for certified plans, but not any other optional benefits, with policy effective date of 1 April 2019 or later. There is no limit on the number of insured persons and/or policies claimed by each taxpayer. Policies purchased for a domestic partner, grandchild(ren) or domestic partner’s parents/children are not eligible for tax deduction. For details about tax deduction, please visit www.bupa.com.hk/taxfaq.
11. Optional benefits are not part of the VHIS certified plan. The premiums paid are not eligible for claiming tax deduction and any family discount.
12. Optional Dental Benefit is available for both Advance and Deluxe plans. Optional Optical Benefit is only offered for Deluxe plans.
13. Items 1 – 7 under Health Coaching Services are available for customers who select the Deluxe plans. Those who select the Advance plans can access items 1 – 5 only. Those who have added Supplementary Critical Illness Benefit can enjoy all items 1 – 8 regardless of choosing the Deluxe or Advance plans. The use of Health Coaching Services is free of charge but you may need to pay for recommended services not covered under your Policy. Terms and conditions for Health Coaching Services apply.
14. Doctors will be available during scheduled office hours to support the nurses in answering enquiries. Office hours: Mon – Fri, from 9am to 6pm (Hong Kong time), except public holidays.
15. The Free Bupa Worldwide Assistance Programme is not part of the VHIS Certified Plan. Please inform Bupa in writing if you don’t want to receive this free benefit.
16. During office hours (9am to 7pm, Monday to Friday, except public holidays), we are pleased to answer all your enquires. Outside office hours, we can provide the following:
    a. Bupa appointed service providers,
    b. Your coverage details,
    c. Claims procedures and other administration procedures, and
    d. Claim forms.
    
17. Family discount will be applied to the standard premium and premium loading of the certified plan only, but not any other optional benefits under the Bupa Hero VHIS Plan. The discount will be valid as long as the eligible family members are all covered under a Bupa Hero VHIS Plan at the same time.
18. To enjoy full cover, you must visit Bupa Hero appointed service providers under the Network Benefit, subject to the maximum number of visits per policy year and the overall annual limit. Please refer to the Benefit Schedule for details.
19. The 85 critical illnesses covered under the critical illness basic benefits and optional Extended Major Critical Illness Benefit of the Supplementary Critical Illness Benefit include 98% of designated critical illnesses in 10Life's Scoring Methodology of Term Critical Illness Insurance. Exclusions and waiting periods apply. Please refer to the contract for the terms and excluded conditions.
20. Supplementary Critical Illness Benefit covers 3 major critical illnesses and 5 early stage critical illnesses under the critical illness basic benefits. You can also add Extended Major Critical Illness Benefit to include a total of 85 covered critical illnesses.
21. Waiting periods apply between payment of benefit items. Additional Cancer Benefit is also subject to active cancer treatment requirements. Please refer to the Important Information section of the Supplementary Critical Illness Benefit brochure for details.

Learn more on our About VHIS and All you need to know about VHIS pages.

You can contact the VHIS Office of the Food and Health Bureau at vhis_enquiry@fhb.gov.hk about:

•      VHIS product availability
•      Features of VHIS Certified Plans
•      Compliance with the Code of Practice 

Please contact the Insurance Authority about the conduct of insurance companies and intermediaries. Please contact the Inland Revenue Department with questions about tax deduction.

Bupa has launched a series of extended coverage for coronavirus disease. View more details here.