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.

The Clinical Benefit includes general practitioners , specialists, diagnostic imaging and laboratory tests, prescribed Western medication, physiotherapists, chiropractors, Chinese herbalists, Chinese bonesetters, psychiatric-related treatments and psychological counselling 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).
Terms and Conditions for the 24-hour Mental Health Service Hotline (pdf, 580 KB)

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.

Cancer Care provides comprehensive support to help you navigate the complexities of cancer care. This includes a dedicated nurse hotline, personalised treatment plans, and fast-tracked booking services.

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).

Use our wellness app Blua Health to manage your health and get rewards! Through Blua Health, you can track your progress, book into wellness classes and read health tips from experts. You can also earn points to redeem rewards for healthy living. Download Blua Health now and start living healthy today! Blua Health is offered, distributed and operated by Horizon Health and Care Limited which is a company registered in Hong Kong under the Bupa Group.

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 service with eligible medical card

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

• Claims: File claims online; track and view claims status/details; provide information to resolve pending claims
• Clinical Benefit Usage: Keep track of your claimed expenses and provider visits under Clinical Benefit (if applicable)
• eMedical Card: Show your eMedical Card at network providers for cashless service*
• Hospital eAdmission: Send your member information to your selected hospital upon admission*
• Doctors Finder: Search for network doctors and clinics based on name, specialty, etc
• Doctors Nearby: Locate the clinic on a map and get directions to the clinic from where you are
• Member Documents: View and download your policy-related documents
• Member Privileges: View and redeem special health and lifestyle offers exclusively for Bupa members
• Member Profile: View your scheme details; update your contact information online
• Direct access to Quality HealthCare Medical Services (QHMS)’s mobile app

*For selected insurance schemes only.

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

You can use your Bupa Hero card (BH card) to enjoy cashless service for confinement at designated private hospitals in Hong Kong or for day case procedures, prescribed non-surgical cancer treatment or prescribed diagnostic imaging tests at a Bupa Hero appointed service provider.

Please submit a pre-authorisation form to Bupa at least 2 working days before treatment and present your BH card and/or pre-authorisation confirmation at registration. For details of obtaining pre-authorisation, please refer to the Membership Guide.

Bupa will settle your eligible medical expenses with the hospital or service provider directly, subject to the approved credit limit stated in your pre-authorisation confirmation / guarantee of payment letter. You’ll need to pay any medical expenses exceeding the credit limit and submit a claim to Bupa for reimbursement. If you’ve chosen a deductible, or your medical expenses exceed the maximum limit or aren’t covered, you’ll also need to reimburse Bupa for the selected deductible and shortfall.

For the list of designated private hospitals in Hong Kong, please visit www.bupa.com.hk/hero. For overseas hospitalisation, you can enjoy cashless service in your chosen area of cover by calling Bupa to make the necessary arrangements. The latest list of Bupa Hero appointed service providers can be found on Bupa’s customer service portal myBupa. These lists are subject to change from time to time. If you’re unable to get pre-authorisation due to an emergency, please arrange subsequent pre-authorisation on the next working day.

Your Bupa Hero card can’t be used for item (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. You also can’t use your medical card at the outpatient department of a local private hospital. Please pay your expenses first and submit a claim to Bupa afterwards.

You can enjoy full benefit coverage for hospitalisation at the restricted ward class or lower as stated in the Summary of Benefits. If you’re voluntarily hospitalised at a higher ward class, Bupa will adjust your reimbursement based on the terms of your Policy.
On the other hand, if you receive treatment outside of your chosen area of cover, your eligible expenses will be paid according to the VHIS Standard Plan Terms and Benefits only regardless of ward class. Please refer to the Policy for details.

No, there’s no minimum number of hours that you must stay in hospital while receiving treatment. Day case surgeries and clinical procedures are covered as well. These include treatments such as plaster casts, wound sutures, radiotherapy, chemotherapy, etc.

A deductible is the amount you’ll pay towards eligible expenses under the certified plan (except for the Medical Check-up Benefit) before Bupa starts paying your medical expenses. You can offset the selected deductible with reimbursement from your group medical plan or existing health insurance, if any, or simply pay the expenses yourself. Here’s some examples of the reimbursement calculation:

Example 1
Mr. Chan has enrolled in the “Advance – HK$12,000 Deductible” option under the Bupa Hero VHIS Plan. He received a minor operation in hospital with HK$50,000 in expenses that are eligible for 100% reimbursement. He offset the HK$12,000 deductible with his company’s group medical plan. So the amount Bupa will pay is:
HK$50,000 – HK$12,000 (deductible) = HK$38,000
Mr. Chan doesn’t need to pay any expenses himself.

Example 2
Ms. Wong has enrolled in the “Advance – HK$80,000 Deductible” option under the Bupa Hero VHIS Plan. She received a minor operation in hospital with HK$50,000 in expenses that are eligible for 100% reimbursement. As her expenses are less than her deductible (HK$80,000), Bupa won’t pay any benefit yet. Ms. Wong needs to pay HK$50,000 herself.